THEMUSCULOSKELETALSYSTEMANDAGING

PH131PhysiologyDr.PaulMichaelHernandez
Group3

DelaCruz,Dean.Desquitado,Lyselle.Dimatatac,MJ.Escovidal,Karl.Espinosa,Elise.
Esparagoza,Jan.Fernandez,Mia.Fernandez,Mon.Flores,Diony.Galapon,Trisha.

Objectives:
1.

Todiscussthephysiologicalstateofthemusculoskeletalsystematdifferentlifestages.

2.

Todiscussprocessesinvolvedinthemaintenanceofthemusculoskeletalsystem.

3.

Toidentifymeasuresinproperlydealingwiththeagingmusculoskeletalsystem.

DEVELOPMENT

Three types of muscles formin the embryo: skeletal,smooth,andcardiac. Skeletalmusclesform

by the fusion of mononucleated myoblasts to form multinucleated myotubes. Smoothmuscle develops
from mesodermal cells that migrate to and envelop the developing gastrointestinal tract and viscera.
Cardiacmuscledevelops frommesodermalcellsthatmigratetoandenvelopthedevelopingheartwhileit
isstillin theformofendocardialhearttubes(Tortora,2009).Musclesatellitecellsarealsoformedduring
embryonicdevelopment,whichpersist in aquiescent state inthe adultmuscles,aidinginmusclegrowth
duringexerciseorinmusclerepair.

Muscle development occurs in the embryo through the formation ofmyoblasts,whichundergo

extensive proliferation toform terminallydifferentiated, postmitotic myocytes. MyocytesexpressActin,
Myosin,andothercontractileproteinsandfusetoformcontractilemyofibrils(Schoenwolfetal.,2009).

Striatedmuscledevelopmentoccursin threewaves:primarymyogenesis,secondarymyogenesis,
and postnatal growth. Prenatally, primary myogenesis occurs during the stage of the embryo and
secondary myogenesis occurs during the stage of the fetus lay down the muscularsystem. Postnatally,
satellitecellsactinmusclegrowthinresponsetoexerciseormuscledamage(Schoenwolfetal.,2009).

Osteogenesis(Boneformation)

The formation of bone has three skeleton lineage namely the somites that generate the axial
skeleton, thelateralplate mesodermthat generatesthelimbskeleton,andthecranialneuralcrestthatgives
risetothebranchialarchandcraniofacialbonesandcartilage(Gilbert2000).

Osteogenesis involves two modes of ossification, intramembranous and endochondral

ossification.
In intramembranous ossification, neural crestderived mesenchymal cells in the skull proliferate and
condense into compactnodules.Someofthesecellsdevelopintocapillariesandotherschangetheir shape
to become osteoblasts, committed bone precursor cells.Theosteoblastssecretea collagenproteoglycan
matrix that isable tobindcalcium salts.Occasionally, osteoblastsbecometrappedinthecalcifiedmatrix
and become osteocytes. As calcification proceeds, bony spicules radiate out from the region where
ossificationbegan. Theentire regionofcalcified spiculesbecomessurroundedbycompactmesenchymal
cells thatform the periosteum.Thecellson the inner surfaceoftheperiosteumalso becomeosteoblasts
and deposit osteoidmatrixparalleltothatofthe existingspicules.Inthismanner,manylayersofboneare
formed(Gilbert2000).

Endochondral ossification on the other hand involves the formation of cartilage tissue from
aggregated mesenchymal cells, and the subsequent replacement of cartilage tissue by bone. It can be
dividedintofive majorstages.First,themesenchymalcellsarecommittedtobecomecartilagecells.After
their differentiation, the committed mesenchymal cells condenseintocompact nodulesand differentiate
into chondrocytes. Then thechondrocytesproliferaterapidly toform themodelforthebone.Afterthis,
the chondrocytes stop dividing and increase their volume dramatically, becoming hypertrophic
chondrocytes.Lastly,theprocessisendedbytheinvasionofthecartilage modelbybloodvessels(Gilbert
2000).

