nutrition and bone health
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Nutrition and Bone Health
Departemen Ilmu Gizi
BLOK DERMATOMUSKULOSKELETAL
K!UISU" #$$%
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& Ade'uate nutrition i( e((ential )or the
de*elopment and maintenan+e o) the(,eleton
& Bone di(ea(e +omple- etiolo.ie(
de*elopment o) di(ea(e /
01 pro*idin.ade'uate amount( o) nutrient(
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& 23 1ear(
#34 o) the population 01 #$#$& 5 ri(, o(teoporo(i( and 6dou0lin. or
triplin.7 hip )ra+ture
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Bone Ma(( and Bone Den(it1
& Bone ma(( 0one mineral +ontent 6BM87
a((e(in. amount o) 0one a++umulated
0e)ore the +e((ation o) .ro9th
& Bone den(it1 de(+ri0e 0one a)ter thede*elopmental period i( +ompleted
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8al+ium Meta0oli(m
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8al+ium Homeo(ta(i(
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:ea, 0one ma(( 6:MB7
& :MB rea+h ;$ 1ear(
& Lon. 0one (top .ro9in. in len.th a.e <=6)emale(7 and a.e #$ 6male(7
& Man > 9oman
& Hereditar1
& Dietar1 +al+ium inta,e(
& ?ei.ht!0earin. ph1(i+al a+ti*it1
& Bod1 9ei.ht
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Lo(( o) 0one ma((
& A.e i( important
& A.e @$ BMD dimini(h .raduall1 60oth
(e-e(7& Lo(( a)ter a.e 3$ 69omen7 or the time
o) the menopau(e <!#4 per 1ear o*er
the ne-t de+ade
& Man lo9er rate than 9omen 6(ame a.e7
& But a.e $ (ame )or 0oth
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Di))eren+e 0et9een normal 0one
and o(teoporoti+ 0one
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Nutrition and Bone
& 8al+ium" pho(phat" and *itamin D
& Mi+ronutrient
& :h1toe(tro.en(
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Re+ommended Inta,e( o) Bone!
Related Nutrition )or Adult(
& 8al+ium <3$$ m.Cda1 )or po(tmenopau(al9omen" <$$$!<#$$ )or 1oun.er 9omen
& itamin D 2$$!<$$$ unit(
& Ma.ne(ium @$$!2$$ m.& Man.ane(e #!3 m.
& in+ <3 m.
& Boron ; m.
& 8opper#!; m.
& itamin K 3$$ m+.
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8al+ium Inta,e
& ood (our+e( are re+ommended )ir(t )or
(uppl1in. +al+ium need( 0e+au(e o) the
+oin.e(tion o) other e((en(ial nutrient(
Sour+e(
& 8al+ium )rom )ood
& 8al+ium )rom (upplement& 8al+ium )rom )orti)i+ation )ood
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8al+ium )rom )ood
& 8al+ium )rom )ood i(.enerall1 .ood" 0ut )roma )e9 )ood( (u+h a((pina+h it ma1 0e lo9er
& ?heat 0read ma1 0e a.ood (our+e o) +al+ium& Green lea)1 *e.eta0le(
(u+h a( 0ro++oli" ,ale"0o, +ho1" and (o1 0ean6lo9er 9ith o-alate7
& Dair1 produ+t( hi.h!+al+ium mil," +hee(e("1o.hurt 60e(t7
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& 8al+ium in (ele+ted
)ood( F To)u F o.hurt F Sardine( F 8ollard .reen("+oo,ed
F 8hee(e F Non!)at mil, F :uddin." *anilla F ?hole mil, F 8u(tard F Buttermil, F I+e!mil, F Spina+h
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8al+ium )rom (upplement
& Si.ni)i+ant in+rea(e( in (pinal and total
0od1 BMD
& Good 0ut it (eem( more li,el1 that ,eepin.
the .ain( in BMD a++rued 0e)ore a.e #$
& Be(t +om0ination o) re.ular ph1(i+al
a+ti*it1 and a rea(ona0le +on(i(tent dail1
+al+ium inta,e(
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8al+ium 0ioa*aila0ilit1 )rom +al+ium
(upplement
& Depend( on the anion u(ed" 0ut in
mar,et .ood 0ioa*aila0ilit1
& 8al+ium +itrate malate a0(or0ed
e))i+ient than +al+ium +ar0onate and other
+al+ium (upplement(
& 8al+ium +ar0onate +on(tip1in. e))e+t
6minimize 01 di*idin. do(e and ta,in.
