Calcium, Bone Health

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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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Function of Bones

• Functions
• Gives structure to body
• Protects internal organs
• Stores essential minerals

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• What is the composition of bone?
• The matrix
• 40 organic
• Type 1 collagen (tensile strength)
• Proteoglycans (compressive strength)
• Osteocalcin/Osteonectin
• Growth factors/Cytokines/Osteoid
• 60 inorganic
• Calcium hydroxyapatite

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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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Life of Bones

• When you are young your body makes new bone
  faster than it breaks down old bones.
• As you get older, this process slows down and you
  start losing bone density.

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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
• The estimated cost for osteoporotic and
  associated fractures is 38 million a day!

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Glimpse of Osteoporosis

• Fractures
• One out of two women gt
  age 50
• One out of eight men
  gt 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 lt 19
• Caucasian or Asian ethnicity
• Family history of fractures or osteoporosis

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Risk Factors

• Past menopause
• Low testosterone levels (men)
• History of eating disorder/strict dieting
• The risk for osteoporosis depends on how much
  bone mass you attained between ages 25 and 35 and
  how fast you lose it.

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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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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 (gt 7 drinks/week)
• Current or former smoker
• Consume large amounts of caffeine

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5 Steps to Strong Bones
Healthy diet
Regular sunshine
Active lifestyle
BMD testing medications
Avoid harmful habits
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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
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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Show Me the Calcium
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Show Me the Calcium
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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
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, gt 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 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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Its Up To You Now!

• What are you going to do to have strong bones
  that last a lifetime?