OSTEOPOROSIS

Dr. Aslis Wirda Hayati, SP, M.Si

 WHAT ?
Osteoporosis : low mass of bone that leads
to bone fragility and enhanced fracture risk.
Assessment : Bone Mineral Density (BMD)
– Normal : BMD > -1 Sd
– Low bone mass (osteopenia) -2.5<BMD<-1 Sd
– Osteoporosis : BMD < -2.5 Sd
 PREVALENCE IN US
Third National Health and Nutrition
Examination Survey : after menopause
women with osteoporosis were 21%
(white), 16% (Spanish), 10% (black); and
38% had low bone mass.
Osteoporosis : 8.0 million women and 2.1
million men
Osteopenia : 15.4 million women and 3.1
million man
 HIP FRACTURES
Probabilities : 14% for white women, 5-6%
white men, 6% black women, and 3%
black men
Heredity accounts for 50% of the variability
in peak bone mass
Study of Osteoporotic Fractures : a
maternal history of a hip fracture doubled
the risk of hip fracture
 HIP FRACTURES

Weight was a strong predictor of bone

mass; thinness increased hip fracture risk
severalfold
Smoking is a strong determinant of hip
fracture
Other risk factors : poor general health,
falling in the past year, & hyperthyroidism
 DIET
Diet is known to influence health
Calcium and vitamin D essential to support
bone growth (children and adolescents)
and help preserve bone mass (adults)
Calcium absorption efficiency declines
with age, the decline is rapid after age 60
Blood levels of 25-hydroxy vitamin D also
decline with age (age-related decline in
skin production of vitamin D)
 DIET

Study : daily oral doses of 1800 IU of

vitamin D2 given in the winter, older men
aged 65-73 years had a significantly
smaller increase in mean blood 25(OH)D
concentration than did younger men aged
22-28 years (19.5 vs 37 nmol/L, p = .027)
 SEASON

Skin production of vitamin D, catalyzed by

exposure to ultraviolet B radiation, is a
major source of the vitamin
Mean 25(OH)D levels were higher in
summer and fall; lower in winter and
spring
 Bone Mineral Density

During the period of most rapid growth

(children, adolescents, and young adults)
>200 mg calcium is deposited in the
skeleton each day
There was a positive role of supplemental
calcium in the preservation of bone mass
in postmenopausal women
 KALSIUM DALAM TUBUH

TUBUH MANUSIA : 1200 g Ca

99% TERDAPAT DI KERANGKA
EKSKRESI :
URIN : 100 – 250 mg
KERINGAT : 15 mg
FECES
 ABSORPSI KALSIUM

PADA ANAK-ANAK : 75%

PADA DEWASA : 20 – 40%
PENGHAMBAT ABSORPSI :
FITAT
SERAT
 KONSUMSI KALSIUM DI AS

RATA-RATA KONSUMSI : 743 mg

DEWASA : 530 mg
12 – 18 th : 1179 mg
REKOMENDASI : 800 - 1200 mg
KONTRIBUTOR :
DAIRY PRODUCT : 55% (440 mg)
SAYURAN HIJAU
Di Indonesia kontribusi susu : 23 mg Ca
 KONSUMSI SUSU
1970 1.82 KG/KPT/TH
1980 4.36 KG
1990 3.44 KG
2000 6.50 KG
PERLU 30 TH + 4.68 KG
AS (100 L) 600 TH
MALAYSIA (20 L) 120 TH
 KONSUMSI SUSU (liter/kap/th)

NEGARA 2004 2005 2006

INDIA 43,7 44,2 44,9
MALAYSIA 25,3 25,0 25,0
THAILAND 23,6 24,9 25,1
SINGAPURA 19,9 20,3 20,8
FILIPINA 11,7 11,3 11,0
VIETNAM 6,4 7,6 8,5
INDONESIA 5,8 6,8 7,7
 Konsumsi Susu Cair (Putih) & Bubuk
Tahun 2004 (juta liter)

NEGARA CAIR BUBUK

USA 22.350 58
INDIA 42.001 936
CINA 6.345 1951
THAILAND 514 69
VIETNAM 58 41
INDONESIA 62 283
 Konsumsi Susu Cair (Flavoured) & Bubuk
Tahun 2004 (juta liter)

NEGARA CAIR BUBUK

USA 1863 0
INDIA 273 1
CINA 996 2.022
THAILAND 375 176
VIETNAM 107 37
INDONESIA 157 192
 PERSEN KONSUMSI SUSU CAIR VS BUBUK

NEGARA PERSEN
USA 99.7
INDIA 97.4
CINA 80.8
THAILAND 75.5
VIETNAM 70.9
INDONESIA 11.7
 KONSUMSI GIZI HEWANI
(2002)
KOMODITAS PER PER PER
TH HARI MINGGU
SUSU 7.05 19 CC ½ GELAS
KG
TELUR 11 g 1 BUTIR
4.04
DAGING KG 16 g 2
POTONG
5.75
 KONSUMSI SUSU DI JAWA
(2002)
(KG/KAPITA/TH)
PROPINSI KONSUMSI SUSU
DKI JAKARTA 22.3
JABAR 7.0
JATIM 5.0
JATENG 3.6
DIY 1.7
INDONESIA 7.1

SEBARAN KONSUMSI SUSU : TIDAK MERATA

KONTRIBUSI 1 GELAS SUSU

GIZI JUMLAH
ENERGI (kkal) 153
PROTEIN (g) 8
LEMAK (g) 9
KALSIUM (mg) 358
 SUSU DAN KOLESTEROL

PANGAN KOLESTEROL (mg)

SUSU (1 gelas) 32
DAGING (1 ptg) 54
TELUR (1 butir) 252
 KANDUNGAN GIZI
PRODUK KALORI PROTEIN LEMAK
(kkal) (g) (g)
SUSU SAPI 61 3,2 3,5
YOGHURT 52 3,3 2,5
KEJU 326 22,8 20,3
ES KRIM 207 4,0 12,5
 MILK HABITS

MENGAPA BERHENTI MINUM SUSU ?

SUDAH BERUSIA 5 TH
PRIORITAS : ANAK YANG LEBIH MUDA

IRONIS : BAPAK MEROKOK !

UNICEF WEST JAVA (1998):
UANG ROKOK SEHARI = 1 L SUSU
= 3,5 btr TELUR
 LACTOSE INTOLERANCE
AKTIVITAS LAKTASE RENDAH:
- BS KULIT BERWARNA (60%)
- BS KULIT PUTIH (35%)

USIA BAYI & ANAK-ANAK LAKTASE TINGGI

USIA DEWASA LAKTASE TURUN
HASIL RISET : 1-2 CANGKIR SUSU TIDAK MASALAH
EKSPOSE SUSU SEJAK USIA DINI - DEWASA

PERLU
 OSTEOPOROSIS
PEAK BONE MASS USIA 25 TH

PERHATIKAN INTAKE Ca (MINUM SUSU)

KEHILANGAN Ca OSTEOPOROSIS
- MENOPAUSE
- KONSUMSI PROTEIN TINGGI
- GULA
- KOPI
- GARAM
- MEROKOK
 SUSU MEMBANTU TUBUH
ISTIRAHAT
• SUSU KAYA TRIPTOFAN
• MELATONIN JAM ALAMIAH BAGI TUBUH
* HASIL DARI KELENJAR PINEAL
* DIKELUARKAN MALAM HARI
* OPTIMAL BILA ADA TRIPTOFAN
* MEMBUAT TUBUH INGIN ISTIRAHAT
SUSU MALAM HARI TIDUR NYENYAK