1. OSTEOMALACIAAND
OSTEOARTHRITIS
CLINICAL NUTRITION II
SUGANESWARAN S

2. OSTEOMALACIA
• occurs due to the deficiencies of vit D, calcium, and phosphorus.
• which are essential for the development and maintenance of strong bones.
• primary affects childrens.
• characterised by softening of the bones, leading to pain and muscle
weakness.
• 50% of children in India are estimated to be deficient in vitamin D, WHO
2020.

3. ETIOLOGY
4 mechanisms involved in the osteomalacia development:
• Vitamin D deficiency
• Calcium deficiency
• Phosphate deficiency
• Inhibition of mineralization caused by the toxic effects of various drugs.

4. SIGNS AND SYMPTOMS
• Muscle weakness, particularly in the legs.
• Bone pain and tenderness, Particularly in the: Pelvis, spine, and legs.
• Difficulty walking and standing.
• Decreased bone density, leading to an increased risk of fractures.
• Muscle cramps and twitching.

5. DIETARY MANAGEMENT
• Vit D- essential for the absorption of Calcium, phosphorus- fatty
fish(salmon, and tuna), egg yolks, fortified milk and cereals.
• Calcium- necessary for bone mineralization and strength- dairy products,
green leafy vegetables.
• Phosphorus- essential for bone mineralization- dairy products, meat, fish,
poultry, whole grains and nuts.
• Magnesium- absorption of calcium and phosphorus- green leafy
vegetables, nuts, seeds, whole grains and beans.
• Vit K- essential for bone health- helps production of bone proteins- green
leafy vegetables, sprouts and etc.

7. OSTEOARTHRITIS
• degenerative joint disease that can range in severity from mild to severe.
• major public health problem in India.
• According to a study published in the Indian Journal of orthopaedics, OA
is the most common form of arthritis in India, affecting more than 10%-
20% of adults over the age of 45 years.
• Risk factors include obesity, joint injury, and genetics. (WHO, 2020)

9. SIGNS AND SYMPTOMS
• Pain -aching or stiffness in the affected joint-worse often periods of
inactivity, such as sitting or lying down, or after physical activity.
• Stiffness-feel stiff-morning or after periods of inactivity.
• Swelling-swollen and tender to the touch.
• Decreased range of motion-over time
• Cracking of popping sounds- crunching or popping sound
• Bone spurs-Bony growths may develop around the affected joint, leading
to further pain and discomfort

10. MANAGEMENT
• Controlling body weight
• high intake of antioxidants specially vitamin C- reduces the progression of
osteoarthritis
• Taking adequate rest
• Avoiding joint overuse or repetitive injury
• Exercise : strengthening of supporting muscles around joints.
• Swimming- aerobic exercise for osteoarthritis of hip or knees.
• Yoga and other alternative therapies have been scientifically documented
to complement the use of drugs.(yogic protocol for Arthritis).

12. REFERENCE
• World Health organisation (2020). Vitamin D Deficiency
• Shetty, A. & Raghuram, N. (2017). Prevalence of osteoarthritis in India: A systematic
Review, Journal of clinical orthopaedics and Trauma. 8(2), 104-110.
• National health survey (NHS),2022, India, rickets, osteomalacia and osteoarthritis.
• American College of Rheumatology (2020), osteoarthritis.
• National osteoporosis Foundation (2021). Vitamin D.
• Salvatore Minisola, Luciano Colangelo, Jeccia pepe, Daniele Diacinte, Christiana
ciprini, and Sudhakar D Rao, Osteomalacia and Vitamin D Status: A clinical update,
2020, doi: 10.1002. JBMR Plus. 2021 Jan Published online 2020. Dec 21.
• Arthritis Foundation of India, 2014, arthfound.org/arthritis

13. THANK
YOU!
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