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Bone Health
Learning objectives
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Structure of bone
Formation of bones
Parts of bone
What is peak bone mass?
Significance of bone health
Interesting facts
Diet & bone health
Significance of Calcium & Vitamin D
Bone diseases & treatments
Live Healthy..!!
Structure of bone
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A bone is a rigid organ that constitutes part of the vertebral skeleton.
Bones support and protect the various organs of the body, produce red and
white blood cells, store minerals and also enable mobility. Bone tissue is a
type of dense connective tissue. Bones come in a variety of shapes and sizes
and have a complex internal and external structure. They are lightweight
yet strong and hard, performing multiple functions
Bone itself consists mainly of collagen fibres and an inorganic bone
mineral in the form of small crystals. d hard, and serve multiple functions
Long bones such as the femur contain two distinct morphological types of
bone:
– Cortical (compact) bone: Cortical bone forms a dense cylinder
down the shaft of the bone surrounding the central marrow cavity.
While cortical bone accounts for 80% of the mass of bone in the
human body, it has a much lower surface area
– Cancellous or Trabecular (spongy) bone: Located at the ends of
long bones, accounts for roughly 20% of the total mass of the
skeleton, and has an open, honeycomb structure. It has a much lower
Young’s modulus than cortical bone, and this graded modulus
gradually matches the properties of the cortical bone to the cartilage
that forms the articulating surface on the femoral head
Formation of bones
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Bone formation or ossification is the laying down of new
bone material by bone cells (osteoblasts). The formation of bone is in
fact conversion of other types of connective tissues into bone. Based
on the type of tissue converted into bone, the process of ossification
is of three types
– Intramembranous ossification is the direct laying down
of bone into the primitive connective tissue (mesenchyme).
Forms the flat bones of the skull, clavicle, and mandible. The
bones formed by this process of ossification are known as
membranous bones or dermal bones
– Endochondral ossification involves cartilage as a
precursor. Here, the mesenchyme has been converted to
cartilaginous models and the process of ossification starts in
these cartilaginous models. The process of conversion of
mesenchymal condensations in cartilage is known as
chondrification and this process takes place during the second
month of intrauterine life. It leads to formation of long bones
and other bones.
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Heterotopic ossification is a process resulting in the formation
of bone tissue that is often atypical, at an extraskeletal location
Parts of bone
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The outer surface of a bone is called the periosteum. It
is a very thin membrane that has nerves and blood
vessels in it. They carry nutrients to the bones.
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The compact bone is the smooth and very hard part
of the bone. It is the part you see when you look at a
skeleton.
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Spongy bone is lighter than compact bone but it is still
very strong. It looks like a sponge or honeycomb with a
lot of spaces in between.
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The inside parts of a bone are hollow. They are filled
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with a jelly called bone marrow. In adults the long bones
of the legs and arms are filled with yellow marrow. The
ends have red marrow. It is the place where billions of
new blood cells are produced every day.
When a child is born it has about 300 “soft” bones . As it
grows up some of these bones grow together to form the
206 bones that a normal grown-up has. During
childhood bones grow with the help of calcium. By the
time you are about 20, bones stop growing.
What is peak bone mass?
Peak bone mass is reached at the age of about 20 – 35
years. Around this age bone is at its strongest. After
this age, bone mass gradually decreases.
Achieving a good peak bone mass is important in
reducing the risk of osteoporosis in later life. This is
because bones are strong before bone loss begins.
Peak bone mass can be increased by ensuring that the
diet contains adequate amounts of vitamin D and
calcium during childhood, adolescence and early
adulthood, and by regular activity especially weightbearing activities such as walking and climbing stairs
(in which the bones bear body weight).
Significance of bone health
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Bones are the body's foundation. Bone is a living tissue from which
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Proper attention should be given for the upkeep of health of bones
since they are the ones around which our body is built, protecting
the delicate internal organs.We need them to stand straight and
carry us, to participate in various events.
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Strong bones gives us protection as well as helps us to stand
straight and carry us.
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They act as storehouse for calcium & phosphorus and can hold up to
some calcium loss when our body uses that calcium for other
essential jobs. Moreover the muscles (including heart muscles &
blood vessels) & nerve fibres need calcium for proper working.
