Nutrition and Chronic Disease - Module 5, Case Assignment -
[Male and Female Osteoporosis Prevention]
For this Case Assignment, I addressed the following scenario:
Suppose that you are a nutritional counselor. Jonathan, a 54 year-old male client, tells you that he does not have to worry about getting osteoporosis because
- healthy bones are things that a person is born with and have absolutely nothing to do with nutrition, and
- osteoporosis is an extremely rare disease that only affects elderly women and not men. Therefore it is not a very serious or significant disease.
I then explained in detail why I did not agree with the above two statements. My opinion and analysis follows:
Jonathan, a 54-year-old man has been advised by his doctor to get nutritional counseling. In the past year, he has had two bone fractures, which led his doctor to believe Jonathan may have brittle bones. Jonathan recently quit smoking after 30 years and his diet consists mostly of animal products i.e. protein. He believes his two fractures were due to an accident and coincidental. He also believes healthy bones are what everyone is born with and nutrition does not affect the bones. To add, he believes because he is a man he is less likely to get osteoposis and that mostly older women are at risk.
Getting the recommended amount of calcium mineral throughout a lifetime is important for osteoporosis prevention. Calcium intake during the developmental years i.e. pregnancy (1,200-1,500 mg), infancy (600 mg), toddler (800-1200 mg), adolescence (1,200-1,500 mg), and young adulthood (1,000 mg) is essential (NOF, 2008). The body's calcium need plateaus in early adulthood and then picks right back up in middle-ages (1,000 mg) into senior (1,500 mg) years (FORE, 2008). Calcium is needed for a healthy heart and for the muscles to function properly. Calcium rich foods are dairy products and calcium enriched foods like cereals and fruit juices. However, calcium cannot be absorbed properly without vitamin D. Vitamin D is found in the sun (15 minutes a day), cod liver oil, milk fortified with vitamin D, egg yolk, and multivitamins (FORE, 2008). A diet that is high in protein has proven to elevate the risk of osteoporosis, as has smoking and excessive alcohol consumption (Palacios, C., 2006). Calcium and vitamin D are not the only vitamins and minerals that are important for healthy bones. In addition to calcium and vitamin D, the process of bone formation also requires an adequate and constant supply of nutrients, such as magnesium, phosphorus, potassium, and fluoride (Palacios, C., 2006). For the metabolic process for bones, manganese, copper, boron, iron, zinc, vitamin A, vitamin K, vitamin C, and vitamin B are also needed (Palacios, C., 2006).
True, osteoporosis is four times more common in women than men. Hormone changes throughout life, especially during menopause, affect woman's bones. However hormone changes are also present in men as they age. The fall of testosterone is to blame. 2 million American men have osteoporosis and another 12 million are at risk (NOF, 2008). Male diagnosis is underreported, which is not good for educating the male population for prevention. Risk factors for men are steroid use to treat chronic illnesses, like asthma or arthritis. Low testosterone level and chronic disease that affect the kidney, lungs, stomach, and intestines are also signs of osteoporosis (NOF, 2008). To add, smoking, excessive alcohol use, low calcium intake, lack of exercise, and a diet high in protein can be the precursor for osteoporosis.
In reality, our bones are to support us throughout life. To think that maintenance is not needed is unrealistic. A simple example is the basic plant, without water, it will die. The body is much the same. Maintenance throughout life is mandatory for healthy aging. Aging affects men and women, therefore prevention is equally as important for both genders. After extensive testing, in fact, Jonathan does have osteoporosis. I am glad Jonathan's doctor was intuitive enough to recommend a blood test and X-ray instead of overlooking Jonathan's coincidental fractures. Though Jonathan may think it's too late for prevention, the intake of calcium and vitamin D, supplements, physical activity, or prescription medication can help slow down the process. Unfortunately, due to lack of promotion of men and osteoporosis, prevention is unknown or dismissed by many men. It is recommended that men over the age of 50 get 1,200 mg of calcium daily (NOF, 2008). This, hand in hand with physical activity will prevent further damage to Jonathan's bones. With scientific facts, i.e. blood test and x-ray, Jonathan accepts his osteoporosis and plans on making nutritional modification and adding physical activity to his lifestyle.
REFERENCE:
Foundation for Osteoporosis Research and Education (2008). Eating Right: Giving your body a nutritional advantage.
- Retrieved from the worldwide web on December 9, 2008 from:
National Osteoporosis Foundation (2008).
- Retrieved from the worldwide web on December 9, 2008 from:
Palacios, C. (2006). The Role of Nutrients in Bone Health, from A to Z. Critical Reviews in Food Science and Nutrition. 46(8), 621-629.
- Retrieved from Proquest on December 9, 2008 at: