Osteomalacia and osteoarthritis are bone diseases that affect many people in India. Osteomalacia is caused by deficiencies of vitamin D, calcium, and phosphorus which are essential for strong bone development and maintenance. It primarily affects children and causes softening of the bones leading to pain and muscle weakness. Osteoarthritis is a degenerative joint disease that ranges from mild to severe and is a major public health problem in India, affecting over 10-20% of adults over age 45. Risk factors include obesity, joint injury, and genetics. Dietary management of both conditions focuses on increasing intake of vitamin D, calcium, phosphorus, magnesium, and vitamin K through foods like fatty fish, dairy products,

1. OSTEOMALACIAAND
OSTEOARTHRITIS
CLINICAL NUTRITION II
SUGANESWARAN S

2. OSTEOMALACIA
• occurs due to the deficiencies of vit D, calcium, and phosphorus.
• which are essential for the development and maintenance of strong bones.
• primary affects childrens.
• characterised by softening of the bones, leading to pain and muscle
weakness.
• 50% of children in India are estimated to be deficient in vitamin D, WHO
2020.

3. ETIOLOGY
4 mechanisms involved in the osteomalacia development:
• Vitamin D deficiency
• Calcium deficiency
• Phosphate deficiency
• Inhibition of mineralization caused by the toxic effects of various drugs.

4. SIGNS AND SYMPTOMS
• Muscle weakness, particularly in the legs.
• Bone pain and tenderness, Particularly in the: Pelvis, spine, and legs.
• Difficulty walking and standing.
• Decreased bone density, leading to an increased risk of fractures.
• Muscle cramps and twitching.

5. DIETARY MANAGEMENT
• Vit D- essential for the absorption of Calcium, phosphorus- fatty
fish(salmon, and tuna), egg yolks, fortified milk and cereals.
• Calcium- necessary for bone mineralization and strength- dairy products,
green leafy vegetables.
• Phosphorus- essential for bone mineralization- dairy products, meat, fish,
poultry, whole grains and nuts.
• Magnesium- absorption of calcium and phosphorus- green leafy
vegetables, nuts, seeds, whole grains and beans.
• Vit K- essential for bone health- helps production of bone proteins- green
leafy vegetables, sprouts and etc.

7. OSTEOARTHRITIS
• degenerative joint disease that can range in severity from mild to severe.
• major public health problem in India.
• According to a study published in the Indian Journal of orthopaedics, OA
is the most common form of arthritis in India, affecting more than 10%-
20% of adults over the age of 45 years.
• Risk factors include obesity, joint injury, and genetics. (WHO, 2020)

9. SIGNS AND SYMPTOMS
• Pain -aching or stiffness in the affected joint-worse often periods of
inactivity, such as sitting or lying down, or after physical activity.
• Stiffness-feel stiff-morning or after periods of inactivity.
• Swelling-swollen and tender to the touch.
• Decreased range of motion-over time
• Cracking of popping sounds- crunching or popping sound
• Bone spurs-Bony growths may develop around the affected joint, leading
to further pain and discomfort

10. MANAGEMENT
• Controlling body weight
• high intake of antioxidants specially vitamin C- reduces the progression of
osteoarthritis
• Taking adequate rest
• Avoiding joint overuse or repetitive injury
• Exercise : strengthening of supporting muscles around joints.
• Swimming- aerobic exercise for osteoarthritis of hip or knees.
• Yoga and other alternative therapies have been scientifically documented
to complement the use of drugs.(yogic protocol for Arthritis).

12. REFERENCE
• World Health organisation (2020). Vitamin D Deficiency
• Shetty, A. & Raghuram, N. (2017). Prevalence of osteoarthritis in India: A systematic
Review, Journal of clinical orthopaedics and Trauma. 8(2), 104-110.
• National health survey (NHS),2022, India, rickets, osteomalacia and osteoarthritis.
• American College of Rheumatology (2020), osteoarthritis.
• National osteoporosis Foundation (2021). Vitamin D.
• Salvatore Minisola, Luciano Colangelo, Jeccia pepe, Daniele Diacinte, Christiana
ciprini, and Sudhakar D Rao, Osteomalacia and Vitamin D Status: A clinical update,
2020, doi: 10.1002. JBMR Plus. 2021 Jan Published online 2020. Dec 21.
• Arthritis Foundation of India, 2014, arthfound.org/arthritis

13. THANK
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