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Transcript of Calcium, Bone Health & Osteoporosis - Introduction University of Georgia Cooperative Extension...
![Page 1: Calcium, Bone Health & Osteoporosis - Introduction University of Georgia Cooperative Extension Service.](https://reader034.fdocuments.in/reader034/viewer/2022051401/56649d9f5503460f94a8968f/html5/thumbnails/1.jpg)
Calcium, Bone Health & Osteoporosis - Introduction
University of Georgia Cooperative Extension Service
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What Is Osteoporosis? Porous bones
Bones have lost calcium & other minerals
Bones are fragile Spine, hip and wrist fractures
are common
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Life of Bones Functions
Gives structure to body Protects internal organs Stores essential minerals
Types Cortical bone
Outer layer Trabecular bone
Spongy inner layer
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Life of Bones Living, active tissue Bone remodeling
Osteoclasts Dissolve or break down bone tissue Stimulated by low calcium intake
Osteoblasts Rebuild bone tissue Stimulated by exercise
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Bone Architecture
Normal Bone
Osteoporotic bone
National Osteoporosis Foundation, http://www.nof.org/osteoporosis/bonehealth.htm
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Prevalence & Cost of Osteoporosis More than 44 million Americans
affected 10 million have osteoporosis 34 million have low bone mass
Called osteopenia More than 1.5 million fractures
each year $17 billion in health costs in 2001
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Osteoporosis in Georgia 1/3 people > age 50 affected
by osteoporosis 75 fractures occur daily $323 million in health costs
in 2000 $570 million in estimated health
costs by 2025
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Glimpse of Osteoporosis Fractures
One out of two women > age 50
One out of eight men > age 50
Nearly 1/2 million hospitalized with fractures each year
One out of five dies within 1 year Half never live independently again
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Glimpse of Osteoporosis Men
80,000 hip fractures/ year Women of all ethnic backgrounds
One in twenty African-American women One in ten Mexican-American women
People of all ages Increasing number of women in 20s-30s
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Risk Factors Female gender
Increasing age Thin, small-boned - BMI < 19 Caucasian or Asian ethnicity Family history of fractures or
osteoporosis
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Risk Factors Abnormal menstrual history
Late menarche Menstrual interruptions/irregularities Early menopause (< age 45)
Past menopause Low testosterone levels (men) History of eating disorder/strict
dieting
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Risk Factors Medical conditions
Bone fracture(s) after age 40 Rheumatoid arthritis Thyroid disorder Parathyroid disorder Poorly controlled Type 1 diabetes Lactose intolerance Digestion disorders
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Risk Factors Medication use
Long-term corticosteroid use High doses thyroid hormone Anti-seizure or epilepsy medications Certain diuretics Excessive aluminum-containing antacids Gonadotrophin-releasing hormone
agonist
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Lifestyle Risk Factors 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
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5 Steps to Strong Bones
Avoid harmful habits
BMD testing & medications
Active lifestyle
Regular sunshine
Healthydiet
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Step 1: Eat a Healthy Diet for Bones Diet rich in calcium & vitamin D
2 – 4 servings milk/dairy foods Calcium-fortified foods Calcium/vitamin D supplements
Foods rich in other bone healthy nutrients 5 or more servings vegetables & fruits
Potassium, magnesium, zinc, copper Vitamin K & vitamin C
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Building Bones Building bones = building
a bank account Calcium is “deposited”
During childhood, teen & young adult years When consume enough calcium & vitamin D
Calcium is “withdrawn” During older adult years When do not consume enough calcium &
vitamin D
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Calcium & Vitamin D Matter at Any Age Children
For bone growth Teens and young adults
For bone growth Maximizing bone mass
Adults Maximizing bone mass Minimizing bone loss
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Calcium Recommendations
Age Calcium (mg/day) 1 – 3 years
500 mg
4 – 8 years
800 mg
9 – 18 years
1,300 mg
19 – 50 years
1,000 mg
51 years
1,200 mg
Pregnant/lactating women < 18 years
1,300 mg
Pregnant/lactating women > 18 years
1,000 mg
1997 National Academy of Sciences
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Choose Calcium-rich Foods Milk, yogurt, buttermilk, ricotta cheese, hard cheeses Calcium-fortified foods
Orange juice, soy drinks Breakfast cereals, cereal bars
Tofu made w/ calcium sulfate Canned salmon w/bones
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Include Foods = 1/2 Calcium-rich Source 2 servings = 1 calcium-rich food
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
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Include Foods = 1/4 Calcium-rich Source 4 servings = 1 calcium-rich food
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
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Show Me the CalciumFood Calcium
1 cup plain nonfat yogurt 450 mg
1 cup fruited yogurt 315 mg
1 cup fat free milk (skim) 300 mg
1 cup chocolate milk (1%) 285 mg
1 ½ ounces cheddar cheese 300 mg
½ cup pudding 150 mg
½ cup frozen yogurt 100 mg
½ cup ice cream 80 mg
½ cup cottage cheese 75 mg
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Show Me the CalciumFood Calcium
1 cup calcium-fortified soymilk
250 – 300 mg
1 cup calcium fortifiedorange juice
300 mg
3 oz canned salmonw/edible bones
205 mg
1 Tbsp blackstrap molasses 170 mg
½ cup cooked greens 50 - 100 mg
1 medium orange 50 mg
2 Tbsp almonds 50 mg
½ cup cooked broccoli 45 mg
½ cup cooked pinto beans 40 mg
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Calcium Check Up How many servings do you eat?