Growthduringinfancy

As early as during infancy, it has tobeensured that thebaby grows normally and healthy. The
firstyearafterbirth is very significantas itdeterminestheoverallwellnessandhealthofthechildforthe
lateryears.Asforthemusculoskeletal systemof ababy,itservesasthephysicalfoundationofababys
growthanddevelopment(Pikechiropractic,2014).

Originally,a babys bodyframeworkconsists mainlyofcartilageand300bones.However,asthe

baby ages, the cartilage elements undergoossification inordertoproduce astrongerframeworkforthe
body.Ontheotherhand,adultshavelessnumber ofbonesthan babys (206bonesascomparedto300),
becauseseparatesmallbonesfusetogetherinordertoformbiggerandstrongerbonesthataremorefitting
foradults(Pikechiropractic,2014).

An example of bones that fuse together is the cranium. At birth, the cranium is comprised of
several separate pieces in order tochange shapeasitpasses throughthemothersbirthcanal.Thebabys
cranium has two soft spots, known as the fontanelles. These are gapsformed between theplates of the
cranium. By the end of the babys first year after birth, these gaps would have already closed. This
processiscalledmolding(Pikechiropractic,2014).

In an infants life, there are five milestones that indicate major musculoskeletaldevelopments.
First would be the lifting and supporting of the head on their own. This is often called head control.
Around onemonth after birth,the babyshouldbeable tolifthisheadslightly. Ataround4months,the
baby shouldbe ableto keephisheaduprightwhenheldinasitting position.By around6 monthsofage,
thebabyshouldbeabletocontrolandsupporthisheadtotally(Pikechiropractic,2014)

The second milestone that occurs is the ability of the baby to roll over. Thebellytobackflip
happens at around 4 months of age, and is mastered fully by the age of 5 or 6 months. However,the
backtopfront flip happens at a later time as it requires moreneck andarm strength(Pikechiropractic,
2014).
Third, mostbabies areable toremaininanupright position bytheage of 4to 7 months.Bythe
time they are 8 monthsold,they should be abletokeepuprightwithoutanyassistance. Meanwhile,the
fourthmilestonethatusually occursinaninfantslifeishisabilitytocrawl.Thisskillusuallydevelopsat
the age of 7 to 10 months, andthisisalso the time whenbabies tryall kinds of approaches inorderto
movefromoneplacetoanother(Pikechiropractic,2014).

Lastly, the fifth milestone that an infant undergoes through is walking. The babys first step
wouldmost likely happenataround9to12 months.Bythetimethebabyreacheshis14thor15thmonth,
he would have to be able to walk on his own. However,sincesomebabies later developlaterthanthe
otherbabies,itisstillquitenormaltobeabletowalkatthe16thor17thmonth(Pikechiropractic,2014).

During puberty, this is when a person, yet again, undergo significant changes in his body,
especially in the aspect of bones and muscles. First, thisis the time when peakbone massis achieved.
Usually, the end of ones puberty stage would also indicate the end of his bone growth.Asidefrom a
personsdietandlifestyle,bone growthmayalso beremarkablyaffectedbytheincreaseinproductionof
sex hormones. It is believed that a girls first menstruation or a boys circumcision is responsible for
his/her growth spurt (Skeletal Development, n.d.). But really, the reason behind this occurrence is the
increase in sex hormoneproduction. It isbymerecoincidencethata girls firstmenstruation ora boys
circumcisionisdoneduringapersonspubertystage.

MAINTENANCEANDREPAIR

Musclesgettheirenergy basedon thesituationthatthemusclesarein.Wheneverweusethemto

produce a low to moderate level of force, we utilize aerobic respiration. Aerobic respiration requires
oxygen and is able to produce about 3638 ATP molecules from a single molecule of glucose. This
processisveryefficient, and cango onas long as the musclereceivesadequateamountsofoxygenand
glucosetomakethemcontract.

