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F. Other Organ Systems
F.7 Bone Health
Content
Areas
- Bone
mass
- Calcium
- Vitamin
D
- Phosphate
- Magnesium
- Dietary
supplements
- Osteoporosis
and osteomalacia
- Rickets
- Prevention
and lifestyle modification
- Physical
activity
- Medical
nutrition therapy
| After
training, the learner will be able to: |
| Knowledge
Objectives: Medical Students |
- List
at least three widely available dietary and supplemental
sources of calcium and vitamin D. Compare and contrast
the sources in terms of its bioavailability, convenience,
and cost.
- Describe
at least three lifestyle changes that can reduce the risk
of osteoporosis.
- Identify
the RDI for calcium and Vitamin D, the AI for calcium, the
RDA for Vitamin D, and describe how an individual can meet
these recommendations according to the USDA food guide pyramid,
and the Dietary Guidelines for Americans.
- Identify
at least four classes of individuals at risk for developing
osteoporosis, and compare and contrast the rationales used
to explain the relationship of each to osteoporosis.
- Explain
the nutritional basis of the homeostatic mechanisms that
maintain adequate bone mass, and describe three common pathophysiological
conditions that reduce bone mass.
- List
at least three medical conditions and at least three medications
that typically result in secondary osteoporosis.
- Identify
at least three good sources of dietary Vitamin D, and evaluate
the limitations of sun exposure for meeting the Vitamin
D requirement.
- Explain
how physiological aging typically affects the intake and
metabolism of nutrients related to bone health.
- Identify
at least three sources of calcium and Vitamin D appropriate
for a patient with lactose intolerance.
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| Knowledge
Objectives: Residents |
- Identify
at least four classes of individuals at risk for developing
osteoporosis, and compare and contrast the rationales used
to explain the relationship of each to osteoporosis.
- List
at least two physical diagnostic tests used to identify
osteoporosis.
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| Knowledge
Objectives: Specialists |
- Identify
at least four examples of dietary constituents that, when
in excess, may increase the need for calcium.
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| Practice
Behavior Skill: Medical Students |
- Effectively
counsel pre-and post-menopausal women to maintain a level
of calcium in the diet adequate to reduce their risk of
osteoporosis.
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| Practice
Behavior Skill: Residents |
- Effectively
counsel patients of all ages to make informed nutritional
decisions that maintain current bone health, establishing
appropriate dietary and behavioral goals and adopting strategies
to prevent future osteoporosis.
- During
a physical examination, recognize common physical manifestations
of late stage osteoporosis.
- Using
the American College of Sports Medicine and NIH guidelines,
effectively counsel a healthy adolescent or adult patient
to adopt an appropriate exercise regimen to reduce the risk
of osteoporosis, especially in females.
- Conduct
an appropriate physical examination of a patient at risk
of osteoporosis, including an assessment of bone mass.
- Seek
out and accurately interpret information from a wide variety
of nutrition-related medical and lay literature, and apply
that knowledge appropriately to maintain the bone health
of all patients.
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| Practice
Behavior Skill: Specialists |
- Identify
and evaluate the dietary sources of calcium in a patient’s
diet and evaluate the sufficiency of dietary calcium.
- Given
a set of detailed medical and dietary histories, identify
those patients that would benefit from calcium supplementation,
and design an appropriate medical nutrition therapy plan
for each.
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| Attitude
Objectives: All Learners |
- Identify
at least one psychosocial factor that commonly affects the
intake of nutrients related to bone health at each stage
of the life cycle.
- Demonstrate
a commitment to encourage patients of all ages, especially
adolescents, to maintain a proper diet adequate to sustain
normal bone growth and development and prevent bone loss.
- Identify
the toxic dose of vitamin D and describe the biological
consequences of
a vitamin D overdose.
- Demonstrate
a commitment to promote sound nutritional decision-making
and appropriate levels of physical activity for all patients
regardless of health status.
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