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Nutrisi Pada Penyakit

Muskuloskeletal

Sumarni
Ilmu Kesehatan Masyarakat
FKIK - Untad
Tujuan Instruksional Umum
Mahasiswa mampu menjelaskan peran nutrisi
pada proses penyakit sistem muskuloskeletal
Mahasiswa mampu menjelaskan prinsip terapi
nutrisi pada penyakit sistem muskuloskeletal
Faktor yang meningkatkan absorpsi
kalsium
Kebutuhan meningkat, cth: masa
pertumbuhan,kehamilan
Defisensi kalsium
Vitamin D
Asam klorida di lambung
Laktosa
lemak
Faktor yang menghambat absorpsi
kalsium
Defisiensi vitamin D
Asam oksalat
Asam fitat
Serat
Rasio Ca : P = 1:1 , >>P PTH
Protein Efek anabolik & efek katabolik. Efek
anabolik 1g/KgBB kadar PTH normal.
Asupan ekstrim kurang/lebih katabolik
Mg 50% kadarnya dalam tubuh disimpan di
tulang, namun perannya belum diketahui
pasti. Efek diet low Mg tdk berefek jelas
pada tulang.
Vitamin K dibutuhkan untuk proses
posttranslational carboxylation (maturasi)
Osteocalcin. Penting suplementasi pada low
vit.k, menopause.
Vit A dibutuhkan pertumbuhan tulang, namun
>> berisiko hip fraktur dari suatu studi
epidemiologik.
Trace element
Boron to be used by osteoblasts for bone
formation,but little information exists on whether
boron is absolutely require.
Copperneeded for an enzyme that increases
the crosslinking of collagen and elastin molecules,
and it may have roles in other enzymes of bone
cells
Fluoride hydroxyapatite crystals of bone,
narrow limits of safety (< 2 ppm) increasing
the hardness of bone mineral
Iron : as a catalytic cofactor for the vitamin C-
dependent hydroxylations of proline and
lysine in collagen maturation. Iron also has
other roles in osteoblasts and osteoclasts in
mitochondrial oxidative-phosphorylation
Manganese : biosynthesis of
mucopolysaccharides in bone matrix
formation
Zinc is essential for several critical enzymes in
osteoblasts that are essential for collagen
sinthesis and other products. In addition, an
important enzyme in osteoblasts, alkaline
phosphatase, requires zinc for its activity.
Osteoporosis

Tulang
Kerusakan rapuh
mikroarsitek
tur/ >> tulang
penyusun belakang,
panggul dan
Pengurangan tulang
pergelangan
massa tulang
tangan.
Faktor risiko

Tidak dapat dimodifikasi Dapat


dimodifikasi
Ras, Jenis Peny.tertentu (DM Merokok, alkohol,
kelamin, usia, tipe 1, RA, kurang olahraga,
menopause, BB menopause dini), diet rendah
kurang, obat-obatan (obat sumber Ca dan
riw.keluarga kanker, antasid,dll) Vit.D
Gout
Gout disorder of purine metabolism in
which abnormally high levels of uric acid
accumulate in the blood (hlperuricemia)
sodium urates are formed and deposited as
tophi in the small joints and surrounding
tissues. Renal diseases is common, and uric
acid nephrolithiasis can occur.
NHANES higher levels of meat and seafood
consumption were associated with increased
serum uric acid levels in adults, but total
protein intake was not (Choi et a1.,2005a).
A moderate intake of purine-rich vegetables is
not associated with an increased risk of gout
(Choi et al., 2004).
Low-fat dairy products, ascorbic acid appear
to be protective (Lee et al., 2006)
Food grouped according to Purine content