رابطه‌ی بین میزان فعالیت بدنی و میزان کلسیم مصرفی روزانه با شاخص‌های منتخب تن سنجی و میزان تراکم استخوان در زنان یائسه مراجعه کننده به مرکز تراکم استخوان شهر رشت

Background and Objective: This study was carried out to investigate the relationship between the amount of physical activity and daily calcium intake with body mass index and the amount of bone density in post-menopausal female patients. Materials and Methods: This descriptive-cross sectional study was performed on 80 post-menopausal women with mean age of 58.13±7.59 years and BMI mean of 26.69±3.66. Participants' physical activity level was measured using Beck Physical Activity Questionnaire and daily calcium intake was measured using Food Frequency Questionnaire (FFQ) and three-day dietary recall. Bone densitometry method was used for determining bone density in the spinal and femur bone regions .To analyze the data, SPSS software was used. Results: Physical activity in 53.8% of the participants was in low level and calcium intake of 62.5% of them was lower than daily recommended level. Frequency distribution of bone density in spine region was 37.5% osteopenia and 26.2% osteoporosis while in femur bone it was 48.8% osteopenia and11.2% osteoporosis (P0.05). Women with a lower physical activity had 51.2% osteopenia and 46.5% osteoporosis in spine region along with 69.8% osteopenia and 20.9% osteoporosis in the femur bone region. Women whose daily calcium intake was lower than the recommended amount suffered from 38% osteoporosis and 36% osteopenia in spine region and 70% osteopenia and 14% osteoporosis in the femur region. Conclusion: In our study, most menopause women had osteopenia in both spinal and femur bone regions. Due to the significant effect of physical activity and daily calcium intake on bone density, an increase in daily calcium intake and encouragement of women to take part in physical activities are recommended. 1- Wickham CA, Walsh K, Cooper C, Barker DJ, Margetts BM, Morris J, et al. Dietary calcium, physical activity, and risk of hip fracture: a prospective study. BMJ (Clinical research ed). 1989 299(6704): 889-92. 2- Sandler RB, Cauley JA, Hom DL, Sashin D, Kriska AM. The effects of walking on the cross-sectional dimensions of the radius in postmenopausal women. Calcif Tissue Int. 1987 41(2): 65-9. 3- Heaney RP. Calcium, dairy products and osteoporosis. J Am Coll Nutr. 2000 19(2 Suppl): 83s-99s. 4- WHO. Prevention and management of osteoporosis. World Health Organ Tech Rep Ser. 2003 921: 1-164, back cover. 5- Jamshidian-Tehrani M, Kalantari N, Azadbakht L, et al. Osteoporosis risk factors in Tehrani women aged 40-60 years. Iranian Journal of Endocrinology and Metabolism. 2004 6(2): 139-45. 6- Maalouf G, Gannage-Yared MH, Ezzedine J, et al. Middle East and North Africa consensus on osteoporosis. J Musculoskelet Neuronal Interact. 2007 7(2): 131-43. 7- Bagheri P, Haghdoost AA, Dortaj Rabari E, et al. Ultra analysis of prevalence of osteoporosis in Iranian women "A systematic review and meta-analysis". Iranian Journal of Endocrinology and Metabolism. 2011 13(3): 315-25. 8- Kumar A, Mittal S, Orito S, Ishitani K, Ohta H. Impact of dietary intake, education, and physical activity on bone mineral density among North Indian women. J Bone Miner Metab. 2010 28(2): 192-201. 9- Carter ND, Kannus P, Khan KM. Exercise in the prevention of falls in older people: a systematic literature review examining the rationale and the evidence.Sports Med. 2001 31(6): 427-38. 10- Chang JT, Morton SC, Rubenstein LZ, et al. Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials. BMJ (Clinical research ed). 2004 328(7441): 680. 11- Layne JE, Nelson ME. The effects of progressive resistance training on bone density: a review. Med Sci Sports Exerc. 1999 31(1): 25-30. 12- Kemmler W, Engelke K, von Stengel S, Weineck J, Lauber D, Kalender WA. Long-term four-year exercise has a positive effect on menopausal risk factors: the Erlangen fitness osteoporosis prevention study. J Strength Cond Res. 2007 21(1): 232-9. 13- Brown JP, Josse RG. 2002 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada. CMAJ. 2002 167(10 Suppl): S1-34. 14- Barnard ND. The milk debate goes on and on and on! Pediatrics. 