Ontheotherhand,wheneverweuseourmusclestoproducea highlevelofforce,theycontractso
muchthat thebloodcarryingtheoxygencannotenterthemuscle.Thisresultsintoaconditionwhereinthe
muscle creates energy through lactic acid fermentation, a form of anaerobic respiration. Compared to
aerobic respiration, this process is much less efficient mainly because only 2 ATP molecules are
producedforeachmoleculeofglucose.

Ourmuscle fiberscontainnumerousimportantenergy molecules.Oneof whichisMyoglobin,a

red pigment that contains iron and stores oxygen. The oxygen from this pigment allows the muscleto
continue aerobicrespiration intheabsenceofoxygen.Anotherchemicalinvolvedinmusclemaintenance
is creatine phosphate. This chemical donates its phosphate group to ADP to turn it back into ATP to
provideadditional energy tothemuscle.Lastly,glycogenwhichis found inthemuscle fibersandstores
energy. It isalargemacromoleculemadeofmanylinked glucoses.Muscles breakofftheseglucosesfrom
theglycogenmoleculesduringactivity.Thisprocessprovidesthemusclesaninternalfuelsupply.

Muscle fatigueisaconditionwhereinthemusclesrunoutofenergyduringrespiration,aerobicor
anaerobic. In this condition, the muscle quickly tires out and is not able tocontract.Whenthemuscle

experiences fatigue, ithas littleto no oxygen,glucose, orATP.Instead it hasmany wasteproducts,like

ADP and lactic acid. In order toreplace theoxygen thatwasstoredinthemyoglobininthemusclefiber,
the body must intake extra oxygen after exertion. This will alsopowerthe aerobicrespiration that will
rebuild the energy supplies of the cell. Extraoxygen thatthebodymustintaketorestorethemusclecells
intotheirresting state is referred toas oxygen debt (recoveryoxygenuptake).Thiswouldexplainwhy a
personfeelsout ofbreath for afewminutes afterdoingastrenuousactivity.Thebodyistryingtorestore
itselftoitsnormalstate.

Themaintenanceofbones canbe summarizedintotwoprocesses:bone modelingandremodeling. Bone

modeling is the
formationofnew boneat oneparticularsite and the optional removal of an oldbonein
anothersite.Theformation ofnew boneis called,deposition and ishandled by osteoblasts. Theprocess
of removing old bone, iscalledresorption andis carriedoutby osteoclasts.Thisistypicallydoneduring
adolescence and early adulthood, because this is where we start to adapt to the environment. Bone
modelingdrasticallychangesthesizeandshapeofthebone.

In boneremodelling, asmall amount ofboneonthesurfaceof trabeculae orthe interiorofthecortex is

replaced. Bone resorptionanddepositionbothoccur atthesamesite.Itisnormallythedominantprocess
in bonemaintenance,happeningthroughoutlife.Doesnotdrasticallychangethebonesizeorshape.Bone
remodelinghappenssothatourbodiesmayfinetunethebonesandthusfurtheradapttotheenvironment.
Thisisalsodoneforcalciumhomeostasis.

DETERIORATION

AGING
"Theageingprocessisofcourseabiologicalrealitywhichhasitsowndynamic,largelybeyondhuman
control...activecontributionisnolongerpossible."Gorman,2000
Agingis part of the naturalprocessthatthehumanbodyundergoes.Itisthenaturaldegradation
of bodilyfunctions that comesasonegrowsolder.It ischaracterizedbyagenerallyweakerphysiquedue
to a decrease in muscle volume, increase in fatty deposits, and brittleness of bones.Despite being a
naturalprocess, agingproceedsat differentratesfordifferentpeopleastherearesomefactorswhichmay
hasten it. These are:
Lifestyle, Stress, Excessive exposure to harsh environments, and Humoral

