Building

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Building Keeping Strong BonesAdult Women

• The University of Georgia
• Cooperative Extension Service

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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• Calcium is withdrawn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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What Is Osteoporosis?

• Porous bones
• Bones have lost calcium and other
  minerals
• Bones are fragile
• Bones fracture easily

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Bone Structure
Normal Bone
Osteoporotic bone
National Osteoporosis Foundation,
http//www.nof.org/osteoporosis/bonehealth.htm
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Risk Factors

• Female gender
• Increasing age
• Thin, small-boned - BMI
• 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 (
• Have had an eating disorder or times
  of 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 steroid 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
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
• 3 or more 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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Calcium Vitamin D

• Recommendations
• 19 - 50 years
• 1,000 mg calcium
• 200 IU vitamin D
• 51 - 70 years
• 1,200 mg calcium
• 400 IU vitamin D

• Amounts supplied by 8 ounces milk
• 300 mg calcium
• 100 IU vitamin D

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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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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

National Academy of Sciences 1997
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Vitamin D

• Two sources
• Diet
• Fluid milk
• 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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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 exercise

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Step 4 Get a Bone Mineral Density (BMD) Test

• Men/women with signs of osteoporosis
• Fractures, chronic back pain
• Loss of height, humped back
• Men/women with significant risk factors
• Women who had early menopause have other risk
  factors
• Women considering medication therapy to help BMD

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Take Medication If Needed

• Calcium/vitamin D supplements
• Hormone replacement therapies
• Bisphosphonates
• Alendronate (Fosamax)
• Risedronate (Actonel)
• Calcitonin (Miacalcin)
• Parathyroid hormone (PTH)

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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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Its Up To You!

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

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Thank You.

• Prepared by Marilyn O. Wright, MS, RD, LD
• Family Nutrition Program Specialist
• University of Georgia
• College of Family Consumer Sciences
• Cooperative 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
  Associations 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.