ABSTRACT
Musculoskeletal diseases are common chronic disorders that affect children and adults in North America. This chapter reviews the common metabolic bone and joint disorders with emphasis on the nutritional aspects of their causes and managements. The predisposition to osteoporosis by virtue of low calcium intake is aggravated by the increase in urinary calcium losses in postmenopausal women. The higher serum parathyroid hormone levels found in older adults, by increasing plasma calcium and therefore the amount of calcium filtered, may contribute to the increase in urinary calcium excretion. Dietary protein may influence urine calcium excretion, and high animal protein intake from meat, fish, and poultry contributes to increased urine calcium excretion and decreased calcium balance. Animal proteins are rich in the sulfur-containing amino acid methionine. Low bone mass, osteoporosis, and fractures are common complications of chronic glucocorticoid therapy. The adverse effects of glucocorticoids on bone are dose related.
