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Osteoporosis

Osteoporosis is often called a “silent disease” becasue bone loss occurs without symptoms. Osteoporosis is not just a woman’s disease—it affects men, women and children alike. Think of it as an adolescent disease with geriatric consequences. More than 1.5 million Americans experience osteoporotic fractures each year with an estimated national cost of $14 billion to the US healthcare system—and costs are rising.
Osteoporosis is a disease in which the density and quality of bone is reduced, increasing the risk of fracture. There is no cure for osteoporosis, although new treatments may be able to stop further bone breakdown and help build new bone tissue. Proper diet and exercise are important cornerstones of prevention as well as treatment.

What factors can lead to osteoporosis?
Calcium is deposited in bones until about the age of 30. After that, we gradually lose bone tissue. This loss accelerates in women after menopause because they produce less estrogen, the main hormone that keeps bones strong. Years of low calcium, combined with other risk factors, result in bones that are brittle and easily fractured.

What about Vitamin D?
Eating calcium-rich foods from early in life is essential to build and maintain strong bones. Research has also shown that adequate vitamin D intake is essential to promote calcium absorption. Experts now recommend a daily intake of between 400 and 800 international units (IU). Fortified foods are common sources of vitamin D. Although milk is fortified with vitamin D, dairy products made from milk, such as cheese and ice creams, are generally not fortified with vitamin D and contain only small amounts. Other dietary sources of vitamin D include:

• Cod Liver Oil
• Salmon
• Mackerel
• Sardines
• Eggs
• Liver
• Fortified breakfast cereals

Foods high in calcium (mg/serving)

Swiss cheese (3.5 ounces)	950	Orange	54
Cheddar cheese (3.5 ounces)	715	Almonds (3/4 cup)	282
>Calcium fortified orange juice (1 cup)	bsp;  Broccoli (1/2 cup cooked)	49
Milk (1 cup)	300<	Nonfat yogurt (1 cup)	345
Soybeans (1/2 cup cooked)	102	Pinto beans (1/2 cup cooked)	40
Soymilk, enriched (1 cup)	300	Dried figs (5)	135
Kale (1/2 cup, cooked)	89	Pink salmon (3 ounce can)	181
Rice Dream, enriched (1 cup)	300	Spinach (1/2 cup cooked)	106
Baked beans (1/2 cup, cooked)	70	Nonfat dry milk powder (1 tablespoon)	52
Tofu, firm (1 cup)	130

Am I at risk for osteoporosis?

• Do you have a family history of osteoporosis?
• Are you Caucasian or Asian? (Studies are now beginning to show that African Americans and Hispanic Americans are also at risk).
• Do you smoke?
• Do you regularly take steroids, seizure medications, large amounts of thyroid hormone or any medications known to interfere with calcium absorption?
• Are you postmenopausal?
• Do you exercise or do weight bearing exercise less than 3 times a week?
• Have you had extended periods of immobilization or bed rest?
• Are you thin and/or have a small frame?
• Do you have an eating disorder?
• Did you have a late onset of menstruation (after age 16)?
• Did you have an early onset of menopause (before age 45), either naturally or due to surgery?
• Have you had an absence of menstrual periods for any extended time?
• I have one or more of the medical conditions: type 1 diabetes, endometriosis, kidney stones, anorexia/bulimia,asthma, rheumatoid arthritis, celiac disease, Cushing syndrome, Addison’s disease, multiple sclerosis, pernicious anemia, hyperthyroidism, stomach or intestinal surgery.

You may not be absorbing enough calcium if you —

• Are a heavy drinker of alcoholic beverages
• Eat an excessive amount of animal protein (meat, cheese, dairy)
• Drink excessive amounts of carbonated beverages (soda)
• Eat high sodium foods
• Have a low intake of dietary calcium
• Consume large amounts of caffeine
• Inadequate intake of vitamin D

What actions can you take to help prevent osteoporosis?

• Stimulate your bones by doing weight-bearing exercise (i.e. walking, dancing, golf, tennis) for 30 minutes at least 3 times per week
• Limit intake of alcoholic beverages
• Avoid excessive intake of animal protein
• Do not smoke
• Hormone replacement therapy and bone health medications (discuss with your doctor)

Daily Calcium Requirements*

Birth to 6 months	400mg
Pregnant or lactating	1200-1500mg
6 to 12 months	600mg
1 to 5 years	800mg
6 to 10 years	800-1200mg
11 to 24 years	1200-1500mg
25 to 50 years	1000mg
Post menopausal on HRT	1000mg
Post menopausal not on HRT	1500mg

*Vitamin D helps in the formation of bone tissue
Source: National Institute of Health