Phosphorus is used in production of energy and DNA.
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The quality of our skeletal structure has a direct impact on our
appearance, vitality and energy level. The better we stand, walk and
move around, the more youthful we will look and feel. Building and
maintaining strong healthy bones is thus, a lifelong concern
substances are constantly being removed and replaced. Healthy bone
is strong and does not break easily.
Interesting facts..!!
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Humans are born with 300 bones in their body,
however when a person reaches adulthood they only
have 206 bones
Most of the bones in the body are in the hands. There
are 54 bones including the wrists
The longest bone in your body, the femur (thighbone),
is about 1/4 of your height
Humans and giraffes have the same number of bones in
their necks
The only bone fully grown at birth is located in the ear.
Adult human bones account for 14% of the body's
total weight.
The strongest bone in your body is the femur
(thighbone), and it's hollow!
Enamel is hardest substance in the human body.
Fingernails grow nearly 4 times faster than toenails!
Most fragile bones in the body are the toe bones
Diet & bone health
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When it comes to building strong bones, there are two key nutrients: calcium and
vitamin D. Calcium supports your bones and teeth structure, while vitamin D
improves calcium absorption and bone growth.
A balanced diet rich in fresh, whole foods is the foundation for good bone health.
– Protein : Protein aids the production of collagen fibers that provide a
framework for bones, and adequate protein intake is important for bone health.
Have skinless poultry, fish, beans, low-fat or fat-free-dairy foods, nuts and
seeds. Avoid having red meat, poultry skin, lard, butter, cream and tropical
oils
– Fruits & veggies: Focus on fresh fruits and green veggies since they are rich
source of vitamins, minerals, antioxidants which can help fortify bones and
maintain the muscles that support them
– Calcium: Eat calcium rich foods like milk, yoghurt, sardines, leafy veggies,
brocolli, spinach, fish, liver etc
– Minerals & vitamins: Have your share of minerals & vitamins from
tomatoes, raisins, oranges, collard greens, papaya, grapes, strawberries,
turnips, sweet potatoes, green peppers etc
Exercise regularly: Aim for at least 30 minutes of exercise each day. Weightbearing and muscle-strengthening exercises helps you build bones in your younger
years. If you're over 30, the right physical activity will help you maintain bone
strength
Kick the salt habit: Avoid eating too much salty foods, to avoid that extra amount
of sodium from your blood
Significance of
Calcium & Vitamin D
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Calcium and vitamin D work together to protect our bones—calcium helps
build and maintain bones, while vitamin D helps our body effectively absorb
calcium. So even if we are taking in enough calcium, it could be going to
waste if we are deficient in vitamin D.
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Calcium:
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An adequate intake of calcium is important throughout life.
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Dairy products such as milk, yogurt and cheese are all good sources of calcium.
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White flour must be fortified with calcium, so bread made from these flours is a
significant source for many people.
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Pulses, nuts, dried fruit and green vegetables, such as spinach, provide calcium,
as does fish which is eaten with the bones, such as canned sardines.
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Some foods may provide significant amounts of calcium, but also contain
substances that reduce the amount that can be absorbed by the body.
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Examples of these substances include phytates in wholegrain cereals and pulses,
and oxalate in spinach and rhubarb.
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As vegans do not eat dairy products, they should make sure that their diet
contains sufficient calcium. In the UK, many soya products, such as tofu and
soya drinks, are fortified with calcium and so can be useful sources
Significance of
Calcium & Vitamin D
• Vitamin D
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Vitamin D is important for healthy bones because it is
needed for the absorption of calcium from food.
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Vitamin D is made in the skin when it is exposed to sunlight.
Most people obtain sufficient vitamin D in this way
(particularly in the summer) but some groups, such as people
that are housebound or who wear clothes that cover most of
their body, need to be sure that their diets contain enough
vitamin D.
When the vitamin D production in our skin is insufficient,
we have to rely on food sources. Good sources are oily fish,
eggs, butter, meat and margarines fortified with vitamin D.