Calcium-rich foods Servings x 1 =
1/2 calcium-rich foods Servings ÷ 2 =
1/4 calcium-rich foods Servings ÷ 4 =
Are you getting enough calcium? Is your total = 3 or 4?
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Do You Need Calcium/vitamin D Supplements? 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?
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Upper Limits Calcium: 2500 mg/day
Vitamin D: 2000 IU/day
1997 National Academy of Sciences
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Vitamin D Two sources
Diet Fluid milk (100 IU/8 ounces) Fatty seafood, fish oils, eggs Other fortified foods, supplements
Regular sunlight exposure Skin produces own vitamin D
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Step 2: Get Regular Sun Exposure Helps you meet vitamin D
needs Expose arms and/or legs for 10 - 15
minutes daily, without sunscreen Apply sunscreen after this time
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Vitamin D Recommendations
Age Vitamin D (IU/day)
1 – 50 years 200 IU
51 – 70 years 400 IU
> 70 years 600 IU
1997 National Academy of Sciences
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Step 3: Maintain an Active Lifestyle Regular weight-bearing exercises
Strength-training exercises
Balance & stretching exercises
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Weight-bearing Exercises 30 minutes daily, > 3 times weekly
Walking, running or jogging Stair climbing, jumping rope, skating Aerobics, tennis Basketball, soccer, volleyball
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Strength Training Exercises 2 times weekly
Lifting weights Dumbbells (free weights),
weight machines Resistance exercises
Push ups, leg lifts Stomach curls/crunches Standing calf & toe raises Squats, lunges
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Balance & Stretching Exercises 3 times weekly (or every day)
Improve balance & flexibility Help reduce risk of falling
Do stretches after other exercises
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Step 4: Get a Bone Mineral Density (BMD) Test . . . All women age 65 and older
All postmenopausal women < age 65 with risk factors or current fracture(s)
Men/women with history of fracture(s), loss of height, and/or chronic back pain
Men/women with significant risk factors
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BMD Testing Women considering medication
therapy for BMD Women with long-term use of
HRT/ERT Men/women being treated for
osteoporosis
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. . . & Talk to Doctor Your About Medications Calcium/vitamin D supplements Hormone replacement therapy
Estrogen only (ERT) Estrogen + progesterone (HRT) Birth control pills Selective estrogen receptor
modulators (SERMs) Raloxifene (Evista®)
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Medications Bisphosphonates
Alendronate (Fosamax®) Risedronate (Actonel®)
Calcitonin (Miacalcin®) Parathyroid hormone (PTH) Testosterone
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Step 5: 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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Extra Advice for Older Adults Fall prevention
Reduce household hazards Keep floors safe Improve lighting Install handrails Reorganize furniture Remove clutter
Improve balance & strength Exercises
Review medicines
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It’s Up To You Now! What are you going to do to have
strong bones that last a lifetime?
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Thank You.
Prepared by Marilyn O. Wright, MS, RD, LD
Family Nutrition Program SpecialistUniversity of Georgia
College of Family & Consumer SciencesCooperative Extension Service
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References 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.
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Resources National Osteoporosis Foundation
www.nof.org Bonebuilders (Arizona)
http://www.bonebuilders.org/ National Institutes of Health
http://www.osteo.org/ American Society for Bone Mineral
Research http://www.asbmr.org/
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Resources Strong Women Stay Young
http://www.strongwomen.com/ Powerful Bones
http://www.cdc.gov/powerfulbones/ NOAHNet
http://www.arches.uga.edu/~noahnet/ NICHD (NIH) – Milk Matters
http://www.nichd.nih.gov/milk/milk.cfm Georgia Osteoporosis Initiative
http://www.gabones.net/
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Resources Pharmaceutical
http://www.merck.com/ http://www.oscal.com/ http://www.tums.com/ http://www.citracal.com/ http://www.caltrate.com/ http://www.calciuminfo.com/
index.htm
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Resources National Dairy Council (800) 426-8271
http://www.nationaldairycouncil.org/ Other dairy councils/industry
http://www.dcwnet.org/index_flash.html http://www.southeastdairy.org/ http://www.oregondairycouncil.org/ http://www.dairycouncilofca.org/ http://www.whymilk.com/ http://www.eatsmart.org/
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Resources Yogurt
http://www.stonyfield.com/ http://www.dannon.com/
Cheese http://www.ilovecheese.com/
Soy http://www.whitewave.com/ http://www.soyfoods.com/ http://www.genisoy.com/
Milk-replacement beverages http://www.Vitamite100.com/