Identifying nutritional and life-style risk factors associated with the development of osteoporosis in women of Asian origin at the Aga Khan University Hospital, Nairobi, Kenya
Date
2006-12
Authors
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Journal ISSN
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Publisher
Stellenbosch : University of Stellenbosch
Abstract
INTRODUCTION: Postmenopausal osteoporosis is associated with significant morbidity,
mortality, reduction in quality of life, and increasing health care costs
OBJECTIVE: The study objective was to identify the risk factors associated with the
occurrence of osteoporosis, in Kenyan Asian women seen at the Aga Khan University
Hospital, Nairobi, Kenya since there is no literature on the prevalence of all these risk
factors for osteoporosis in a similar middle aged population sample of Kenyan Asian
women.
METHOD: The study was of a retrospective design and used recall as a basis of data
collection. A socio-demographic questionnaire was completed and anthropometric
measurements, of height, weight, waist and hip circumference taken. Bone mineral
density (BMD) had been measured previously using Quantitative Computed
Tomography (QCT) at the lumbar spine, T11 to L4. Nutrient intake was assessed using
a validated food frequency questionnaire (FFQ) and physical activity was determined
using the Epic Physical Activity Questionnaire 2 (EPAQ2). BMD scans had been done
on all study participants from January 2004 to December 2004 and the subjects were
aware of their bone status.
RESULTS: Risk factors that were identified by being associated with the development of
osteoporosis in Asian women were age (p<0.001), waist size (p<0.001), hip size
(p<0.001) and BMI (p<0.001), low physical activity (p=0.001) and use of prescription
drugs. Seventy two percent of the study sample was using prescription drugs and the
effect on bone mass was most likely detrimental. Anti-hypertensive (p=0.002), non
steroidal anti inflammatory drugs (p=0.003) and anti-diabetic drugs (p=0.033) had a
significant negative association with bone health. Energy, protein, fat and carbohydrate
intake in all the groups was above the EAR and comparatively similar. The intake of all
the micronutrients in the study group was above the DRI. There were no statistical
significant differences in most of the trace element intake between the two groups, apart
from iodine, biotin and manganese. No dietary risk factors were identified which
impacted adversely on bone health in this group. The impact of gynaecologic history
(parity, oral contraceptive use, age of menarche) on BMD was uncertain. The educational level of the study sample was high as 50% of the subjects were graduates
and had a relatively better diet.
CONCLUSION: As Kenyan Asian women age they experience the menopausal
transition and the risk of developing osteoporosis increases. No nutritional factors were
identified that were adversely associated with BMD. Low level of physical activity,
prescription drugs for chronic diseases like hypertension, asthma, diabetes and arthritis,
age, weight and body mass index were identified and found to be adversely associated
with bone mineral density. Early detection, and implementation of patient education,
physical activity, and a diet rich in all nutrients, will help to slow down the progression of
osteoporosis.
Description
Thesis (MNutr (Interdisciplinary Health Sciences. Human Nutrition))--University of Stellenbosch, 2006.
Keywords
Osteoporosis -- Nutritional aspects -- Kenya -- Nairobi, Dissertations -- Nutrition, Theses -- Nutrition