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  1. What is osteopenia?
    Low bone mass density but not yet osteoporosis
  2. osteoporosis (2)
    -Low bone mineral density

    -microarchitectural deterioration of bone tissue resulting in increased skeletal fragility and fracture susceptibility
  3. What is one machine used to diagnose osteoporosis?
    DXA scan
  4. Diagnosis for osteoporosis) t score= >1 is considered...
  5. Diagnosis for osteoporosis) t score = -1 to -2.5 is considered...
    Low BMD, osteopenia
  6. Diagnosis for osteoporosis) t score = more than -2.5 is considered
  7. Diagnosis for osteoporosis) when using tscore, what is the comparison group?
    20 yr old sex matched healthy population
  8. Etiology of osteoporosis
    Imbalance between bone restoration and bone formation
  9. Facts about trabecular bone (2)
    -makes up 20% of skeletal mass

    -80% of turnover occurs here though
  10. What percent does cortical bone make up in skeletal mass?
  11. How much percent does cortical bone experience turnover?
  12. Bone is resorbed by
  13. New bone is deposited by
  14. 3 main causes of osteoporosis
    -inadequate peak bone mass

    -excessive bone resorption

    -inadequate formation of new bone during remodeling
  15. What is an important determinant of peak bone mass?
    Adequate calcium intake
  16. What does estrogen do to osteoclasts?
    Estrogen suppresses osteoclast bone resorption
  17. Menopause causes what formula to occur?
    Lack of estrogen (menopause) = bone resorption more than bone deposition
  18. Adequate calcium intake is critical to..(2)
    -achieving optimal peak bone mass

    -modifies the rate of the bone loss associated with aging
  19. How is vitamin D deficiency characterized by?
    • -inadequate mineralization of the skeleton
    • *osteomalacia
  20. 2 medications for osteoporosis

    • -proton pump inhibitors
    • *inhibit calcium absorption
  21. What are non-modified risk factors (8)
    -advanced age


    -European and Asian ancestry

    -family history for fracture

    -previous fracture

    -hypogonadal states

    -rheumatoid arthritis

    -GI disorders
  22. Modified risk factors for osteoporosis (6)
    -tobacco smoking

    -low BMI


    -soft drink consumption

    -heavy metals

    -excess dietary protein
  23. Modified risk factor for osteoporosis) tobacco smoking
    Inhibits the activity of osteoblasts
  24. Modified risk factor for osteoporosis) low bmi
    Being overweight protects by increasing load on bone
  25. Modified risk factor for osteoporosis) alcoholism (2)
    -can inhibit calcium absoprtion

    -liver disease can interfere with vitamin D activation
  26. Modified risk factor for osteoporosis) soft drink consumption (2)
    -drinks contain phosphoric acid

    • -displacement of calcium containing drinks from the diet
    • *meaning, people usually replace milk with soda
  27. Modified risk factor for osteoporosis) heavy metals
    • Strong correlation between lead and cadmium exposure and bone disease
    • *low levels of cadmium leads to loss of BMD
  28. Modified risk factor for osteoporosis) excess dietary protein
    • Premise is that excess protein intake enhances calcium excretion with or with our a concomitant rise in calcium absorption
    • *mixed results
  29. rda for calcium) 51-70 yr old, how many mg/day for men
    1000 mg
  30. rda for calcium) 51-70 yrs old women, how many mg/day ?
    1200 mg/day
  31. rda for calcium) over 70 years old mg/d for men?
    1000 mg/d
  32. rda for calcium) mg/d for women over 70 yrs old?
    1200 mg/day
  33. Why should calcium be taken throughout the day?
    We only absorb 500 mg at a time
  34. vitamin D) Recommended intakes for 51-70 yrs old?
    600 IU
  35. vitamin D) recommended intakes for over 70 yrs old?
    800 IU
  36. Modifiable risk factors for osteo) insufficient activity
    Bed rest is a significant risk factor
  37. Modifiable risk factors for osteo) excessive exercise
    Can lead to constant damaging insult to bone which can cause exhumation to structural elements
  38. Treatments for osteoporosis) which medications is predominantly prescribed?
  39. Treatments for osteoporosis) bisphosphonates
    -molecules preferentially bind calcium which form strong bonds with bone mineral