Factors.
Lifestylereferstothewayapersonliveshis/herlife.Itisthemostchoiceorientedfactoramongst
the four. A person who chooses to live a sedentary lifestyle lacksexercise, preventinghis/hermuscles
from improvingandbeing worked upthus,giving itlessstrengthandmakingitmuchmorepronetothe
effects of aging. An unhealthy diet prevents the body from receiving the proper nutrients, and may
potentially increase the amount of fat in the body. Bad habits and vices such as drugs, alcohol and
smoking may cause complications within the body that may ultimately lead todiseases, which in turn,
leadstoanincreaserateofbodydegradation.(McLaughin,2013)
Stress
is the reaction of the bodyto astimulus that disturbsitsstate ofequilibrium.More often
than not, stress triggers reactionsthatpromotethewearandtear of organs inorderto makethebody
work fasterandmoreefficiently for the type ofsituationit isin.Themorestressedsomeoneis,themore
worn and tornthebody might end up.Too muchstress willaffecttheorgansinsuchawaythattheywill
not function properly. Additionally, in order to cope with the loss of energy that stress brings, one is
stimulated to eat more, increasing the fatty deposits in the body. Stress may also be responsible for
makingsomeonedevelopabadposture,andmayweakensomeonesimmunity.(McLaughin,2013)
Excessive exposure to harsh environments refers to too much exposure to some elements
aroundussuchassunlight,heat,cold,andradiationwhichmayin turnhavevarying degrees of adverse
effectsto the body. Toomuch sunlightwill make one sufferthe effectsofbeingtooexposedtoUVrays.
Too much heat may cause burns, dehydration and wrinkling of the skin. Too much cold may cause
dehydration, and in extreme cases, frostbite a condition which may potentially make someone lose a
body part. Exposure to too much radiation may lead to radiation sickness, which may, inturn,lead to
cancer.(McLaugin,2013)
Humoral Factors refer to factors transported by the blood such as hormones. Hormones are
chemicalsproduced bythebrainwhichhelpregulatetheamountofdifferentmineralsofthebody.Some
hormoneswhichhelpmaintain themusculoskeletal system are(a) ParathyroidHormonewhichregulates
calcium content in blood by extracting calcium from the bone when there is a lack of it in blood, it
increasesin age andmayeventuallylead toweakerbones and osteoporosis(b)Estrogencounteractsthe
effects of the parathyroid hormoneandminimizescalcium loss of the bone, itdecreaseswithage,thus,
increasing the possibility of osteoporosis(c)Testosteroneisinvolvedinthedevelopmentofmusclebulk

andstrength,andincreasesgrowthhormone production,itdecreaseswithage,thus,lesseningmusclebulk
and strength, and (d) Growth hormone which promotes increased muscle mass and skeletal growth, it
naturally decreases with age thus, makingitharder for someone tohave increasedmuscle mass. (Hurd,
2014)
Deteriorationoftheskeletalsystem
Maximum bone density is achieved, on average, at the age of 2530 years old, after which, a
gradual decrease inbone densitycanbeobserved. This decreaseismoreevidentin femalesthanmales,
losingabout 53% ascomparedto18% inmales.Thisisfurtheracceleratedbythefactthatwomentendto
havesmallerbonesandhavelowerpeakbonemass.
In addition,ageingleadsto adecrease inbonedensityastherateofdepositionisnowlowerthan
therateofresorption.Thisis,however,affectedbyseveralfactors:
Calciumand VitaminD Deficiency.
Calciumisthe oneofthemain mineralsusedbythebody
fornormalfunction. For one, it is usedtostrengthen bones.However,thesmallintestinecanonlyabsorb
a total of 30% of the daily required intake (A.D.A.M., 2014). Thiscanlead toa deficiency of the said
mineral. Vitamin Disimportantintheabsorptionofcalciumforbodyconsumption.Usualsources ofthis
vitaminincludeexposureto sunlight, leafy andgreen vegetables,andmilk. LackofvitaminDcan affect
theamountofcalcium inthebody,therebypromotingcalcium resorptionleadingto lowerbonedensity.
Moreover, lactose intolerant individuals are more likelyto havecalcium deficiency as theyareunableto
efficiently digest dairy which are good sources of said of both Calcium and Vitamin D (Office of the
SurgeonGeneral,2004)
Decrease in Reproductivehormones.
Thisis more evidentinwomen asitisinmen.Itcanbe.
observed that a sudden drop in bone density in women after they have gonethrough menopause.This
means that adecrease intheproduction of sexhormones, inthiscase estrogen, canlead toadecreasein
bone density. Menopause can also elevate levelsofFolliclesecretinghormones (FSH)whichpromotes
osteoclasticactivityandboneperforation(Demontiero,et.al.,n.d.)
Estrogen stimulates an increase in the production of transforming growth factor B and
Osteoprotegrin which are essential in the decrease of osteoclastic activity.Moreover, thishormonecan
stimulate both bone formation and procollagen synthesis,whichis essentialin the maintenance of bone

