The term ‘musculoskeletal disorder’

covers any injury, damage or disorder

of the musculoskeletal system (that is,
muscles, nerves, tendons, ligaments,
joints and bones).
 The ABCDEFs of
Nutritional Status
These include anthropometry,
biochemistry, clinical evaluation,
dietary history, environmental
assessment, and functional status.
Nutrients That
Affect Bone Health
• Vitamin A: Bone-building
osteoblasts cannot
develop properly without
it.
Nutrients That
Affect Bone Health
Vitamin D: Factors that can affect
vitamin D levels include reduced
exposure to sunlight, decreased dietary
intake and absorption problems. An
excess of this vitamin has not shown
an increased benefit. The body's use of
vitamin D is enhanced in the presence
of magnesium and boron.
Nutrients That
Affect Bone Health
Magnesium: Is responsible for many
biochemical processes within the bone.
Magnesium is essential for the
conversion of vitamin D to its
biologically active form.
Nutrients That
Affect Bone Health
Manganese: is essential for the
mineralization of the bones as well as
the production of cartilage and
connective tissues.
The best source is from grains but as
much as 75 percent of all manganese
is lost in the refining of wheat to white
flour.
Strontium: Many foods such as fruits
and vegetables are naturally high in
this mineral which has been shown to
prevent dental caries while exercising
a beneficial effect on persons with
osteoporosis.
Copper: Experiments showed that
animals fed copper-deficient diets
had a marked reduction in bone
mineral content and bone strength:
copper has been shown to strengthen
connective tissue by its effect upon
collagen strands.
Zinc: This vital trace mineral is
essential for normal bone formation
and is involved in the biochemical
activities of vitamin D.
Boron: Small amounts of this trace
element can greatly enhance the
absorption of calcium via a positive
effect upon the hormone levels of the
body. It is estimated that 1 to 2 mg per
day is adequate for this mineral.
 B Vitamins and
Homocysteine
Homocysteine is an amino acid which can
interfere with collagen synthesis, the main
protein in bone.
When blood levels of vitamin B6, vitamin
B12 and folic acid are low, homocysteine
levels can rise. There is association between
high homocysteine levels and lower BMD,
and increased hip fracture risk in older
people.
Osteoporosis is a condition in
which the bones become less
dense and more likely to
fracture.
Risk factors
OSTEOPOROSIS
• Small frame,
• Family history.
• Post (early) menopausal Amenorrhe,
• Medications: lupus, asthma,
thyroid deficiencies, and seizures
• Low Calcium intake
• Lack of physical activity
• Smoking
• Excessive alcohol intake.
In women with breast cancer,
chemotherapy with drugs
such as cyclophosphamide
and methotrexate can cause
the ovaries to stop
functioning.
Cancer-related bone loss can
occur for many reasons,
including issues due to cancer
therapies, such as surgery and
certain medications, and
metastatic disease to the bone.
Surgery: Because the ovaries are the
body’s primary site for estrogen
production, women who have their
ovaries surgically removed (called an
oophorectomy) experience a
substantial drop in estrogen production
Radiation therapy to treat
cancers of the pelvic area is
known to make bones more
fragile.
Hormonal therapy: Estrogen-
sensitive tumors are commonly
treated with medicines known as
aromatase inhibitors.
Arimidex (anastrozole), Aromasin (exemestane),
and Femara (letrozole)
In men, a type of prostate
cancer treatment called
androgen-deprivation therapy
suppresses male sex hormones,
including testosterone.
While protein seems to have a
direct anabolic effect on bone, the
relation between protein intake
and bone is further complicated by
the potential negative effect of
overall dietary acid-base balance.
Urinary calcium increase with acid-
forming foods, such as meat, fish,
eggs, and cereal, and negatively
associated with plant foods and is
likely determined by the acid-base
status of the total diet.
Protein intake increases
urinary calcium loss, but
whether negative calcium
balance results will depend
on dietary calcium intake.
In simplest terms, a high-protein
diet drops the blood’s pH. To
restore optimal pH, the body
draws calcium compounds from
bone.
1 gram of dietary protein
increases urinary calcium
excretion by 1 to 1.5 mg.
Avoid very high protein
diets (> 2.0 g/kg BW/day)
when associated with low
calcium intake (<600
mg/day)
Each 10 g increase in dietary
protein increases urinary
calcium by 6 mg, and doubling
protein increases urinary
calcium by 50%.
Protein requirement is
between 0.6 and 1.5 g of
high biological
protein/kg/d.
Eat a chicken breast or a hamburger
and you lose twenty to thirty
milligrams of calcium. Over a lifetime,
If that calcium is not returned to the
bones, the loss can add up to a good
deal of the skeleton—and eventually
osteoporotic fractures.
Each gram of increased
sodium intake increases
urinary calcium excretion
by 15 mg per day.
Each cup of coffee,
there is a 5 mg loss of
Calcium.
Dried fruits are the most
alkaline plant foods, and
cheeses, particularly hard
cheeses, are the most acid-
forming animal foods.
Be focused on increasing the intake of
alkalinizing fruits and vegetables
rather than reducing protein sources.
Alkaline diet
The Alkaline Way diet is a health-
promoting, fiber-rich diet that consists
primarily of whole foods based on
individual food tolerances and
sensitivities.
Preference is given to locally, organic,
or biodynamic sources of foods.
Mineral-rich water is the preferred
beverage.