Boning up on Bone Health. Why diet & exercise are important in preventing Osteoporosis

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Part Two. *

Bone is a living tissue that is constantly renewed through a process in which old bone is removed and replaced by new bone. Cells called osteoclasts erode the bone, creating small cavities; bone-forming cells called osteoblasts then fill in the cavities with new bone. This is nature’s way of restoring bones and keeping them healthy.

In younger people with healthy bones, the osteoclasts and osteoblasts work together, maintaining healthy bones. However, after our mid-30s the process is not as efficient, and we begin to gradually lose bone. In someone with osteoporosis, bone loss occurs more rapidly, causing the bones to become thinner and weaker over time. If you have osteoporosis, you have already lost a significant amount of bone and may continue to do so unless you receive medication.  Over 80% of all fractures in people 50+ are caused by osteoporosis.

That’s why diet and exercise is recommended as part of an overall healthy approach to preventing osteoporosis.

 We need to emphasize the importance of regular weight-bearing exercise for bone health. Weight bearing exercise, where you use your body weight in activities such as walking, running and weight lifting will help your bones become denser. The result is that you develop more bone material, and your bones become denser. Brisk walking, dancing, tennis, and yoga have all been shown to help your bones.

It will also help your balance and strength, which could help to prevent falls

Diet

  • Calcium is the cornerstone of strong bones. Adults up to age 50 need 1,000 milligrams per day. Beginning at age 51, women need 1,200 milligrams every day, and when men hit 71, they need to hit that mark, too. The pop star of calcium sources is undoubtedly milk. A single, 8-ounce cup of milk, whether skim, low-fat, or whole, has 300 milligrams of calcium.
  • Not a milk drinker? A cup of yogurt has at least as much calcium as an 8-ounce cup of milk. And 1 ounce of Swiss cheese has nearly as much. Even if you’re lactose intolerant, yogurt and hard cheeses are low in lactose. Or try dairy products that are lactose-reduced or lactose-free. Removing lactose from milk and dairy foods does not affect the calcium content
  • You might be surprised to learn that calcium is plentiful in many vegetables. Go for dark leafy greens such as Bok Choy, Chinese cabbage, and kale. If dairy products, sardines, and leafy greens leave you cold, consider eating fortified foods. These are products that do not naturally contain calcium but have been enhanced with varying amounts of the essential mineral.
  • Breakfast foods are a great start — fortified orange juice has up to 240 milligrams of calcium, and fortified cereals deliver up to 1,000 milligrams per cup. Check the nutritional label for the exact amount.
  • Half a cup of calcium-enriched tofu has as much as 861 milligrams of calcium, but calcium is not the only mineral that gives bones a leg up. New research suggests plant-based chemicals called isoflavones strengthen bone density as well. Isoflavones are plentiful in soy foods, such as tofu, and seem to have an estrogen-like effect on the body. For some women, this is a positive side effect, while others may choose to limit their intake
  • Salmon and other types of fatty fish offer an array of bone-boosting nutrients. They contain calcium as well as vitamin D, which aid in calcium absorption. They’re also high in omega-3 fatty acids, important as antioxidants in the body

 Calcium Supplements

Supplements are an easy way to boost your calcium intake, but some reports suggest you may not need them. If you’re already getting enough calcium from food, taking more in pill form won’t contribute to bone health. Experts say there’s little benefit in getting more than 2,000 milligrams of calcium per day, and too much can lead to kidney stones. For the best absorption, take no more than 500 milligrams at one time. Some calcium supplements, such as calcium carbonate, are better absorbed if taken with meals; however, calcium citrate can be taken anytime

Vitamin D

 

 

Vitamin D helps the body absorb calcium and store calcium from the foods we eat. Our bodies can produce vitamin D when we are exposed to sunlight. However, during the winter months, most Canadians do not get enough sun exposure to produce adequate amounts of vitamin D, nor do we get enough vitamin D through our dietary intake. However, Vitamin D intake can be enhanced through dietary sources and supplements.  It is important to continue to take Vitamin D, even in the summer months, as we tend to wear sunblock that limits the absorption of vitamin D.

Osteoporosis Canada recommends the following intake of vitamin D (total intake through diet and supplementation) on a daily basis.  For people age 19-50; 400-1,000 IU, and for those of us over the age of fifty; 800-2,000 IU’s.

