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INTRODUCTION
Aging is unavoidable by any human. As one age, the individual will experience a gradual loss of bone mass thereby resulting in bone-associated diseases, such as osteopenia and osteoporosis, regarded as public health problems (Bischoff-Ferrari, et al., 2016). Other associated effects include frequent falling and experiencing a fragile fracture. Due to loss of bone mass, it has been reported that women that are of age 50 years and above with osteoporosis have cumulative lifetime fracture risk above 60% (Chen et al., 2014). The old people in nursing homes have an annual falling risk above 50% (Chen et al., 2014). They complain of serious hip, humerus, wrist, and spine pains. These areas are where fractures usually occur. Since the above-mentioned issues have become a serious burden to public health, and in as much as every individual must pass through this stage in life, adequate preventive measures and management of bone diseases are seriously required. To prevent fracture and osteoporosis, one must ensure to eat good foods, engage in a healthy lifestyle, and regular exercise (Bischoff-Ferrari, et al., 2016; Chen et al., 2014).
Calcium and Vitamin D are good supplements for improving bone health. As for calcium, it is one of the major constituents of bones. Therefore, an increase in calcium supplementation or the consumption of calcium-rich foods is very beneficial to build bone mass thereby reducing osteoporosis risks (Bolland et al., 2015). On the other hand, vitamin D supplementation is very useful in maintaining good bone mass structure and bone mineral density. Vitamin D plays more role as a hormone than vitamins, and it is mainly produced in the skin. We produce vitamin D when the skin is exposed to ultraviolet rays, and from the foods, we eat, which get absorbed in from the diet (inactive). It is responsible for regulating calcium and phosphorus level in the body when it becomes activated. Such actions help in bone growth and development and also balance bone resorption and deposition (Chen et al., 2014).
Vitamin D deficiency has been associated with several bone diseases in children and adults. For children, it has been attributed to resulting in rickets in both infants and children (Chang & Lee, 2019). On the other hand, deficiency of vitamins in adults has been attributed to osteomalacia and osteoporosis. It has also been attributed to frequent falls and fractures experienced by the aged ones (Chang & Lee, 2019).
Bone mineral density starts from pregnancy and is likely assumed to climax at the adolescent stage (Chang & Lee, 2019). As for bone mass, it increases up to 40 times from birth to adulthood (Chang & Lee, 2019). Hence the reason a public health report stated that supplementation (calcium) of healthy children does not significantly lower the incidence level of being fractured. It was concluded that eating a balanced diet was recommended over routine supplementation calcium. But, since there is a limited source of vitamin D supplementation of vitamin D is essential (Chang & Lee, 2019).
Several studies have shown that calcium plays an important role in bone mineral density. Chiodini & Bolland highlighted a randomized control trial on 220 Chinese adolescents, after taking some levels of calcium supplement for two years, those that took higher calcium supplements had an increased body mass (Chiodini & Bolland, 2018). In another study, it was identified that women who took less milk during their childhood and adulthood are at increased risk of being fractured (Chiodini & Bolland, 2018). Therefore, it is evident to say that calcium supplementation is important in children and adolescents to reduce the risks of bone diseases. Chen et al. concluded that calcium and vitamin D are very important for skeletal health. They refuted the adverse effect assumed that increase in supplementing calcium and vitamin D will lead to myocardial infarction or other cardiovascular diseases (Chen et al., 2014). A more recent study stated that calcium and vitamin D are very useful in preventing, treating, and management of postmenopausal women (Argyrou et al., 2020).
Other studies reported that calcium had no significant role in bone mineral deposition and that vitamin D does not have any preventive effect on fractures (Tai et al., 2015; Hill & Aspray, 2017). In a review conducted by Yao et al., he summarized by saying that bias was found in the studies that reported improved bone mineral density and improved bone mass after calculating the confidence interval level used in those studies (Yao et al., 2019). Reid and Bolland condemned the widespread use of calcium supplements and vitamin D among healthy individuals and suggested that it may cause harm to them (Reid & Bolland, 2020). Therefore, it is necessary to investigate the effect of calcium and vitamin D on bone health, which will be considered in this study.
AIM
SPECIFIC OBJECTIVES
RESEARCH PROBLEM
Aging is part of human growth and can never be escaped unless the individual dies prematurely. Aging individuals will experience a gradual loss of bone mass results thereby resulting in bone associated diseases, such as osteopenia and osteoporosis, regarded as public health problems (Bischoff-Ferrari, et al., 2016). Other associated effects include frequent falling and experiencing fragile fractures. Due to loss of bone mass, it has been reported that women that are of age 50 years and above with osteoporosis have cumulative lifetime fracture risk above 60% (Chen et al., 2014). The old people in nursing homes have an annual falling risk above 50% (Chen et al., 2014). Calcium and vitamin have been known to protect and build up bones. Hence the reason for this research is to determine the effect of calcium and vitamin D on bone health.
