Transcript Calcium and Osteoporosis - College of Family and Consumer

Building & Keeping Strong
Bones
Adult Women
The University of Georgia
Cooperative Extension Service
Building Bones
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Building bones = building
a bank account
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Calcium is “deposited”
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During childhood, teen & young adult years
When consume enough calcium & vitamin D
Calcium is “withdrawn”
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During older adult years
When do not consume enough calcium &
vitamin D
Calcium & Vitamin D Matter at
Any Age
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Children
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Teens and young adults
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For bone growth
For bone growth
Maximizing bone mass
Adults
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Maximizing bone mass
Minimizing bone loss
What Is Osteoporosis?
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Porous bones
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Bones have lost calcium and
other minerals
Bones are fragile
Bones fracture easily
Bone Structure
Normal Bone
Osteoporotic bone
National Osteoporosis Foundation,
http://www.nof.org/osteoporosis/bonehealth.htm
Risk Factors
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Female gender
Increasing age
Thin, small-boned - BMI < 19
Caucasian or Asian ethnicity
Family history of fractures or
osteoporosis
Risk Factors
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Abnormal menstrual history
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Late menarche
Menstrual interruptions/irregularities
Early menopause (< age 45)
Have had an eating disorder or
times of strict dieting
Risk Factors
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Medical conditions
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Bone fracture(s) after age 40
Rheumatoid arthritis
Thyroid disorder
Parathyroid disorder
Poorly controlled Type 1 diabetes
Lactose intolerance
Digestion disorders
Risk Factors
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Medication use
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Long-term steroid use
High doses thyroid hormone
Anti-seizure or epilepsy medications
Certain diuretics
Excessive aluminum-containing antacids
Gonadotrophin-releasing hormone agonist
Lifestyle Risk Factors
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Inactive lifestyle
Diet low in calcium
Little sun exposure and diet low in vitamin D
Consume few fruits and vegetables
Drink excess alcohol (> 7 drinks/week)
Current or former smoker
Consume large amounts of caffeine
5 Steps to Strong Bones
Healthy
diet
Regular sunshine
Active lifestyle
BMD testing & medications
Avoid harmful habits
Step 1: Eat a Healthy Diet for
Bones
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Diet rich in calcium & vitamin D
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3 or more servings milk/dairy foods
Calcium-fortified foods
Calcium/vitamin D supplements
Foods rich in other bone healthy nutrients
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5 or more servings vegetables & fruits
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Potassium, magnesium, zinc, copper
Vitamin K & vitamin C
Calcium & Vitamin D
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Recommendations
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19 - 50 years
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1,000 mg calcium
200 IU vitamin D
51 - 70 years
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1,200 mg calcium
400 IU vitamin D
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Amounts supplied by
8 ounces milk
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300 mg calcium
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100 IU vitamin D
Choose Calcium-rich Foods
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Milk, yogurt, buttermilk,
ricotta cheese, hard cheeses
Calcium-fortified foods
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Orange juice, soy drinks
Breakfast cereals, cereal bars
Tofu made w/ calcium sulfate
Canned salmon w/bones
Include Foods = 1/2 Calciumrich Source
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2 servings = 1 calcium-rich food
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1/2 cup pudding
1/2 cup frozen yogurt or ice cream
1/2 cup mustard or turnip greens
1/2 cup cooked rhubarb
1/3 cup almonds
1 piece cornbread
Include Foods = 1/4 Calciumrich Source
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4 servings = 1 calcium-rich food
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1/2 cup cottage cheese
1/2 cup broccoli, kale, or okra
1 cup romaine lettuce
1/2 cup cooked beans
1 medium orange
2 dried figs
3 oz fresh fish or seafood
1/2 English muffin
Calcium Check Up
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How many servings do you eat?
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Calcium-rich foods
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1/2 calcium-rich foods
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Servings ÷ 2 =
1/4 calcium-rich foods
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Servings x 1 =
Servings ÷ 4 =
Are you getting enough calcium?
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Is your total = 3 or 4?
Do You Need Calcium/vitamin
D Supplements?
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Lactose intolerant or allergic to milk?
Avoid milk/dairy foods?
On a strict weight-loss diet?
Over age 50, consume little milk and/or
do not get sun exposure?
On long-term steroid therapy?
Upper Limits
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Calcium: 2500 mg/day
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Vitamin D: 2000 IU/day
National Academy of Sciences 1997
Vitamin D
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Two sources
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Diet
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Fluid milk
Fatty seafood, fish oils, eggs
Other fortified foods, supplements
Regular sunlight exposure
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Skin produces own vitamin D
Step 2: Get Regular
Sun Exposure
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Helps you meet vitamin D
needs
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Expose arms and/or legs for 10 - 15
minutes daily, without sunscreen
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Apply sunscreen after this time
Step 3:
Maintain An Active Lifestyle
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Regular weight-bearing exercises
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Strength-training exercises
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Balance & stretching exercises
Weight-bearing Exercises
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30 minutes daily, > 3 times weekly
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Walking, running or jogging
Stair climbing, jumping rope, skating
Aerobics, tennis
Basketball, soccer, volleyball
Strength Training Exercises
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2 times weekly
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Lifting weights
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Dumbbells (free weights),
weight machines
Resistance exercises
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Push ups, leg lifts
Stomach curls/crunches
Standing calf & toe raises
Squats, lunges
Balance & Stretching Exercises
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3 times weekly (or every day)
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Improve balance & flexibility
Help reduce risk of falling
Do stretches after other exercise
Step 4: Get a Bone Mineral
Density (BMD) Test
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Men/women with signs of osteoporosis
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Fractures, chronic back pain
Loss of height, humped back
Men/women with significant risk factors
Women who had early menopause &
have other risk factors
Women considering medication therapy
to help BMD
Take Medication If Needed
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Calcium/vitamin D supplements
Hormone replacement therapies
Bisphosphonates
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Alendronate (Fosamax®)
Risedronate (Actonel®)
Calcitonin (Miacalcin®)
Parathyroid hormone (PTH)
Avoid Harmful Habits
Smoking
 Strict dieting
 Heavy drinking (alcohol)
 High caffeine consumption
Diet low in calcium and vitamin D
 Inactive lifestyle
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It’s Up To You!
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What are you going to do to have
strong bones for a lifetime?
Thank You.
Prepared by Marilyn O. Wright, MS, RD, LD
Family Nutrition Program Specialist
University of Georgia
College of Family & Consumer Sciences
Cooperative Extension Service
References
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Nelson, M.E. (2000) Strong Women, Strong Bones. Berkley Publishing Group
(Perigee), New York. http://www.strongwomen.com
Nelson, M.E. (1997) Strong Women Stay Young. Bantam, New York.
National Academy of Science Institute of Medicine (1999) Dietary Reference
Intakes for Calcium, Phosphorus, Magnesium, Vitamin D & Fluoride. National
Academy Press, Washington, D.C. http://www.nap.edu/catalog/5776.html
National Osteoporosis Foundation, http://www.nof.org/
NIH Osteoporosis & Related Bone Disease National Resource Center,
http://www.osteo.org/
Duyff, R.L. (1996) The American Dietetic Association’s Complete Food &
Nutrition Guide. Chronimed, Minneapolis.
USDA Nutrient Data Laboratory, http://www.nal.usda.gov/fnic/foodcomp/
Picado, C., & Luengo, M. (1996) Corticosteroid-induced bone loss. Prevention &
management. Drug Saf, 15(5): 347-59.