Bone Health and Osteoporosis Part 2

Question 1

dietary protein above the RBA (>0.8g/kg/d) may be ______ for bone

Answer 1

beneficial

Question 2

low protein intake (<12% TEE) was associated with ________ fragility fracture risk

Answer 2

increased

Question 3

bone mineral density can _______ potentially in individuals that have a higher protein intake. ONLY IF __________________

Answer 3

1. increase
2. they are supplemented or they have adequate levels of calcium and vitamin D

Question 4

when we strength the ______, we strength the bone. Why?

Answer 4

muscle.

• the muscle pulls on the tendons and causes our bones to react to the stress which increases turnover and builds stronger bonds
• when increasing turnover, you need to provide building blocks so nutrition and exercise go hand in hand

Question 5

balance is important for elders, especially with osteoporosis. why?

Answer 5

their bones are fragile, if they fall they can fracture a bone

Question 6

what does osteoporosis canada 2023 guidelines say to prioritize?

Answer 6

• balance, functional, and resistance training more than twice weekly
• other activities encouraged but don’t replace training above.
• progression: increase exercise difficulty, pace, frequency, volume (sets, reps) or resistance over time
• seek exercise advice and guidance from professional

Question 7

what is functional exercise?

Answer 7

target muscles used in everyday life (ex. walking with dumbbells everyday to practice grocery shopping)

Question 8

Medication of osteoporosis?

Answer 8

biphosphonates: alendronate or risedronate:
- anti-resorptive therapy –> targets osteoclasts so they cannot resorption of bone

hormone replacement therapy:
- anti-resorptive therapy
- replacement of estrogen in post-menopausal females

Question 9

what is RED-S?

Answer 9

relative energy deficiency in sport
- happens in athletes when they have chronic low energy availability causing impaired physiological functioning
- seeing athletes have issues with fractures and bone pain

Question 10

if energy is expended for immunity, is it available for growth?

Answer 10

no. can only be available for one thing. for athletes, they use energy during exercise

Question 11

what is energy availability?

Answer 11

the daily energy from food and drink - daily cost of exercise = whatever energy is left to undergo all other physiological processes like metabolism and important bodily functions

: energy consumed from diet (kcals) - energy burned from exercise (kcals) all / kg of fat free mass

Question 12

what is low energy availability?

Answer 12

inadequate energy intake relative to exercise energy expenditure, leaving inadequate energy to support the functions required by the body to maintain optimal health and performance

Question 13

what is normal energy per day? vs low?

Answer 13

45kcal/kg FFM/day and low is below 30

Question 14

health consequences of RED-s

Answer 14

• stress fractures
• menstrual function
• cardiovascular issues
• stunted growth

Question 15

low energy availability (LEA) prevalence and risk factors?

Answer 15

• prevalence ranges from 22-58% depending on sport and population

risk factors:
- calorie restriction. exercise for prolonged time, pressure to lose weight to improve performance, competitive nature, traumatic events

Question 16

highest risk factor sports for LEA?

Answer 16

sports involving:
- high training volumes
- weight classes/low body weight
- aesthetics and/or are subjectively assessed

Question 17

RED-s symptom

Answer 17

symptoms:
- fatigue
- menstrual irregularities
- problems with controlling body temperature and sleep
- reduced bone mass

Question 18

RED-s treatment

Answer 18

• increase energy intake
• reduce energy expenditure
• combination of both
• counselling (may fail to address underlying factors)

Question 19

how does restrictive eating affect the bone and osteoporosis?

Answer 19

restrictive eating –> energy deficit/negative energy balance = LEA –> metabolic/hormonal changes –> reduced bone formation –> compromised skeletal health, fractures and increased osteoporosis risk

Question 20

how does elevated caloric expenditure affect bone and osteoporosis?

Answer 20

elevated caloric expenditure –> energy deficit/negative energy balance = LEA –> menstrual irregularities - low estrogen –> increased bone resorption –> compromised skeletal health, fractures and increased risk for osteoporosis