more )luid( and )i0er(7
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E))e+t o) (upplement
& Hi.h do(e +al+ium (upplement ma1
redu+e the a0(orption o) nonheme iron
and po((i0l1 zin+ Ma.ne(ium" and other
di*alent +ation(
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:otential Ri(,( A((o+iated 9ith
E-+e((i*e 8al+ium Supplementation
& 8ontamination o) 0one meal or dolomite(upplement( 9ith +admium" mer+ur1" ar(eni+" or
lead& Urinar1 tra+t or renal (tone( in (u(+epti0le
indi*idual(
& H1per+al+emia or mil, al,ali (1ndrome )rom
e-tremel1 hi.h inta,e( 6>@$$$ m.Cda17& De)i+ien+1 o) iron and other mineral di*alent
+ation( re(ultin. )rom de+rea(ed a0(orption
& 8on(tipation
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8al+ium )orti)i+ation o) )ood
& Another 9a1 to in+rea(e the +on(umption
o) +al+ium 01 )emale(
& Oran.e ui+e and man1 0rand( o) non!
dair1 mil,( at a*out ;$$ m.C +up o) ui+e
and to 0readd( and other )ood(
& ood pre)era0le
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itamin D
& itamin D inta,e ade'uate *it D inta,e i(
important e-+e(( need i( a*oided
& Sun li.ht e-po(ure )or (,in
& 8al+ium and *itamin D (upplement( are
o)ten .i*en
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Ri+,et(
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:ho(phat inta,e
& 8al+ium and :ho(phat J << needed )or
mineralization
& Hi.h pho(phoru( 0one lo((
& 8on(umption <$$$ m. to <#$$ m.Cda1
6)emale(7" <#$$!<@$$ m.Cda1 6male7
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:rotein inta,e
& Ana0oli+ e))e+t
& Hi.h dietar1 proteinno e))e+t
& Lo9 dietar1 protein Lo9 (erum al0uminlo9
IG!< and (erum +al+ium *ulnera0le )ra+ture
& < .C,. per da1
& Animal protein ri(e urinar1 lo((e( o) +al+ium
6a+id7& :lant proteinlittle e))e+t 6neutral or 0a(i+ urin7
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Ma.ne(ium inta,e
& Little e))e+t" 0ut (u..e(t ade'uate inta,e(
o) M. impro*e( BMD
itamin K inta,e
& O(teo+al+in need( *itamin K
& itamin K (upplementation retard 0one lo((
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Inta,e( o) other dietar1 +omponent
& Dietar1 )i0er e-+e((i*e inta,e
depre((ion +al+ium a0(orption
& :ota((ium 0i+ar0onate(u))i+ient to
neutralize endo.enou( a+id
& e.etarian diet 0ene)i+ial e))e+t 0u1
pro*ide( le(( +al+ium than animal protein
& I(o)la*on 6ph1toe(tro.en7 (o10ean
lo9er li)etime e-po(ure )or e(tro.en(
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& 8a))ein and +ar0onated 0e*era.e(
e-+e((i*e inta,e( deteriou( e))e+t on
BMD
& Inta,e( o) +ola(lo9er BMD
& Al+oholad*er(e e))e+t
Inta,e( o) other dietar1 +omponent
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O(teopenia and O(teoporo(i(
& O(teopenia ?hen BMD )all( (u))i+ientl1
0elo9 health1 *alue( 6< SD7 a++ordin.
?HO (tandard
& O(teoporo(i( ?hen BMD 0e+ome( (o
lo9 6.reater than #3 SD( 0elo9 health1
*alue(7
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Nutrition mana.ement
& Ade'uate +al+ium inta,e
& Ade'uate*itamin D inta,e )rom )ood"
(upplement" and (un e-po(ure
& A*oidan+e o) e-+e(( phophoru(
& A 0alan+e diet that pro+ide( ade'uate
protein" ener.1" and mi+ronutrient(& E-er+i(e
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:re*ention
& Three )a+tor( in)luen+ed 6)or 9omen7 diet"e-er+i(e" and e(tro.en
& Diet +al+ium )rom )ood 6in+ludin.
)orti)ied )ood7" ade'uate inta,e o) *itaminD either )rom (un e-po(ure or )ood( or(upplement
& En.a.in. in re.ular 9ei.ht!0earin.e-er+i(e
& E(tro.en 60e)ore 3$7
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The end