1. Role of nutrition in prevention
Prof. Muhammad Aslam
Department of ObGyn
LGH, Lahore

2.  Osteoporosis causes more than 8.9
million fractures annually worldwide
 Lifetime risk for fracture ~ 30%-40%
 Osteoporosis causes elderly people to
become bedridden with serious
complications
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3.  20% of people >60 who fracture a hip,
die within six months to one year
 50% become dependent on family
 Only 30% regain their Independence
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4.  Metabolic bone disease characterized
by low bone mass and micro-
architectural deterioration of bone
tissue, leading to enhanced bone
fragility and a consequent increase in
fracture risk
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5. Normal bone Osteoporotic bone
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6. Normal bone Osteoporotic bone
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8. Dual energy X-ray absorptiometry
(DEXA-Scan)
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9. T Score Diagnosis
+1 to -1 Normal Bones
-1 to -2.5 Osteopenia
-2.5 or lower Osteoporosis
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10.  Attainment of peak bone mass ~
during growth and early adulthood
 Maintaining bone mass ~ in adulthood
 Loss of bone mass ~ with advancing
age
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11.  Genetic
 Endocrine
 Mechanical
 Nutritional
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12.  Ca is the most abundant mineral in
the body
 99% of Ca is located within the bones
and teeth
 It supports structural integrity &
regulates metabolic function
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13.  Vit D is critical for Ca absorption ~
increases Ca absorption by 30-80%
 Vitamin D stimulates bone matrix
formation and bone maturation
 It also enhances osteoclastic activity
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14.  About 15-20 minutes of sunlight a day
 Vit D is found in fish oils and species
of fish e.g. salmon, tuna, sardines
 Many milk products, margarines and
breakfast cereals are fortified with
vitamin D
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15.  Recently published studies suggest a
key role for vitamin K nutrition for
optimisation of bone health
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16.  The prevention of osteoporosis is
essential for the maintenance of
health, quality of life, and
independence in elderly population
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17.  Diet rich in Calcium & Vit. D
 Ca & Vit. D taken as a supplement
 1000 mg Ca/day (premenopausal) &
1200mg Ca/day (menopausal)
 Vit. D 800 IU/day (menopausal) & 600
IU/day (premenopausal)
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18.  Yogurt
 Milk
 Cheese
 Cereal
 Whole grains
 Leafy green vegetables
 Sardines & Salmon
 Molasses
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19.  Strength-Training has a profound
effect of strengthening bones
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23.  Alendronate (Fosamax®)
 Risedronate (Actonel®)
 Raloxifene (Evista®)
 HRT
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24.  Good evidence to support the effects
of nutrition on the skeleton
 Ca and vit D are key nutrients for
bone health ~ effective strategies for
fracture prevention in the elderly
 Evidence has emerged for a role of vit
K in bone health. Further data are
urgently required
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