Better Bones, Brighter Futures

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Better Bones, Brighter Futures Osteoporosis
Prevention
This project was funded by Michigan Department of
Community Health,
Michigan Public Health Institute, Procter
Gamble
Pharmaceuticals, and United Dairy Industry of
Michigan.
Updated October 2005
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Using the Guide The Better Bones, Brighter
Futures community program is divided into
sections for easy use 1. What is
Osteoporosis 2. Osteoporosis and Its Risk
Factors 3. Talking with Your Health Care
Provider 4. Resources Present the
information outlined above. Sections 1-2 give a
great review of osteoporosis information. You
can present the program in its entirety or by
individual sections over several contacts to keep
the message simple and clear. Tailor the
information to your target group. For example,
you may want to review section 3, Talking with
Your Health Care Provider with a senior
group. There are handouts and activities that
review key ideas. Copies may be found in the
resource section. If you review the information
over several contacts check client progress the
next time you meet by discussing the activity
and obstacles that the group or individual
experienced. Use the guide in one of its several
forms flip chart, overheads, or CD for lap-top
use. Customize the program for your presentation
style. In the resource section add your own
community contacts with phone numbers, addresses,
etc. Make this guide a practical one for your
community. Use educator notes, on the flip
charts reverse page for your handy reference.
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What is Osteoporosis?
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What is Osteoporosis?
A condition of porous, weakened bone that can
lead to breaks or fractures.

• Bones that break include
• Wrist
• Spine
• Hip

Osteoporosis is preventable and treatable.
Graphic used with permission from The 2004
Surgeon Generals Report on Bone Health and
Osteoporosis What It Means To You.
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Bone Growth Overtime
Graphic used with permission from The 2004
Surgeon Generals Report on Bone Health and
Osteoporosis What It Means To You.
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Possible Changes in Bone
Graphic used with permission from The 2004
Surgeon Generals Report on Bone Health and
Osteoporosis What It Means To You.
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What Do You Think?

• Is osteoporosis serious?
• Does a healthy person need to think
  about osteoporosis?
• At what age should you think about
  osteoporosis?

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Osteoporosis and Its Risk Factors
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Risk Factors
You Cannot Change

• Gender
• Age
• Family History
• Ethnicity
• Bone Structure

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You Can Change
Risk Factors

• Food Choices
• Physical Activity
• Smoking
• Alcohol

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Medications Other Treatments
Risk Factors

• Asthma
• Arthritis
• Cancer
• Seizures

For
Discuss with your health care provider whether
your treatment puts you at increased risk.
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Risk Factors
Reduced Hormone Levels
?Estrogen ?Testosterone
As hormones decrease risk increases.
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Ways to Reduce Your Risk
Live A Healthy Lifestyle

• Choose foods rich in calcium and vitamin D
• Be physically active every day
• Reduce your risk of falls

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Reduce Risk
Choose Foods for Bone Health

• Calcium is essential for bone health. If intake
  is poor, your bones may lose calcium.
• Vitamin D allows calcium to be used by the bone.

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Recommendations Daily Calcium

Examples of one serving include 1 cup of skim
milk, 1 cup of fortified orange juice, ½ cup of
part-skim ricotta cheese, 1 ½ ounces of cheese, 1
cup of frozen yogurt or low-fat ice cream.
Childrens servings are usually half the amount
served to an adult.
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Estimating Calcium Intake
Look at the label to see the percent of calcium
in each serving. Add a 0 after the number to
see how much calcium you get from food. For
example , a 1 cup serving of this food would
provide 20 of the average persons daily calcium
needs, or 200 mg of calcium.
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Calcium in Selected Foods
Meat, Beans and Nuts Group Calcium Sardines,
canned in oil, w/ bones, 3 oz 324 mg Soybeans,
cooked, 1 cup 261mg Tofu, firm, with calcium, ½
cup 204 mg Baked Bean, 1 cup 142
mg Salmon, canned, with bones, 3 oz 181
mg Almond, dried roasted, whole, 1/3 cup 126
mg Fruit Group
Calcium Orange juice, calcium fortified, 6
oz. 200-260 mg Fig, dried, 2
60 mg Combination
Food Calcium Fortified
oatmeal, 1 packet 350 mg Spaghetti, lasagna, 1
cup 125 mg Cheese pizza, 1 slice 100 mg
Milk Group Calcium 1 low fat milk, 1 cup
313 mg Yogurt plain, low fat,
1 cup 300 mg Milk shake, 10 fl oz
300 mg Cheddar cheese, 1
½ oz 306 mg Frozen yogurt,
vanilla, soft-serve, 1 cup 103 mg Grain Group

