Building & Keeping Strong Bones

Adult Women

The University of Georgia Cooperative Extension Service

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Calcium is “withdrawn” During older adult years When do not consume enough calcium &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

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

What Is Osteoporosis? Porous bones

Bones have lost calcium and other minerals

Bones are fragile Bones fracture easily

Bone Structure

Normal Bone

Osteoporotic bone

National Osteoporosis Foundation, http://www.nof.org/osteoporosis/bonehealth.htm

Risk Factors Female gender Increasing age Thin, small-boned - BMI < 19 Caucasian or Asian ethnicity Family history of fractures or

osteoporosis

Risk Factors Abnormal menstrual history

Late menarche Menstrual interruptions/irregularities Early menopause (< age 45)

Have had an eating disorder or times of strict dieting

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

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

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

5 Steps to Strong Bones

Avoid harmful habits

BMD testing & medications

Active lifestyle

Regular sunshine

Healthydiet

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

Calcium & Vitamin D Recommendation

s 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

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

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

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

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?

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?

Upper Limits Calcium: 2500 mg/day

Vitamin D: 2000 IU/day

National Academy of Sciences 1997

Vitamin D Two sources

Diet Fluid milk Fatty seafood, fish oils, eggs Other fortified foods, supplements

Regular sunlight exposure Skin produces own vitamin D

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

Step 3: Maintain An Active Lifestyle Regular weight-bearing exercises

Strength-training exercises

Balance & stretching exercises

Weight-bearing Exercises 30 minutes daily, > 3 times weekly

Walking, running or jogging Stair climbing, jumping rope, skating Aerobics, tennis Basketball, soccer, volleyball

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

Balance & Stretching Exercises 3 times weekly (or every day)

Improve balance & flexibility Help reduce risk of falling

Do stretches after other exercise

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

Take Medication If Needed Calcium/vitamin D supplements Hormone replacement therapies Bisphosphonates

Alendronate (Fosamax®) Risedronate (Actonel®)

Calcitonin (Miacalcin®) Parathyroid hormone (PTH)

Avoid Harmful Habits Smoking

Strict dieting Heavy drinking (alcohol)

High caffeine consumption Diet low in calcium and vitamin D

Inactive lifestyle

It’s Up To You! What are you going to do to have

strong bones for a lifetime?

Thank You.

Prepared by Marilyn O. Wright, MS, RD, LD

Family Nutrition Program SpecialistUniversity of Georgia

College of Family & Consumer SciencesCooperative Extension Service

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 Association’s 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.