density. Consequently, a lack of estrogen can increase osteoclastic activity whilst decreasing bone
formation. Males alsoexhibitthispatternasestrogenispresentintheirbody asaderivativeof theirmain
sex hormone. Moreover,testosteroneis vitalindevelopmentofthebonesbecause it increases thelevels
of the growth hormone and releases neurotransmitters that stimulate tissue growth. (Demontiero,et al,
n.d.).
Sedentary Lifestyle.
Physicalactivity havedirect effectsonbonedensityasitisadeterminantof
the density the bone needs in order to sustain pressure applied to it. Therefore, a decrease in physical
activity promotes osteoclastic activity within that site, thereby decreasingbone density. Conversely,an
increase in physical activity can lead to an increase in bone density as the area is subject to more
mechanicalforce.(OfficeoftheSurgeonGeneral,2004)
Endocrine and Gastrointestinal Pathology.
Several diseases of the endocrine and digestive
system can affect bone resorption, and to a greater extent, bone density. Hyperprolactinemia,
Hyperparathyrodism and Hyperthyroidism, conditionsthatarecausedbytheincreaseintheproductionof
prolactin,parathormone and thyroidhormonesrespectively,allcauseadecreaseinbonedensityduetoan
increase in osteoclastic activity (Dhanwal, D, n.d.). A condition wherein the body tends to produce
copious amounts of calcium, referred to as hypercalcemia, can lead to an excess in the excretion of
calcium,whichinturn, thinsouttheboneandposesmoreriskforfracture.Also,anoverproductionofthe
gastrointestinalderivedserotonin,canleadtotheinhibitionofboneformation(Clarke&Khosla,n.d.).
In addition, chronic use of corticosteriods can lead to decrease in bone formation and bone
densityasitpromotesthecelldeathofosteoblasts(Romas,n.d.)

Deteriorationofthemuscularsystem

Sarcopenia
Sarcopenia is a common consequence of normal aging that describes a gradual loss ofmuscle
mass and strengththatmaybegin attheage of30.Thiscontinuesontogetherwithageingandbytheage
of 80, musclestrength wouldhavedecreasedby50%(Marieb,2013).Sarcopeniamaybeattributedtothe

reduction of fiber number,fiber size or acombinationof the two.Thecauseofthisismultifactorialwith

reducedphysicalactivityasakeyfactor(Marcell,2003).

For healthy young adults,under equilibriumconditions, thedegradationand synthesisofskeletal

muscle is a balanced and dynamic process.Small imbalances between degradation and synthesis
accumulatedoverseveralyearsresulttothesignificantlossinmusclemass(Marcell,2003).