RESEARCH QUESTIONS
SIGNIFICANCE OF THE STUDY
There are lots of controversy over the efficacy of calcium and vitamin D in the prevention and management of fractures. Some studies agree that calcium and vitamin D has a protective effect (Argyrou et al., 2020; Bischoff-Ferrari, et al., 2016; Chen et al., 2014). However, other studies disagree (Yao et al., 2019; Hill & Aspray, 2017; Tai et al., 2015). Therefore, this study will investigate the effect of calcium and vitamin D on bone health.
METHODOLOGY
ANALYSIS
The following will be used for analysis in this review, they are; cluster analysis (CA) and/or factor analysis (FA), and/or principal component analysis (PCA). The results will be presented as odds ratios (OR).
RISK ASSESSMENT
The risk assessment conducted for this project is provided in the table below:
Table 1: Risk assessment
Risk
Impact
Mitigation Plan
Inability to meet the deadline
Low
Get an extension from the supervisor in due time
Inability to get required process inputs, skill, and manpower
Moderate
Refer to municipalities and research institutes for help
Inability to properly develop the process set up
High
Refer to your supervisor for help
Insufficient data
Refer to journals and textbooks for help
SCHEDULE
Table 2: Project Plan
Task Name
Start Date
End Date
Duration (Days)
Initial Research
15/01/2022
29/01/2022
14
Proposal
06/02/2022
21
Introduction Chapter
18/03/2022
23/03/2022
5
Literature Review Chapter
20/04/2022
24
Methodology Chapter
02/05/2022
12
Presentation 1
02/07/2022
10/07/2022
8
Analysis
24/07/2022
Evaluation of Gotten Results
01/08/2022
7
Discussion Chapter
11/08/2022
10
Evaluation Chapter
16/08/2022
Conclusion Chapter
18/08/2022
2
Project Management Chapter
20/08/2022
Abstract and Report compilation
22/08/2022
Report Proofreading
01/09/2022
Presentation 2
11/09/2022
REFERENCES
Argyrou, C., Karlafti, E., Lampropoulou-Adamidou, K., Tournis, S., Makris, K., Trovas, G., Dontas, I., & Ioannis K. T. (2020). Effect of calcium and vitamin D supplementation with and without collagen peptides on bone turnover in postmenopausal women with osteopenia. In Article in Journal of Musculoskeletal & Neuronal Interactions. https://www.researchgate.net/publication/339769487
Bischoff-Ferrari, H.A., Dawson-Hughes, B., Orav, E.J. (2016) Monthly high-dose vitamin D treatment for the prevention of functional decline: A randomized clinical trial. JAMA Intern Med 176(2):175–83.
Bolland, M.J., Leung, W., and Tai, V. (2015). Calcium intake and risk of fracture: Systematic review. BMJ 351: h4580.
Chang, S. W., & Lee, H. C. (2019). Vitamin D and health - The missing vitamin in humans. In Pediatrics and Neonatology (Vol. 60, Issue 3, pp. 237–244). Elsevier (Singapore) Pte Ltd. https://doi.org/10.1016/j.pedneo.2019.04.007
Chen, L. R., Wen, Y. T., Kuo, C. L., & Chen, K. H. (2014). Calcium and vitamin D supplementation on bone health: Current evidence and recommendations. In International Journal of Gerontology (Vol. 8, Issue 4, pp. 183–188). Elsevier (Singapore) Pte Ltd. https://doi.org/10.1016/j.ijge.2014.06.001
Chiodini, I., & Bolland, M. J. (2018). Calcium supplementation in osteoporosis: Useful or harmful? In European Journal of Endocrinology (Vol. 178, Issue 4, pp. D13–D25). BioScientifica Ltd. https://doi.org/10.1530/EJE-18-0113
Hill, T. R., & Aspray, T. J. (2017). The role of vitamin D in maintaining bone health in older people. In Therapeutic Advances in Musculoskeletal Disease (Vol. 9, Issue 4, pp. 89–95). SAGE Publications Ltd. https://doi.org/10.1177/1759720X17692502
Reid, I. R., & Bolland, M. J. (2020). Calcium and/or vitamin D supplementation for the prevention of fragility fractures: Who needs it? In Nutrients (Vol. 12, Issue 4). MDPI AG. https://doi.org/10.3390/nu12041011
Tai, V., Leung, W., Grey, A., Reid, I. R., & Bolland, M. J. (2015). Calcium intake and bone mineral density: Systematic review and meta-analysis. In BMJ (Online) (Vol. 351). BMJ Publishing Group. https://doi.org/10.1136/bmj.h4183
Yao, P., Bennett, D., Mafham, M., Lin, X., Chen, Z., Armitage, J., & Clarke, R. (2019). Vitamin D and Calcium for the Prevention of Fracture: A Systematic Review and Meta-analysis. In JAMA network open (Vol. 2, Issue 12, p. e1917789). NLM (Medline). https://doi.org/10.1001/jamanetworkopen.2019.17789
Last updated: Jan 21, 2022 04:49 PM
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