2003 112(2): 448. 15- Werner P. Self-reported prevalence and correlates of osteoporosis: results from a representative study in Israel. Arch Gerontol Geriatr. 2003 37(3): 277-92. 16- Weaver CM, Heaney RP. Dairy consumption and bone health. Am J Clin Nutr. 2001 73(3): 660. 17- Krahe C, Friedman R, Gross JL. Risk factors for decreased bone density in premenopausal women. Braz J Med Biol Res. 1997 30(9): 1061-6. 18- Rollins D, Imrhan V, Czajka-Narins DM, Nichols DL. Lower bone mass detected at femoral neck and lumbar spine in lower-weight vs normal-weight small-boned women. J Am Diet Asso. 2003 103(6): 742-4. 19- Henderson NK, White CP, Eisman JA. The roles of exercise and fall risk reduction in the prevention of osteoporosis. Endocrinol Metab Clin North Am. 1998 27(2): 369-87. 20- Bonaiuti D, Shea B, Iovine R, et al. Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst Rev. 2002(3): Cd000333. 21- Lanyon LE. Functional strain as a determinant for bone remodeling. Calcif Tissue Int. 1984 36 Suppl 1: S56-61. 22- Kalkwarf HJ, Specker BL, Bianchi DC, Ranz J, Ho M. The effect of calcium supplementation on bone density during lactation and after weaning. N Engl J Med. 1997 337(8): 523-8. 23- Kelley G. Aerobic exercise and lumbar spine bone mineral density in postmenopausal women: a meta-analysis. J Am Geriatr Soc. 1998 46(2): 143-52. 24- Kemmler W, Engelke K, Weineck J, Hensen J, Kalender WA. The Erlangen fitness osteoporosis prevention study: a controlled exercise trial in early postmenopausal women with low bone density-first-year results. Arch Phys Med Rehabil. 2003 84(5): 673-82. 25- Lau EM, Woo J, Leung PC, Swaminathan R, Leung D. The effects of calcium supplementation and exercise on bone density in elderly Chinese women. Osteoporos Int. 1992 2(4): 168-73. 26- Esfahani FH, Asghari G, Mirmiran P, Azizi F. Reproducibility and relative validity of food group intake in a food frequency questionnaire developed for the Tehran Lipid and Glucose Study. J Epidemiol. 2010 20(2): 150-8. 27- Ebrahim S, Thompson PW, Baskaran V, Evans K. Randomized placebo-controlled trial of brisk walking in the prevention of postmenopausal osteoporosis. Age Ageing. 1997 26(4): 253-60. 28- Kelley GA, Kelley KS. Exercise and bone mineral density at the femoral neck in postmenopausal women: a meta-analysis of controlled clinical trials with individual patient data. Am J Obstet Gynecol. 2006 194(3): 760-7. 29- Kelley GA, Kelley KS, Tran ZV. Exercise and lumbar spine bone mineral density in postmenopausal women: a meta-analysis of individual patient data. J Gerontol A Biol Sci Med Sci. 2002 57(9): M599-604. 30- Guglielmi G, De Serio A, Fusilli S, et al. Age-related changes assessed by peripheral QCT in healthy Italian women. Eur Radiol. 2000 10(4): 609-14. 31- Hamilton CJ, Swan VJ, Jamal SA. The effects of exercise and physical activity participation on bone mass and geometry in postmenopausal women: a systematic review of pQCT studies. Osteoporos Int. 2010 21(1): 11-23. 32- Martyn-St James M, Carroll S. High-intensity resistance training and postmenopausal bone loss: a meta-analysis. Osteoporos Int. 2006 17(8): 1225-40. 33- Martyn-St James M, Carroll S. Meta-analysis of walking for preservation of bone mineral density in postmenopausal women. Bone. 2008 43(3): 521-31. 34- Bonjour JP, Carrie AL, Ferrari S, et al. Calcium-enriched foods and bone mass growth in prepubertal girls: a randomized, double-blind, placebo-controlled trial. J Clin Invest. 1997 99(6): 1287-94. 35- New SA, Bolton-Smith C, Grubb DA, Reid DM. Nutritional influences on bone mineral density: a cross-sectional study in premenopausal women. Am J Clin Nutr. 1997 65(6): 1831-9. 36- Dawson-Hughes B, Dallal GE, Krall EA, Harris S, Sokoll LJ, Falconer G. Effect of vitamin D supplementation on wintertime and overall bone loss in healthy postmenopausal women. Ann Intern Med. 1991 115(7): 505-12. 37- Dawson-Hughes B, Harris SS, Krall EA, Dallal GE. Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. N Engl J Med. 1997 337(10): 670-6. 38- Cobayashi F, Lopes LA, Taddei JA. Bone mineral density in overweight and obese adolescents. J Pediatr (Rio J). 2005 81(4): 337-42.