Musclecellchanges
As muscles age, smoothening of sarcolemma inthe muscleend platedecreasessurface area and
diminishes stimulation of muscle cells. Thus, cells contract slower and become decreasingly able to
recover from a contraction and to ready itself for the next one. The slowing of calcium release and
retrieval of the sarcoplasmic reticulum with increasing age also affects this. A decreased number of
sarcomeres shortens the muscle, causing a reduced distance for moving which would then affect
flexibility(DiGiovanna,1994).

DenervationandMUremodeling
There is a loss of motor axons due to the normal aging process, with the loss of alphamotor
neurons being greatest among type II musclefibers.Thesemuscles either thenbecome reinnervatedby
sprouts of other axons within the vicinity, which are commonly from type I fibers, or denervates and
ultimatelydisappears(Marcell,2003).
This may explain why Type II (fasttwitch) fibers decline with increasing age whereas Type I
(slowtwitch) fibers are seemingly resistant to agerelated atrophy until the ages of 7080. The sizeof
remaining motor units(MU) increase with reinnervation causing adecreaseincontrollingthestrengthof
eachcontraction,thusaffectingfinemovements(DiGiovanna,1994).

ProteinSynthesis
Declines in protein synthesis are involved in reduced protein mass but not all muscle proteins
display changes in synthesis rates. Separation of muscle proteins showed that Myosin Heavy Chain
(MHC) synthesisratesare lessfor themiddleagedandoldaged.MHCbeingakeycontractileprotein,its
reduction wouldlead toa declineinlocomotor functionand musclestrength.. Asweagewedonot lose
theability tometabolizeproteins,weloseabilitytosynthesize ourownproteins andthisisinfluencedby
hormonalchanges(Williams,Higgins,&Lewek,2002).

Hormones
Reduced levels of circulating anabolic hormones such as somatotropin and testosterone, that
decline frommiddle ageonwards, alsoaffect muscleageing.There isalsoanincreasedinsulinresistance
withage thatmaycontributetomuscledeteriorationthroughtheinhibitionof thenitricoxidecascadethat
is responsible for the absorption of amino acids in protein synthesis. Inlikemanner, cortisol increases
withageandisapotentstimulustoproteincatabolism(Knight,2008).

Replacementofactivemuscle
Active muscle fibers are progressively replaced bycollagenrich,noncontractilefibrous tissue.
There is also an Increased deposition of fats with decreased lean muscle tissue, decreasing the force
productioncapability(Knight,2008).

As mentioned earlier, muscleageingisamultifactorialprocessandsoitisaffectedbynumerous

other processes inthebodywithnotoneofthemclaimingtobethesolereasonforthechanges.Capillary
structure and decrease in capillary density in muscles also affect muscle ageing. There is also an
increasingaccumulationoflipofuscin(Knight,2008).
The proper functioning of the muscular system is also dependenton other systemsthatchange
withagesuchasthenervous,circulatoryandrespiratorysystems(DiGiovanna,1994).

TendonStiffening
Tendons are cord like tissues in the body thatattaches muscles tobones.Asone ages,tendons
may become stiff, causing someone to have more strain when it moving. The stiffening of tendons is
primarily caused bylossofwaterduetothedecrease ofproteoglycan(amineralwhichisa componentof
theground substance ofthe tissueandhelpsin retainmentofwatercontent). Another causewouldbethe
lossofelastinthatcomeswithage.Elastinisamineral whichmakesthetissuemoreflexibleandelastic,a
decreaseofitwillcausethetendonstobelessflexibleandelastic.(Leadbetter,etal.2005)

AddressingtheAgingMusculoskeletalSystem
RegularPhysicalActivity
Decline in physicalactivityincreases the ageassociatedchangesin the musculoskeletalsystem.
Thesechanges can be delayedor preventedbylivingaphysically active lifestyle.Elderly peoplewhoare
sedentary can greatly benefit from exercise (Seeley, Regan, & Russo, 2014). Aerobic activities and

