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What is osteopenia?
Low bone mass density but not yet osteoporosis
-Low bone mineral density
-microarchitectural deterioration of bone tissue resulting in increased skeletal fragility and fracture susceptibility
What is one machine used to diagnose osteoporosis?
Diagnosis for osteoporosis) t score= >1 is considered...
Diagnosis for osteoporosis) t score = -1 to -2.5 is considered...
Low BMD, osteopenia
Diagnosis for osteoporosis) t score = more than -2.5 is considered
Diagnosis for osteoporosis) when using tscore, what is the comparison group?
20 yr old sex matched healthy population
Etiology of osteoporosis
Imbalance between bone restoration and bone formation
Facts about trabecular bone (2)
-makes up 20% of skeletal mass
-80% of turnover occurs here though
What percent does cortical bone make up in skeletal mass?
How much percent does cortical bone experience turnover?
Bone is resorbed by
New bone is deposited by
3 main causes of osteoporosis
-inadequate peak bone mass
-excessive bone resorption
-inadequate formation of new bone during remodeling
What is an important determinant of peak bone mass?
Adequate calcium intake
What does estrogen do to osteoclasts?
Estrogen suppresses osteoclast bone resorption
Menopause causes what formula to occur?
Lack of estrogen (menopause) = bone resorption more than bone deposition
Adequate calcium intake is critical to..(2)
-achieving optimal peak bone mass
-modifies the rate of the bone loss associated with aging
How is vitamin D deficiency characterized by?
- -inadequate mineralization of the skeleton
2 medications for osteoporosis
- -proton pump inhibitors
- *inhibit calcium absorption
What are non-modified risk factors (8)
-European and Asian ancestry
-family history for fracture
Modified risk factors for osteoporosis (6)
-soft drink consumption
-excess dietary protein
Modified risk factor for osteoporosis) tobacco smoking
Inhibits the activity of osteoblasts
Modified risk factor for osteoporosis) low bmi
Being overweight protects by increasing load on bone
Modified risk factor for osteoporosis) alcoholism (2)
-can inhibit calcium absoprtion
-liver disease can interfere with vitamin D activation
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
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
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
rda for calcium) 51-70 yr old, how many mg/day for men
rda for calcium) 51-70 yrs old women, how many mg/day ?
rda for calcium) over 70 years old mg/d for men?
rda for calcium) mg/d for women over 70 yrs old?
Why should calcium be taken throughout the day?
We only absorb 500 mg at a time
vitamin D) Recommended intakes for 51-70 yrs old?
vitamin D) recommended intakes for over 70 yrs old?
Modifiable risk factors for osteo) insufficient activity
Bed rest is a significant risk factor
Modifiable risk factors for osteo) excessive exercise
Can lead to constant damaging insult to bone which can cause exhumation to structural elements
Treatments for osteoporosis) which medications is predominantly prescribed?
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
Treatments for osteoporosis) bisphosphonates , what are the side effects?>
GI reflux which prevent many from using these
Definition of sarcopenia
Age associated decline in skeletal muscle mass and strength
sarcopenia) after age 50, muscle mass..
Decrease 1-2% each year
Rate muscle strength decreases between age 50 and 60
1.5% per year
Rate muscle strength is decreased after age 60
3% per year after that
sarcopenia and high activity levels
sarcopenia occurs independent of high activity levels
What may sarcopenia be attributed to? (2)
-generation of motor units
-net conversion of fast type II muscle fibers into slow type I fibers
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
sarcopenia and lack of physical activity
Physically inactive adults see faster and greater muscle mass loss compared to active adults
sarcopenia: dietary protein) RDA for protein in older adults
.8 grams/kg body weight per day
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
Has protein needs for older adults who resistance train been established yet?
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
Resistance training and sarcopenia) how often does ACSM recommend
2-3 days per week of resistance training
Resistance training and sarcopenia) how many sets and reps per muscle group
1-2 sets of 8-15 reps per muscle group
Resistance training and sarcopenia) how long may the program need to last at leapt to see significant improvement in the older population?
Resistance training and sarcopenia) intensity (3)
-70-80% of 1 rep max
-or moderate 5-6/10
-or vigorous 7-8/10
Resistance training and sarcopenia) when should the load be increased for older people?
When they can perform reps of 12 in perfect form
Obesity and sarcopnia in older adults) Obesity and Sarcopenia
- Prevalence of older adults with sarcopenia and obesity is increasing
- *sarcopenic obesity
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
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
Treatment for sarcopenic obesity ) 2 things to consider with physical exercise
-improves physical functioning
-doesn't always lead to large losses of body weight
What is the most powerful countermeasure for sarcopenia?
combination of what provides the greatest improvement in physical function and minimizes loss in muscle?
Weight loss and exercise
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
Resistance training and sarcopenia) can older adults grow muscle?
They can grow muscle and synthesize muscle protein if given intense enough RT