Osteoporosis & Importance of Calcium By :Tansheet Jawad 5/25/2019

What is Osteoporosis? A skeletal disorder characterized by compromised bone strength predisposing a person to an increased risk of fracture. 5/25/2019

BONE REMODELING Bone is a living tissue A large multinuclear cell invades bone surface Carves out cavities Release calcium FORMATION New cells fill in the cavities by building new bones OSTEOPOROSIS OCCURS When multinuclear cell carves too deeply New cell fails to fill enough new bone 5/25/2019

SCOPE OF THE PROBLEM 28 million people affected in USA 10 million have the disease 18 million at the risk 1.5 million fractures per year Annual cost $13.8 billion,or $38 million per day 5/25/2019

SITUATION IN PAKISTAN 6million patients in Pakistan 2 million have the disease 4 million at risk 4 million are women 1in 2 women will have an osteoporotic fracture 144,000 fractures annually 5/25/2019

LIFE AFTER A MAJOR FRACTURE One third do not survive one year after surgery Half of those who survive will not walk Half of the rest will become dependant 5/25/2019

WHY SHOULD I WORRY? Problem of old people None of my parents had this problem If anything breaks, doctors can fix it It is not a real problem,pharmaceutical companies just scare people to sell drugs 5/25/2019

OSTEOPOROSIS MYTHS Osteoporosis does not exist as a disease Only problem of old women around 70 years age with low bone density 5/25/2019

OSTEOPOROSIS FACTS Affects women as well as men Younger patients ,in 40’s and 50’s are common Bone density is a reasonably accurate predictor of fracture risk but fractures can occur in patients without poor BMD. 5/25/2019

PEDIATRIC DISEASE WITH GERIATRIC OUTCOME 5/25/2019

DIAGNOSIS Blood test to see calcium levels are useless. Bone density is always evaluated in the light of the individual patient. A poor reading in a young patient does not signify osteoporosis. 5/25/2019

DON’T FORGET TO TAKE CALCIUM AND VITAMIN D TREATMENTS AVAILABLE Fluorides Antiresorptive – e.g. calcitonin Bone anabolic Most important DON’T FORGET TO TAKE CALCIUM AND VITAMIN D 5/25/2019

IMPORTANCE OF CALCIUM Most abundant mineral element in the body. Crucial and active Biological role 5/25/2019

Biological Functions of Calcium Blood clotting Heart beat regulation B.P.regulation Cell division Releasing energy from food Blood sugar control Sending nerve impulses Skeletal muscle movement Communication between cells Sending signals between cells 5/25/2019

Calcium Deficiency Disorders Rickets Osteomalacia Osteopenia Osteoporosis Fractures 5/25/2019

RDA of Calcium (NIH) Birth to 6 months = 400 mg 1 – 5 years = 800-1200 mg Adolescence = 1200 – 1500 mg Pregnant / lactating women = 1200 mg Pre-menopausal women 25-50 y =1000 mg Post-menopausal women = 1500 mg All women & men over 65 yrs = 1500 mg 5/25/2019

CALCIUM IN DIET Milk (250 ml) = 306 mg Cheese (45 g) =432 mg Yogurt (125 g) =203 mg Bread white(1 slice) = 20 mg Rice white (125 g) = 15 mg Potato (1 medium) = 07 mg Peanuts(125 g) = 56 mg 5/25/2019

WHY A CALCIUM CRISIS 5/25/2019

WHY A CALCIUM CRISIS Low Calcium Intake Calcium Robbers Vitamin D Deficiency Sedentary Life 5/25/2019

LOW CALCIUM INTAKE Less intake of Dairy products due to: Change in Dietary Habits Quality of Milk Financial Reasons Dairy Food Myths 5/25/2019

DAIRY FOOD MYTHS 1) PEOPLE WHO ARE SENSITIVE TO LACTOSE SHOULD AVOID MILK AND OTHER DAIRY FOODS. 2) FLAVORED MILK ISN’T GOOD FOR CHILDREN DUE TO SUGAR CONTENT. 3) ORGANIC MILK IS HEALTHIER THAN REGULAR MILK. 4) “RAW” MILK (UNPASTEURIZED) IS SAFER AND MORE NATURAL THAT PASTEURIZED MILK. 5) CONSUMING DAIRY PRODUCTS CAN LEAD TO WEIGHT GAIN. 5/25/2019

CALCIUM ROBBERS Coffee & Soft Drinks(Caffeine) Drugs 5/25/2019

CALCIUM ROBBERS Stress Excessive Animal Protein Protein metabolism produces H2PO4 & H2SO4 which must first be buffered with calcium, an alkalizing mineral,before they can be excreted in the urine, resulting in calcium resorption 5/25/2019

VITAMIN D DEFICIENCY Vitamin D is fat – soluble. It helps in absorption of calcium through GIT. Main cause of deficiency may be lack of exposure to sunlight. Where is my sunshine ??? 5/25/2019

Solution to Vitamin D Deficiency 30 minutes exposure to sunlight / day provides 400 I.U of Vitamin D. Recommend vitamin D along with calcium supplements. 5/25/2019

Sedentary Lifestyle 5/25/2019

Solution to Sedentary Lifestyle Exercise Program Aerobic Exercise (walking, jogging) Strength Training Program (weight lifting, cycling) Combination of Both 5/25/2019

TAKE CALCIUM RICH DIET 5/25/2019

AVOID CALCIUM ROBBERS 5/25/2019

ENSURE ADEQUATE INTAKE OF VITAMIN D 5/25/2019

Osteoporosis is best prevented rather than treated. 5/25/2019

Thank You 5/25/2019