10

strength training programs improvemusculoskeletal performance

(Tortora &Derrickson, 2009)
. During
these activities, muscles push and tug against bones, making them both stronger (National Institute of
ChildHealthandHumanDevelopment[NICHD],2014).The musclefibersdamagedduringworkoutare
replaced by the body and the repaired myofibrils grow in thicknessandnumber(musclehypertrophy).
Moderate activity and weightbearing exercises (e.g. walking,jogging,hiking, dancing, etc.)help build
bone mass and enhance neuromuscular function. Resistance exercises (strength or weight training)can
help build bone strength and musclemass(Marieb &Hoehn, 2013). However,riskofinjuryassociated
withtheincreaseofstrenuousphysicalactivitymustbeassessed.

Maintaining a high level of physical activity throughout life has several positive effects to the
muscularsystem.Itslowsthedeclineinenergymolecules(ATP,creatinephosphate,glycogen),oxidative
enzymes, blood supply, speed of movement, stamina, endurance, Vo
max(maximaluptakeof oxygen),
2
and increase inoverall musclesizeandstrength.Effectsofexerciseontheskeletalsystemincludeslower
decline inbone mineralsanddecreasedriskoffracturesand osteoporosis. For those people whoarejust
startingto engageinregularphysicalactivity,thebenefits arealmostsimilar,soitisnevertoolatetostart
workingout(DiGiovanna,1994).

HealthyDiet
Eating a wellbalanceddietcan dowonderstothegrowingbonesandmuscle. Makesureto get
enough calcium asthebonesareincreasingin density. It greatlyreducestheriskoffractures(Marieb&
Hoehn, 2013). Phosphorus, including smaller amountsofmagnesium, fluoride, and manganeseare also
needed in bone remodeling
(Tortora& Derrickson, 2009)
.Some sources of calciumaremilk(andother
dairyproducts),leafygreens,fruits,legumes,andseafood.

VitaminD,whichisnaturallymadebythebodywhentheskinisexposedtothesun,isneededby
the body to absorb calcium from food into the blood. Other essential vitamins, such as vitamin A
(stimulates activity of osteoblasts), vitamin C (necessary for collagen synthesis), vitamin K and B12
(needed for synthesis of boneproteins)arealso important
(Tortora &Derrickson, 2009)
. F
ishoils, fatty
fish, mushrooms, beef liver, cheese, egg yolk, fruits, and vegetables are possible sources of these
vitamins.

Protein requirement for adults is higher than for younger people. However, too much animal
proteins cancauselossofboneandmusclemass(Brink, 2007).Makesuretogetproteinfromavarietyof

11

sourcessuchasseafood,whiteandleanmeat,dairy,eggs,beans,soy,peas,quinoaandnuts.

Stick to minimally processed foods (fruits, vegetables, whole grains, seeds, etc.) and prevent
processed foods. High intake of carbonated beverages, sugar, and alcohol promote poor bone
mineralization. They extract mineralsfrom bone, decreasingitsdensity (Marieb&Hoehn,2013).Fruits
and vegetables,on the other hand, contains the vitaminsandminerals needfor healthy boneandmuscle
growth.

OtherTipstoSlowDownMusculoskeletalAging
Hormonesaffect bonesandmuscleaspeople age. Annualbloodtestingtotrackhormonelevelsis
recommended, especially to the elderly (Brink, 2007). Some medications and hormone replacement
therapiescanbehelpfultothosewhocanaffordit.

Those who strive to maintain healthy bones and muscle must consider some major lifestyle
changes. Make great efforts to stop smoking. According to the American Academy of Orthopaedic
Surgeons (2010), smoking decreasesblood supply tothebones, aswellas calciumabsorption. Nicotine
also reduces the production of osteoblasts. It speeds up estrogen breakdown, making the bones more
fragile. Moreover, it causes decrease in oxygen uptake, so less is available for muscleuse.Also, avoid
stress as much as possible. Any damage to the other body systems due to stress can, in one way or
another,affectthemusculoskeletalsystem.

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