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

[摘要] INTRODUCTION: Postmenopausal osteoporosis is associated with significant morbidity,mortality, reduction in quality of life, and increasing health care costsOBJECTIVE: The study objective was to identify the risk factors associated with theoccurrence of osteoporosis, in Kenyan Asian women seen at the Aga Khan UniversityHospital, Nairobi, Kenya since there is no literature on the prevalence of all these riskfactors for osteoporosis in a similar middle aged population sample of Kenyan Asianwomen.METHOD: The study was of a retrospective design and used recall as a basis of datacollection. A socio-demographic questionnaire was completed and anthropometricmeasurements, of height, weight, waist and hip circumference taken. Bone mineraldensity (BMD) had been measured previously using Quantitative ComputedTomography (QCT) at the lumbar spine, T11 to L4. Nutrient intake was assessed usinga validated food frequency questionnaire (FFQ) and physical activity was determinedusing the Epic Physical Activity Questionnaire 2 (EPAQ2). BMD scans had been doneon all study participants from January 2004 to December 2004 and the subjects wereaware of their bone status.RESULTS: Risk factors that were identified by being associated with the development ofosteoporosis 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 prescriptiondrugs. Seventy two percent of the study sample was using prescription drugs and theeffect on bone mass was most likely detrimental. Anti-hypertensive (p=0.002), nonsteroidal anti inflammatory drugs (p=0.003) and anti-diabetic drugs (p=0.033) had asignificant negative association with bone health. Energy, protein, fat and carbohydrateintake in all the groups was above the EAR and comparatively similar. The intake of allthe micronutrients in the study group was above the DRI. There were no statisticalsignificant differences in most of the trace element intake between the two groups, apartfrom iodine, biotin and manganese. No dietary risk factors were identified whichimpacted 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 graduatesand had a relatively better diet.CONCLUSION: As Kenyan Asian women age they experience the menopausaltransition and the risk of developing osteoporosis increases. No nutritional factors wereidentified 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 associatedwith 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 ofosteoporosis.

[发布机构] Stellenbosch University