* Source – www.osteoporosiscanada.com

 

No Bones about it: Protect Yourself From Osteoporosis

Fitness Assessment (2)

Part # 1

A ninety-four year old woman has had two major falls in the past twenty years. Upon falling down a flight of stairs, she fractured her arm. More recently, when this tiny woman was picked up by a gust of wind and then dropped on the parking lot pavement one icy winter day, she fractured her elbow.  In both situations she could have also easily broken her hip or spine yet she didn’t. She recovered fully, continues to drive, live independently and most importantly enjoys a healthy and active life.

At ninety-four she most certainly has lost bone mass which peaks at the age of 16-20 for girls and 20-25 in men.  As women approach menopause they lose bone mass at the rate of 2-3% a year. Yet it would seem that a healthy diet, regular weight-bearing exercise and preventative medication are able to decrease the risk of fractures and the advance of osteoporosis.  And in a healthy, fit, active person, even when there is a fracture, there is better healing and recovery.

What is osteoporosis? 

Osteoporosis is a disease characterized by low bone mass and deterioration of bone tissue. This leads to increased bone fragility and risk of fracture (broken bones), particularly of the hip, spine, wrist and shoulder. Osteoporosis is often known as “the silent thief” because bone loss occurs without symptoms. Osteoporosis is sometimes confused with osteoarthritis, because the names are similar. Osteoporosis is a bone disorder, with loss of the normal strength and quality of the bone, as well as a decrease in the amount of bone. Osteoarthritis is a disease of the joints and surrounding tissue, often described as wear and tear of a previously normal, smooth joint.  *

Consider this:

Osteoporosis can strike at any age and affects both men and women.

The most common sites of fractures are the hips, wrist, spine and  shoulder.

At least 1 in 3 women and 1 in 5 men will suffer from an osteoporotic fracture during their lifetime.

Twenty-eight per cent of women and 37% of men who suffer a hip fracture will die within the following year.

Over 80% of all fractures in people 50+ are caused by osteoporosis.

How can you protect yourself?

Fortunately, there are a variety of ways an individual can protect or improve their bone health.

Have your physician conduct a fracture risk assessment! This may include a bone mineral density test, (BMD) which determines the amount of healthy bone you maintain.  Risk assessment is also evaluating your personal risk, your family history, your age and other complicating factors.  The average age for a BMD is 65 according to Osteoporosis Canada, but a risk assessment begins at age 50!

The two main issues I try to look at with every patient over the age of 50 is significant height loss, yes that’s why we measure your height, and if you have had a fracture since I last saw you–that way I quickly have an idea if there is an increased risk of osteoporosis in that patient.

Eat a healthy diet of calcium rich foods such as leafy greens and dairy products or soy-based products if you are averse to dairy.

Take Calcium & Vitamin D. If you are eating well, you may be getting enough calcium in your diet and supplements are not needed.  Generally speaking, we all need Vitamin D supplements as we get little direct sunlight in North America and that is the common source of Vitamin D.

For those over 50, Canada’s Food Guide recommends 3 servings of milk and alternatives – yogurt, cheese, calcium-fortified beverages, puddings, custards, etc.

This essentially means that, if you are over 50, you need the equivalent of one good serving of dairy at each meal or 1200 units a day of calcium supplements.

I have yogurt each day and at least one latte, so I often decide at night if I have had that 3rd serving of dairy that day.  If not, I take 500mg of Calcium.  If I have had 3 servings, then the third calcium is not needed and NOT advised. More is not better. So you can decide day by day, depending on your diet as it is normal for this to vary a bit every day.

Vitamin D a day –400-1000 IU’s for adults under 50 and 800-2000 IU for adults over 50.  That is a must!

Exercise.  Use weight-bearing exercises that uses your body weight such as walking, running, weight lifting to help to strengthen both bones and muscles, as well as improving your balance.

Consider taking medications that build bone density and prevent bone loss if your risk assessment is significant and you are at risk for fracture. We know that low risk individuals have less than a 10% risk of fracture in the next year and can do well with diet and exercise.  High-risk folks have a greater than 20% risk and should be on medications. And for those of us between 10 and 20%, the moderate risk patients, the decision is individualized, as there are more issues to consider this is the art of medicine and warrants a discussion with your physician.
*Osteoporosis Canada  WWW.osteoporosis.ca