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      Factores de riesgo relacionados con los hábitos de vida en pacientes con patología osteomuscular Translated title: Risk factors related with lifestyle in patients with musculoskeletal disorders

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          Abstract

          Resumen Introducción: las enfermedades osteomusculares (EOM) engloban una serie de patologías discapacitantes con alta incidencia y prevalencia, representando un alto costo económico y social. Es fundamental su prevención, por lo que es de gran interés determinar factores de riesgo modificables, como son los relacionados con los hábitos de vida. Métodos: se realizó un estudio descriptivo y trasversal en 91 pacientes seleccionados mediante muestreo aleatorio sistemático y que fueron distribuidos en tres grupos experimentales según la causa y evolución de su EOM (cervicalgia, gonalgia y lumbalgia). Se realizó una medición biométrica, evaluación nutricional, de la actividad física y laboral, del balance muscular y del estado oxidativo. Resultados: el sexo femenino es el más afectado por la presencia de lesiones osteomusculares como cervicalgia y lumbalgia. En conjunto, la mayor parte de los pacientes (67,4%) tiene normopeso, el 24,41% sobrepeso y tan solo un 8,1% obesidad tipo I. Los pacientes con cervicalgia son el grupo que realiza menos actividad física y peor balance muscular presentan. El estrés oxidativo fue superior en pacientes con gonalgia que en los otros grupos. Con respecto a la dieta consumida, se observan diferencias entre grupos experimentales en el contenido mineral (Zn, Mn, Se y I) y vitamínico (folato y ácido ascórbico). Conclusiones: la ingesta de colecalciferol y vitaminas A y D es inferior a las recomendadas en todos los sujetos, lo que favorece la dolencia muscular. La ingesta de folato está por debajo de las recomendaciones, incidiendo en la mayor susceptibilidad al estrés oxidativo. La obesidad y estrés oxidativo se relacionan con la prevalencia de los diferentes tipos de EOM estudiados.

          Translated abstract

          Abstract Background: Musculoskeletal disorders (MSDs) encompass a series of debilitating diseases with high incidence and prevalence, representing a high economic and social cost. Prevention is crucial, so is of great interest to determine modifiable risk factors, such as those related to lifestyle. Methods: A descriptive cross-sectional study was performed in 91 patients selected by systematic random sampling and were divided into three experimental groups according to the cause and evolution of its MSD (neck pain, knee pain and back pain). A biometric measurement, nutritional assessment, physical and occupational activity, muscle balance and oxidative status was performed. Results: The female is the most affected gender by the presence of musculoskeletal injuries such as neck pain and back pain. Overall, most patients (67.4%) had normal weight, overweight 24.41% and only 8.1% were obese type I. Patients with neck pain are the group doing less physical activity and worse muscular balance present. Oxidative stress was higher in patients with knee pain than in the other groups. Regarding the consumed diet, differences between experimental groups on the mineral content (Zn, Mn, Se and I) and vitamins (folate and ascorbic acid) are observed. Conclusions: Cholecalciferol intake and vitamins A and D is less than those recommended in all subjects, which promotes muscle disease. Folate intake was below recommendations, increasing susceptibility to oxidative stress. Obesity and oxidative stress related to the prevalence of the different types of MSDs studied.

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          Effects of obesity on bone metabolism

          Jay Cao (2011)
          Obesity is traditionally viewed to be beneficial to bone health because of well-established positive effect of mechanical loading conferred by body weight on bone formation, despite being a risk factor for many other chronic health disorders. Although body mass has a positive effect on bone formation, whether the mass derived from an obesity condition or excessive fat accumulation is beneficial to bone remains controversial. The underline pathophysiological relationship between obesity and bone is complex and continues to be an active research area. Recent data from epidemiological and animal studies strongly support that fat accumulation is detrimental to bone mass. To our knowledge, obesity possibly affects bone metabolism through several mechanisms. Because both adipocytes and osteoblasts are derived from a common multipotential mesenchymal stem cell, obesity may increase adipocyte differentiation and fat accumulation while decrease osteoblast differentiation and bone formation. Obesity is associated with chronic inflammation. The increased circulating and tissue proinflammatory cytokines in obesity may promote osteoclast activity and bone resorption through modifying the receptor activator of NF-κB (RANK)/RANK ligand/osteoprotegerin pathway. Furthermore, the excessive secretion of leptin and/or decreased production of adiponectin by adipocytes in obesity may either directly affect bone formation or indirectly affect bone resorption through up-regulated proinflammatory cytokine production. Finally, high-fat intake may interfere with intestinal calcium absorption and therefore decrease calcium availability for bone formation. Unraveling the relationship between fat and bone metabolism at molecular level may help us to develop therapeutic agents to prevent or treat both obesity and osteoporosis. Obesity, defined as having a body mass index ≥ 30 kg/m2, is a condition in which excessive body fat accumulates to a degree that adversely affects health [1]. The rates of obesity rates have doubled since 1980 [2] and as of 2007, 33% of men and 35% of women in the US are obese [3]. Obesity is positively associated to many chronic disorders such as hypertension, dyslipidemia, type 2 diabetes mellitus, coronary heart disease, and certain cancers [4-6]. It is estimated that the direct medical cost associated with obesity in the United States is ~$100 billion per year [7]. Bone mass and strength decrease during adulthood, especially in women after menopause [8]. These changes can culminate in osteoporosis, a disease characterized by low bone mass and microarchitectural deterioration resulting in increased bone fracture risk. It is estimated that there are about 10 million Americans over the age of 50 who have osteoporosis while another 34 million people are at risk of developing the disease [9]. In 2001, osteoporosis alone accounted for some $17 billion in direct annual healthcare expenditure. Several lines of evidence suggest that obesity and bone metabolism are interrelated. First, both osteoblasts (bone forming cells) and adipocytes (energy storing cells) are derived from a common mesenchymal stem cell [10] and agents inhibiting adipogenesis stimulated osteoblast differentiation [11-13] and vice versa, those inhibiting osteoblastogenesis increased adipogenesis [14]. Second, decreased bone marrow osteoblastogenesis with aging is usually accompanied with increased marrow adipogenesis [15,16]. Third, chronic use of steroid hormone, such as glucocorticoid, results in obesity accompanied by rapid bone loss [17,18]. Fourth, both obesity and osteoporosis are associated with elevated oxidative stress and increased production of proinflammatory cytokines [19,20]. At present, the mechanisms for the effects of obesity on bone metabolism are not well defined and will be the focus of this review.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                nh
                Nutrición Hospitalaria
                Nutr. Hosp.
                Grupo Arán (Madrid, Madrid, Spain )
                0212-1611
                1699-5198
                April 2017
                : 34
                : 2
                : 444-453
                Affiliations
                [1] Granada Andalucía orgnameUniversidad de Granada orgdiv1Departamento de Fisiología e Instituto de Nutrición y Tecnología de los Alimentos José Mataix Spain
                [2] Granada orgnameCentro Andaluz de Medicina del Deporte España
                Article
                S0212-16112017000200444
                10.20960/nh.237
                8e7792b0-a051-4e4d-8114-5f50d7dfbae1

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 02 October 2016
                : 23 June 2016
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 69, Pages: 10
                Product

                SciELO Spain


                Musculoskeletal disease (MSD),Nutritional counseling,Micronutrients,Oxidative stress.,Enfermedad osteomuscular (EOM),Consejo nutricional,Micronutrientes,Estrés oxidativo.

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