Question

Mrs Leece is 81 years old and is currently in hospital recovering from a fractured hip (fractured neck of femur), which occurred when she was trying to mobilise outside to get the mail. She reports that she had noticed that she had been getting ‘weaker’ in the legs and had not been able to shop regularly, or cook for herself for a while. She says that her appetite has been reduced also and that she has noticed that her clothes are looser and that her wedding ring is now too big. On examination the dietitian reports that she in underweight and malnourished, while a bone density scan has confirmed her osteoporosis.

3. What are her risk factors for malnutrition?

4. What factors have contributed to her recent fall?

5. What other nutrients are particularly important for Mrs Leece at present? Please explain why each is important.

Nutrient	Why is it important?
Protein
Iron
Calcium
Fibre
Vitamin B12
Vitamin B2
Vitamin D

6. The medical team will be reviewing Mrs Leece and making recommendations about ongoing treatment and medications. Will there likely be role for supplements? If so, which ones might be prescribed and why?

7. What factors can assist in reducing the risk of osteoporosis for others?

Answer 1

3)

• Being in hospital.
• Chronic illnesses such as cancer, diabetes, lung disease.
• Dental problems.
• Loss of taste and smell.
• Losing weight without trying to.
• Medication side effects.
• Physical disability.
• Poor appetite

4)* aging

* Decrease appetite

* Weaker

* Fatigue

* Osteoporosis

5) * protein: Protein is an important nutrient for bone health and in the prevention of osteoporosis. It gives bone its strength and flexibility and is also the big component of muscles, which are, of course, crucial for mobility and in preventing falls.

* Iron: Iron is essential in oxygen transport and participates in many enzymatic systems in the body, with important roles in collagen synthesis and vitamin D metabolism. The relationship between iron and bone health comes from clinical observations in iron overload patients who suffered bone loss.

* Calcium:Calcium is needed for our heart, muscles, and nerves to function properly and for blood to clot. Inadequate calcium significantly contributes to the development of osteoporosis. Many published studies show that low calcium intake throughout life is associated with low bone mass and high fracture rates

* Fiber : Eating more fiber will not guarantee that you will never get osteoporosis. However, eating a healthy diet that is high in plant fiber can reduce your risk of losing bone mass and developing this disease.

* Vitamin B12:Pernicious anemia has recently been recognized as a risk factor for osteoporosis and fractures. Although vitamin B12 is important for osteoblast function, the effect of vitamin B12 replacement in states of vitamin B12 deficiency on bone density and fracture incidence is not known.

* Vitamin B2:Inadequate B vitamin intake has been reported among hip fracture patients. The association between various B vitamins (B2, B6, folate, or B12) and a lower risk of osteoporosis or hip fracture has also been demonstrated in several observational studies.

* Vitamin D :Vitamin D helps the body absorb calcium and phosphorus from the food you eat. So the nutrient is important for people with osteoporosis. Studies show that calcium and vitamin D together can build stronger bones in women after menopause. It also helps with other disorders that cause weak bones, like rickets.

6) Dietary supplements are substances might use to add nutrients to Leave diet or to lower of health problems, such as osteoporosis .Osteoporosis poses a significant public health issue, causing significant morbidity and mortality. Calcium and vitamin D utilization in the optimization of bone health is often overlooked by patients and health care providers.

7)

• Know your risks. Knowing your risks is the first step to prevention.
• Exercise. Exercise, particularly weight-bearing exercises like walking, is important for good bone health.
• Look at your calcium and vitamin D intake.
• Stop smoking.
• Limit alcohol consumption.
• Treat the underlying cause of a fracture.