Calcium Pancakes, made with milk, 2 166 mg
Fortified Waffle, 2
100 mg Cereal, fortified with calcium, 1
cup 100-1000 mg Vegetable Group
Calcium Collards, ½ cup
200 mg Turnips greens,
boiled, ½ cup 99 mg Broccoli, raw, 1
cup 90 mg
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The Lowdown on Lactose Intolerance
What is lactose intolerance? Lactose intolerance
is the inability of your body to digest lactose,
the sugar in milk.
If you are lactose intolerant here are some tips
to try

• Start small
• Say cheese
• Get a little culture
• Look for lactose-reduced milk

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Vitamin D for Bone Health

• Necessary for calcium absorption.
• Made by the body with exposure to sunlight.
• Found in
• Fortified foods
• Saltwater fish
• Egg yolks
• Liver

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Vitamin D and Sunlight

• Little sun exposure is needed, approximately 15
  minutes each day.
• Barriers to making vitamin D include
• -Michigan winter
• - Increasing age
• - Sunscreen and clothing
• - Darker skin

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600-800 IU
400 IU
200 IU
Graphic used with permission from The 2004
Surgeon Generals Report on Bone Health and
Osteoporosis What It Means To You.
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Use Food First!
Try to get the nutrition you need
from food you eat.
For people who cannot get enough calcium a
supplement may be needed. Talk to your health
care provider.
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Calcium Supplement Guidelines

• Check for interactions
• Avoid bone meal or dolomite that may contain lead
  or other toxic metals.
• Take in doses of 250 - 500 mg.
• Do not take too much, consider
• the recommended level for your age.
• the amount of calcium in your foods.
• Drink plenty of fluids

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Reduce Risk Physical Activity

• Maintains bone mass
• Improves strength
• Improves balance
• Improves coordination

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Physical Activity
Adults keep your bones strong with physical
activity.
Physical activity at least 30 minutes each
day
Strength training 2-3 times a week
Balance training once a week
Graphic used with permission from The 2004
Surgeon Generals Report on Bone Health and
Osteoporosis What It Means To You.
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Reduce Risk
Protect Yourself from Falls

• Improve your balance, coordination, and strength
  through weight-bearing physical activity such as
  dancing or Tai Chi.
• Review medicines with a health care professional
  (some medicines may cause drowsiness or
  dizziness)
• Have your vision checked
• Make your home safer

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Other Changes
Fall-proof your home
Graphic used with permission from The 2004
Surgeon Generals Report on Bone Health and
Osteoporosis What It Means To You.
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• Talking With Your Health Care
  Provider

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Talking with Your Health Care Provider

• When scheduling, request extra time to discuss
  osteoporosis.
• Know your family history.
• Make a list of your questions and concerns.

Be prepared!

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Talking with Your Health Care Provider
At Your Visit

• Ask questions from your list.
• Ask for an explanation of confusing terms.
• Find out what resources are available in your
  community.
• Take notes.

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Who should be tested?
Women may need a BMD test if they
and men

• Take medication that increases bone loss.
• Have a condition or disease that affects bone
  health.
• Are currently being treated for osteoporosis to
  monitor therapy.

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Detection
A Bone Mineral Density (BMD) test is a
painless procedure that measures bone
strength in certain parts of the
body.
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Prevention or Treatment
Medications

• Actonel
• Boniva
• Calcitonin
• Estrogen/ Hormone Replacement Therapy (ERT/HRT)
• Evista
• Fosamax
• Teriparatide

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Better Bones, Brighter Futures?
Its up to You!
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Resources
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Where Can I Go For More Information
WIC Office __________________ Health
Clinic __________________ MSU Extension
Office __________________ Other
________________ __________________ Other
________________ __________________ References
in the community for educators questions MD/DO
Phone Number __________________ Nurse Phone
Number __________________ Dietitian Phone
Number __________________ Pharmacist Phone
Number __________________ Other
________________ __________________ Other
________________ __________________
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For More Information on Osteoporosis
American Dietetic Association

