Epidemiology of Non-Communicable Diseases

Running head: EPIDEMIOLOGY OF NON-COMMUNICABLE DISEASES
EPIDEMIOLOGY OF NON-COMMUNICABLE DISEASES
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1EPIDEMIOLOGY OF NON-COMMUNICABLE DISEASES
Question 1
The scholarly article chosen for this paper is the systematic review by Eastell et al.,
(2016), which discusses extensively on the epidemiological associations between the post-
menopausal stage in females the increased risk of osteoporosis – a non-communicable disease.
The life course which is related to this disease and the chosen research is the ‘sensitive period
model’. The sensitive period model in the life course theory of epidemiology implies a time
period in the life of an individual when being exposed to a particular disease exposure exerts the
highest detrimental effect of disease risk, acquisition and progression than alternative time
periods during the life span (Nishi et al., 2015). Hence, taking insights from the review by Eastell
et al., (2016) as well as the sensitive period model, the risk of osteoporosis disease acquisition is
the highest in females belonging to the post-menopausal stage if acquainted with exposures of
fractures, dietary calcium and Vitamin D deficiencies due to prevalence of reduced estrogen
levels characteristic of this time period.
Bone remodeling and calcium homeostasis are positively associated with each other due
to the interlinked functions of osteoids like osteoblasts and osteoclasts. Osteoblasts are
associated with the initiation of bone modeling by mobilizing serum calcium via calcitonin and
parathyroid hormone mechanisms resulting in bone strength maintenance and repair from minor
injuries and fractures (Lafage-Proust et al., 2015). Osteoclasts alternatively are responsible for
the initiation of bone resorption via secretion of digestive enzymes which results in calcium
leakage from the bone for the maintenance of adequate calcium levels. The female hormone play
a characteristic function in maintenance of bone strength by strengthening the function of
osteoblasts and hindering the function of osteoclasts (Siddiqui & Partridge, 2016). However, the

2EPIDEMIOLOGY OF NON-COMMUNICABLE DISEASES
post menopausal stage is characterized by a drop in estrogen levels resulting in hindered
equilibrium between osteoclastic and osteoblastic activities, increased bone resorption, loss of
bone mineral density and osteoporotic disease progression of bone porosity and bone fragility.
Hence, for this reason, post menopausal women, when exposed to risk factors like fractures or
calcium-vitamin D (minerals essential for bone formation) deficiency increases their
susceptibilities to osteoporosis due to the estrogen loss-induced increased bone resorption and
decreased bone modeling (Xiao et al., 2016).
The review by Eastell (2016), reports that approximately 50% of women belonging to the
age group of 50 years are at an increased risk of fracture acquisition in the hip or vertebrae which
further results in a detrimental loss of quality of life and hindered physiological, psychological
and social wellbeing. Post menopausal women possess an increased disease risk due to estrogen
deficiency resulting in high bone turnover, loss of trabecular bone connectivity and increased
cortical bone porosity and thinness. Strategies of osteoporotic prevention among such high risk
populations must be aimed at mitigating exposure to key risk factors like fractures and nutritional
deficiency which can be performed through administration of falls prevention procedures and
consumption of a diet consisting of 800 – 1000 mg of calcium/day and Vitamin D
supplementation at more than 50nmol/liter.
Question 2
For the purpose or summarizing the basis of evidence which supports the sensitive period
model concerning post menopausal risk and acquisition of osteoporosis, an electronic literature
search strategy was conducted to obtain articles relevant to this disease association. Using
relevant life science based databases such as BioMed, Medline and PubMed, and key word such