By law margarine is fortified with vitamin D, and many low
fat spreads and breakfast cereals are also fortified.
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Bone problems
There are many kinds of bone problems:
1. Low bone density and osteoporosis:
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Progressive bone disease that is characterized by a decrease in bone
mass and density which can lead to an increased risk of fracture.
Bone mineral density (BMD) is reduced, bone microarchitecture
deteriorates, and the amount and variety of proteins in bone are
altered.
Risk factors: Ageing, being female, low body weight, low sex
hormones or menopause, smoking, and some medications
Symptoms :
– Back pain, caused by a fractured or collapsed vertebra.
– Loss of height over time.
– A stooped posture.
– A bone fracture that occurs much more easily than expected
Treatment: Treatment of osteoporosis include change of lifestyles
with respect to food habits, exercising etc. Medications include
intake of calcium tablets/capsules, medicines as prescribed by
doctors. Diet rich in calcium like milk, yoghurt, orange juice, green
veggies, soy milk, calcium fortified cereals. Brocolli, salmon etc
should be taken.
Bone problems
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Rickets & osteomalacia:
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Osteomalacia is softening of the bones caused by defective bone
mineralization secondary to inadequate amounts of available
phosphorus and calcium, or because of overactive resorption of calcium from
the bone as a result of hyperparathyroidism (which causes hypercalcemia, in
contrast to other aetiologies). Osteomalacia in children is known as rickets.
Rickets affects the structure of the growing bone. The bones lack calcium and
are weak. The weight of the body causes the bones of the legs to become bent
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Symptoms: Include weak bones, muscle weakness, bone pain, hypercalcemia,
pelvic flattening, easy fracturing, bone softening, bending of bones etc
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Treatment: If a lack of vitamin D is causing osteomalacia, the patient
will be advised to increase their vitamin D intake. Some foods rich in
vitamin D are:
– enriched or fortified milk and milk products
– herring, salmon, shrimp, sardines
– Calcium fortified cereal
– Cod liver oil
– Egg yolks
The doctor may prescribe a concentrated supply of vitamin D as well as a
calcium supplement. The doctor or dietitian may also suggest alternative
sources of vitamin D for people who are lactose intolerant or are allergic to
milk.
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Bone problems
• Paget’s disease: Paget's disease of bone causes
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your bones to grow too large and weak. They also
might break easily. The disease can lead to other
health problems, too, such as arthritis and hearing
loss. You can have Paget's disease in any bone, but
it is most common in the spine, pelvis, skull, and
legs.
No one knows what causes Paget's disease. In some
cases, a virus might be responsible. It tends to run
in families. Doctors use blood tests and imaging
tests to diagnose Paget's disease. Early diagnosis
and treatment can prevent some symptoms from
getting worse.
Symptoms include pain, enlarged bones, broken
bones, damaged cartilage in joints.
Treatments include medicines and sometimes
surgery. A good diet and exercise might also help.
Bone problems
• Bone cancer:
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Bone cancer is an uncommon cancer that begins in a
bone. Bone cancer can begin in any bone in the body, but it most commonly
affects the long bones of the arms and legs. The term "bone cancer" doesn't
include cancers that begin elsewhere in the body and spread to the bone.
Generally occurs due to an error in DNA of a cell.
Types of bone cancer:
– Osteocarcoma: begins in bone cells & most common in children &
young aqdults
– Chondrosarcoma. Chondrosarcoma begins in cartilage cells that are
commonly found on the ends of bones. Chondrosarcoma most commonly
affects older adults.
– Ewing's sarcoma : It's believed that Ewing's sarcoma may begin in
nerve tissue within the bone. Ewing's sarcoma occurs most often in
children and young adults.
Signs and symptoms of bone cancer include bone pain, swelling and
tenderness near the affected area, broken bone, fatigue, unintended weight loss
etc
May be diagnosed using MRI, CT, bone scan, X-ray etc
The treatment options for your bone cancer are based on the type of cancer
you have, the stage of the cancer, your overall health and your preferences.
Bone cancer treatment typically involves surgery, chemotherapy, radiation or
a combination of treatments.
Live Healthy...!!!