Phone [phone]

Website www.eatright.org Michiga
n Public Health Institute- Osteoporosis Program
Phone (517)
324-8363

Websitewww.michiganosteoporosisconnection.org
National Osteoporosis Foundation

Phone [phone]

Website www.nof.org National Dairy Council

Website
www.nationaldairycouncil.org National Institutes
of Health Osteoporosis and Related Bone
DiseaseNational Resource Center


Phone [phone]

Website www.osteo.org More
information about the Surgeon Generals Report on
Bone Health and Osteoporosis is available on the
Surgeon Generals website at www.surgeongeneral.
gov

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Activity Tell Family Tell Friends
Osteoporosis is a condition of porous weakened
bone. Silently and over time, it affects bone
strength. The hip, spine and wrist are target
sites. These breaks seriously affect health.
The good news? Osteoporosis is mostly
preventable! List 3 people that you will tell
about this preventable condition 1. 2. 3.
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ActivityThe Importance of Physical Activity for
Healthier Bones
Directions Please answer the following
questions and determine whether you need to
increase your level of exercise to improve bone
health.

• How much physical activity are you currently
  getting?
• Less than 30 minutes 3 times a week
• 30 minutes 3 times a week
• 30 minutes 5 times a week
• 60 minutes 5 or more days a week
• If you are not physically active at least 30
  minutes 5 days a week, what can you change?
  (check all that apply)
• The number of days of the week that you
  physically active
• How many days of the week do you need to be
  physically active?____
• The amount of time you are physically active
  each day
• How much time each day do you need to be
  physically active?____
• What types of physical activities are you
  currently doing to improve your bone health?
• Physical activity that will increase bone
  density, such as weight-bearing, resistance
  training and weightlifting
• Physical activity that improves balance, such
  as dancing, tai chi or yoga
• What types of physical activity would you like to
  add to your daily routine to increase bone mass?
• ____________________________________

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Activity Eliminate Hazards in Your Home
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Weakened Bone Demonstration
PURPOSE To demonstrate the strength that
calcium provides to the bone. MATERIALS
Cooked chicken bones, wishbones, two glass
beakers or containers, vinegar, distilled
water, and saran wrap. PROCEDURE Place cooked
chicken bones in each of the two glass beakers,
or containers. In one container, pour vinegar
to immerse the bone completely. This is the
treated container. In the other container,
pour water to immerse the bones completely.
This is the control container. Cover each
container with saran wrap. Let stand several
days. Add vinegar to the treatment container to
keep the bones covered. Similarly add water to
the control container, if needed, to immerse
the bones. After several days, the treated
bones will appear rubbery, due to leaching of
calcium. The untreated bones will remain the
same.
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Reprinted with permission from United Dairy
Industry of Michigan
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Reprinted with permission from United Dairy
Industry of Michigan
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Calcium in Selected Foods
Meat, Beans and Nuts Group Calcium Sardines,
canned in oil, w/ bones, 3 oz 324 mg Soybeans,
cooked, 1 cup 261mg Tofu, firm, with calcium, ½
cup 204 mg Baked Bean, 1 cup 142
mg Salmon, canned, with bones, 3 oz 181
mg Almond, dried roasted, whole, 1/3 cup 126
mg Fruit Group
Calcium Orange juice, calcium fortified, 6
oz. 200-260 mg Fig, dried, 2
60 mg Combination
Food Calcium Fortified
oatmeal, 1 packet 350 mg Spaghetti, lasagna, 1
cup 125 mg Cheese pizza, 1 slice 100 mg
Milk Group Calcium 1 low fat milk, 1 cup
313 mg Yogurt plain, low fat,
1 cup 300 mg Milk shake, 10 fl oz
300 mg Cheddar cheese, 1
½ oz 306 mg Frozen yogurt,
vanilla, soft-serve, 1 cup 103 mg Grain Group

Calcium Pancakes, made with milk, 2 166 mg
Fortified Waffle, 2
100 mg Cereal, fortified with calcium, 1
cup 100-1000 mg Vegetable Group
Calcium Collards, ½ cup
200 mg Turnips greens,
boiled, ½ cup 99 mg Broccoli, raw, 1
cup 90 mg