Nutrition and the Musculoskeletal System

Question 1

What is Sarcopenia?

Answer 1

Sarcopenia is the loss of muscle mass and function ( strength and physical performance)

Question 2

What are the two commonly used classification systems used to diagnose sarcopenia?

Answer 2

1. The European Working Group on Sarcopenia in Older People (EWGSOP)
2. The Society on Cachexia , Sarcopenia and Wasting Disorders (SCWD)

Question 3

True or False? Muscle Mass declines ~ 5 % to 13 % in persons ages 50- 80 years of age.

Answer 3

FALSE!! ~ 5 % to 13 % in persons 60 to 70 years of age

Question 4

True or False? The muscle mass declines ~ 1 % per year after the age of 30 years.

Answer 4

TRUE!!

Question 5

What is the percentage of muscle mass decline in persons 80 years and older?

Answer 5

11-50%

Question 6

What are the selected factors that affect maintenance of muscle mass with advancing age?

Answer 6

• Innervation
• Genetics
• Hormones
• Nutritional Status
• Oxidative Stress
• Inflammation
• Exercise ( Activity )
• Disease

Question 7

What are the consequences of Sarcopenia?

Answer 7

1. Loss of muscle mass
2. Decreased physical activity
3. Loss of autonomy
4. Loss of Muscle strength
5. Increases risk of Falls
6. Dependency

Question 8

What are the Clinical findings found in Sarcopenia ?

Answer 8

1. Decreased amino acid intake
2. Decreased physical activity
3. Increased motor unit denervation
4. Age- related loss of spinal motor neuron function
5. Age-related decline in anabolic hormone levels ( ex. testosterone, vitamin D, GH, IGF-1)

Question 9

What are the Clinical findings of Cachexia?

Answer 9

1.Increased REE
2. Host humeral factors : glucocorticoid and angiotensin II
3. Anorexia

Question 10

Which measurement method is commonly used as a proxy for muscle mass?

Answer 10

Appendicular Skeletal Mass (ASM) - it measures the mass of the muscle of the limbs

Question 11

Fill in the blanks. “ Lean Body Mass (LBM ) is the mass of all organs except __________, ________,_____ ,_______.”

Answer 11

Except body fat including bones, muscles, blood, skin

Question 12

Fill in the blanks. ‘___________ is body weight less body fat and essential fat.”

Answer 12

Free Fat Mass (FFM)

Question 13

What are the causes of bone mass deficiency ?

Answer 13

1. Dietary calcium
2. Physical activity
3. Protein- energy malnutrition
4. Micronutrients
5. Hormones - Sex steroids, growth factors
6. Genetics

Question 14

When is maximum bone density gained?

Answer 14

In mid-adolescence

Question 15

What are the conditions relating to bone deformities?

Answer 15

1. Osteomalacia
2. Osteodystrophy
3. Hyperparathyroidism
4. Malnutrition
5. Malabsorption disorder
6. Meetaphyseal chondrodysplasia
7. Renal Tubular disorder

Question 16

What is the treatment for conditions relating to bone deformities?

Answer 16

 Supplementation with Ca, phosphate or vit D
 Orthopedic surgery for severe skeletal
deformities

Question 17

What is the normal bone density ?

Answer 17

T- score >/= -1.0

Question 18

A bone intensity score of less than -2.5 indicates ?

Answer 18

Osteopenia or Osteoporosis

Question 19

What are the non-modifiable risk factors for Osteoporosis?

Answer 19

 Family history
 Race: Asian or Caucasian
 Advanced age
 Being female
 Low body weight <127 lbs (<57.7 kg)

Question 20

What are the Modifiable risk factors of Osteoporosis?

Answer 20

 Cigarette smoking
 Excessive use of alcohol
 Insufficient calcium and vitamin D intake
 Inadequate physical activity
 High sodium diet
 Protein malnutrition
 Caffeine
 Oestrogen or testosterone deficiency
 Chronic use of steroids
 Frailty, poor vision, recent falls, dementia