    • -prevent bone resorption and increase bone formation for about a year
    • *then it plateaus
  40. Treatments for osteoporosis) bisphosphonates , what are the side effects?>
    GI reflux which prevent many from using these
  41. Definition of sarcopenia
    Age associated decline in skeletal muscle mass and strength
  42. sarcopenia) after age 50, muscle mass..
    Decrease 1-2% each year
  43. Rate muscle strength decreases between age 50 and 60
    1.5% per year
  44. Rate muscle strength is decreased after age 60
    3% per year after that
  45. sarcopenia and high activity levels
    sarcopenia occurs independent of high activity levels
  46. What may sarcopenia be attributed to? (2)
    -generation of motor units

    -net conversion of fast type II muscle fibers into slow type I fibers
  47. sarcopenia) why does it cause a significant difference if type 2 muscles convert to type 1 muscles?
    Person will experience in loss of muscle power needed for activities of daily living
  48. sarcopenia and lack of physical activity
    Physically inactive adults see faster and greater muscle mass loss compared to active adults
  49. sarcopenia: dietary protein) RDA for protein in older adults
    .8 grams/kg body weight per day
  50. What does American college of sports medicine say about protein intake?
    Athletes require 50-100% more dietary protein to meet demands of exercise related erngy production, post exercise muscle damage repair, and muscle hypertrophy
  51. Has protein needs for older adults who resistance train been established yet?
  52. Results of data of men and women 50-80 age in protein needs
    Older adults who RT may require more than 1 gram or protein/kg/d to grow muscle
  53. Resistance training and sarcopenia) how often does ACSM recommend
    2-3 days per week of resistance training
  54. Resistance training and sarcopenia) how many sets and reps per muscle group
    1-2 sets of 8-15 reps per muscle group
  55. Resistance training and sarcopenia) how long may the program need to last at leapt to see significant improvement in the older population?
    12 weeks
  56. Resistance training and sarcopenia) intensity (3)
    -70-80% of 1 rep max

    -or moderate 5-6/10

    -or vigorous 7-8/10
  57. Resistance training and sarcopenia) when should the load be increased for older people?
    When they can perform reps of 12 in perfect form
  58. Obesity and sarcopnia in older adults) Obesity and Sarcopenia
    • Prevalence of older adults with sarcopenia and obesity is increasing
    • *sarcopenic obesity
  59. Obesity and sarcopnia in older adults) Obese older adults have a higher absolute quantity of fat free mass but (2)
    -have lower muscle quality

    -impairments in physical functioning similar to those of physically frail non obese
  60. Treatment for sarcopenic obesity )  why should you caution with losing weight? (2)
    -higher BMI often associated with reduced mortality in older adults

    • -accelerate age associated decline in Fat free mass
    • *bc regardless of whichever way to lose weight, you will lose FFM which is already happening fast as you grow older
  61. Treatment for sarcopenic obesity ) 2 things to consider with physical exercise
    -improves physical functioning

    -doesn't always lead to large losses of body weight
  62. What is the most powerful countermeasure for sarcopenia?
    Resistance training
  63. combination of what provides the greatest improvement in physical function and minimizes loss in muscle?
    Weight loss and exercise
  64. Resistance training and sarcopenia) what did some studies find out regarding RT in older adults?
    Increased protein synthesis rates with as little as 2 weeks of RT in adults 76-92
  65. Resistance training and sarcopenia) can older adults grow muscle?
    They can grow muscle and synthesize muscle protein if given intense enough RT
Card Set:
2014-11-23 01:25:35
Life Nutrition

Sarcopenic obesity and osteoporosis
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