20 October 2020 Cagayan de Oro – Every 3rd week of October, we celebrate Bone and Joint Awareness Week as declared in Proclamation No. 658 signed on 5 July 2004. Bone and joint disorders are one of the most common medical conditions that affect our daily lives that substantially influence health, quality of life, and unnecessary loss of resources among Filipinos of all ages.
Our bone is a living tissue that plays a structural role in the body, and the joint or articulation is the connection made between the skeleton that holds the bones together and supports movement. As we grow older the bone mass increases, and its peak bone mass is achieved until the early twenties. Indeed, life begins at forty because at this stage bone loss happens since bone formation and bone mass gradually decrease. Excessive loss of bone tissue leads to osteoporosis, a condition characterized by bone fragility. This condition increases the risk of bone fracture. Other joint disorders are rheumatoid arthritis, osteoarthritis, and gouty arthritis. Among these types of arthritis, gout is the most common experienced by adults that is highly related to consuming high purines that produce the by-product uric acid. Pregnant and lactating women, overweight and obese, and elderly particularly women are most at risk to poor bone and joint health.
As early as possible it is important to maintain our bones and joints through a healthy lifestyle. Calcium, vitamin D, vitamin K, and omega-3 fatty acids are nutrients that play major role in establishing and maintaining healthy and strong bones. Thus, the consumption of its food sources in the diet is essential.
About 99% of calcium is stored in our bones. Calcium has always been important for bone development from childhood, adolescents, and early adulthood. Adequate consumption for adults has a recommendation of 750-800 mg (PDRI 2018). The best food sources of calcium are milk, dairy products, and dilis. Green leafy vegetables are also included in the list.
Vitamin D is essential in helping the body absorb and use calcium efficiently. A lack of vitamin D can cause the bones to become soft and weak which may lead to bone deformities. When exposed to enough sunlight the bone activates the inactive form of vitamin D (cholecalciferol and ergocalciferol) to its active form calcitriol (1α, 25- dihydroxyvitamin D). Known food sources are mackerel, sardines, liver, egg, and dairy products. According to PDRI 2018, the recommended intake of vitamin D among adults is 5 μg for ages 19-49 years old, and 10 μg for ages 50-59 years.
Vitamins K is mostly found among green leafy vegetables such as malunggay, meat, and dairy products. Its recommended intake is 53 μg among adults. This vitamin mainly functions in the carboxylation of much bone-related protein regulating gene transcription of osteoblastic markers, and bone reabsorption. People with osteoporosis have shown to have low blood levels of vitamin K. The low consumption of vitamin K and impaired vitamin K status are associated with lower bone mass and a higher risk of hip fracture among elders.
Another nutrient that plays a role in bone and joint health is omega-3 fatty acids. Omega-3 fatty acids help prevent joint injuries and have anti-inflammatory properties. People consuming adequate omega-3 fatty acids ease joint pain and swelling. The recommended dietary intake of this nutrient is 0.5% from fat for both male and female adults (PDRI 2018). Consumption of fish like salmon and tuna ensures better joint function being a food source of omega-3 fatty acid.
Excessive consumption of purines develops uric acid crystals which are eventually deposited as crystal in the joints causing it to inflame. Foods that are high in purines are seafood and shellfish including anchovies, sardines, herring, mussels, codfish, scallops, red meat and organs like liver, and the high consumption of alcoholic beverages. Limiting these foods in the diet can alleviate the occurrence of gouty arthritis.
Consuming the abovementioned nutrients and accompanied with physical activity for 30 minutes to 1 hour a day makes the bones healthier. Doing physical activity should not be hindered because of the COVID-19 pandemic. Exercise helps to maintain a good weight and avoids bone losses. Being overweight and obese can add stress on bone and joints that is why it is important to maintain a body mass index (BMI) of 18.5 kg/m2 – 24.9 kg/m2. Many indoor activities can help us even with limited space.
The Bone and Joint Awareness Week Celebration is a reminder of how we should maintain healthy lifestyle, especially on building stronger bones and joints for a stronger future. After all, our body should be taken cared of daily by consuming a variety, balance, and moderate diet with proper exercise. Our health is our sole responsibility, ask support from your Nutritionist-Dietitians and medical professionals for a more productive and healthier lifestyle. (Angelique Jean Maggay, ND II)
References:
Bone and joint health. British Nutrition Foundation 2018. Registered Charity 251681. A Charity registered in Scotland SC040061. https://www.nutrition.org.uk/nutritionscience/health-conditions/bone -and-joint-health.thml?
Helmes, Nathalie 2019. Dairy for strong bones? 2 essential nutrients for bone and joint health. The University of Chicago Medicine. 5841 S. Maryland Avenue Chicago, IL 60637 / 773-702-1000. https://www.uchicagomedicine.org/forefront/orthopaedics-articles/essential-nutrients-for-bone-and-joint-health#:~:text=Calcium%2Drich%20foods%20include%20dairy,healthy%20for%20bones%2C%20Condon%20said" https://www.uchicagomedicine.org/forefront/orthopaedics-articles/essential-nutrients-for-bone-and-joint-health#:~:text=Calcium%2Drich%20foods%20include%20dairy,healthy%20for%20bones%2C%20Condon%20said.
Higdon, Jane 2000. Vitamin D micronutrients information center. https://lpi.edu/mic.vitamins/vitamins-D#metabolism-function.
National Council on Disability Affairs 2012. Proclamation no. 658. NCDA Building, Isidora Street, Barangay Holy Spirit, Diliman, Quezon City, Philippines 1127. https://www.ncda.gov.ph/disability-laws/proclamations/proclamation-no-658/
