BACKGROUND
CHAPTER I. LITERATURE REVIEW
1.1. Bone mass, consequences of adult bone loss and interventions to increase bone density
Bone mass is the mass of minerals in the bones, an important factor affecting bone strength and strength. Peak Bone Mass (PBM) is the bone mass achieved at skeletal maturity.
1.1.1. Consequences of reduced bone density in adults
Decreasing bone density (BMD) causes many consequences, the disease usually progresses slowly, leading to osteoporosis at some point. The early stages of bone loss usually have no obvious bone manifestations but will manifest in areas where bone supports the bone, with common problems such as decreased flexibility compared to younger age, cervical spondylosis. and lumbar spine, which can lead to dangerous complications such as herniated disc, sciatica, and paralysis of the extremities. But when the BMD decreases by more than 30%, then osteoporosis has occurred and will cause symptoms such as: Pain, kyphosis, insomnia, depression, fracture. Pain is usually localized in the lumbar region or cervical vertebrae, accompanied by numbness and tingling. Pain may also follow the path of the nerve, spreading down the buttocks, even down to the feet.
The main consequence of osteoporosis is fractures, fractures can occur with minor injuries, even fractures themselves, often in load-bearing positions of the body such as the lumbar spine, femoral neck. In the United States each year, up to two million fractures are caused by osteoporosis, causing 432,000 hospitalizations, nearly 2.5 million visits to medical facilities, and about 180,000 hospitalizations.
Many cases of thoracic fractures can cause restrictive lung disease, lumbar spine fractures can change abdominal anatomy leading to constipation, abdominal pain, abdominal distention, decreased appetite and satiety. Soon. Spinal fractures can lead to pain, reduced height, and kyphosis, which in turn can lead to consequences such as difficulties in performing daily activities and low self-esteem with change. body shape, severe kyphosis also gives rise to diseases related to the respiratory system and digestive disorders. Hip fractures caused by osteoporosis leave the most severe consequences, which can lead to disability, dependence, and even death. Fractures in any location can cause psychosocial symptoms, especially depression and low self-esteem, this is because the patient has to endure pain, must limit movement. influence and influence changes in living habits.
1.1.2. Interventions to increase peak bone mass
Supplement calcium - vitamin D
In the world, there had been many studies proving that increasing dietary calcium increases bone mass. In 2005 Velimir et al., studied for 4 years on 354 girls 7-14 years old. Calcium supplementation (670 mg/day) significantly affects bone growth in pubertal girls. Calcium requirements for growth are related to bone size. These results could be important for both the early prevention of osteoporosis and the prevention of fractures during growth spurts.
The study lasted 15.5 months, on 144 female students 16-18 years old, with an average dietary calcium intake of 938 ± 411 mg/day, Stear S et al showed that calcium carbonate supplementation (1000 mg/day) and exercise (45 minutes/day, 3 times/week) to improve bone health. This effect can be long-lasting by increasing peak bone density and reducing fracture risk.
Rozen GS et al., 2003 had the results of a 12-month randomized double-blind study on 100 female children aged 14-15 years with low dietary calcium < 800 mg/day. The intervention group (49 subjects) was given 1000mg calcium supplement. Bone density was measured by DEXA method at baseline, after 6 months and 12 months of intervention. The study results also showed that bone density also improved well in the supplement group compared to the control group.
CHAPTER II.
RESEARCH SUBJECTS AND METHODS
2.1. Research subjects
2.2. Research location
2.3. Research time
2.4. Research Methods
2.4.1. Cross-sectional descriptive study
Calculate: n=315 objects
Estimated 10% give up, we have sample size n = 346 female students actually surveyed 352 female students.
Sampling: Make a list of female students aged 17-19 years old at Thai Nguyen Medical College according to the sampling criteria at the research and screening stage so that the sample size is sufficient according to the formula. In fact, the number of girls aged 17-19 years old selected for nutritional status assessment and dietary survey was 352 girls.
2.4.2. Intervention study
2.5. Intervention implementation
2.6. Technical methods of data collection and assessment
2.7. Data processing
2.8. Ethical compliance in research
CHAPTER III. RESEARCH RESULT
3.1. Some anthropometric indicators, knowledge - practice to prevent calcium - vitamin D deficiency and dietary nutritional value
3.1.1. Anthropometric characteristics of the group of female students at Thai Nguyen Medical College
Table 3.2. Anthropometric index characteristics of the study subjects (n=352)
Table 3.2 shows that 352 female college students aged 17-19 years old participating in the study had an average height of 154.4 ± 4.9cm and an average weight of 46.5 ± 6.2kg. The average BMI was 19.5 ± 2.4 kg/m2. In which, 36.3% of the total subjects were classified as chronically deficient in energy based on BMI classification as recommended by the Asian Diabetes Association. There are 9/352 (2.6%) girls are classified as overweight and 1/352 girls (0.3%) are classified as obese.
Table 3.5. The subject's knowledge about preventive measures is lacking calci - vitamin D (n = 352)
Table 3.6. Habits of using beverages of study subjects (n = 352)
3.1.3. Dietary nutritional value of 17-19 year old female students at Thai Nguyen Medical College
Table 3.7: Dietary nutritional characteristics of study subjects (n = 352)
Table 3.10. Change in T-score of bone density of lumbar spine and femoral neck between study groups at different time points.
Table 3.13. Evaluation and classification of spinal bone condition among 3 groups at T0, T12, T18
Table 3.14. Efficacy of changing bone density of CS after 12 months of intervention
Table 3.15. Effective intervention to change the bone density of LB after 18 months of intervention
Table 3.17. Density of femoral neck at study time points
CHAPTER IV. DISCUSSION
4.1. Some anthropometric indicators, knowledge - practice to prevent calcium - vitamin D deficiency and dietary nutritional value
4.1.1. Anthropometric characteristics of the group of female students at Thai Nguyen Medical College
4.1.2. Knowledge and practice of consuming foods rich in calcium - vitamin D of female students at Thai Nguyen Medical College