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May is Osteoporosis Awareness Month

May 09, 2010

May is Osteoporosis Awareness Month a good reminder to think about what you are doing for your bones.

At every age, our bones can be affected by diet, physical activity, and other lifestyle factors. During childhood and adolescence, the goal is to build maximal bone density. Middle age adults need to maintain bone density, and older adults should try to reduce bone loss. Older adults also need to reduce their risk of falling.

Our diets contain nutrients that form the structural part of bone as well as some that are involved in the process of bone growth, density, and repair. When it comes to structure, the most obvious ingredient of bone is calcium.

Many people are not aware that bone is also made up of protein and many minerals. Some studies on older adults who were inadequate in their protein intake showed positive changes in bone just from an increase in dietary protein. It appears that adequate but not excessive dietary protein is important.

Since bone requires a number of nutrients, just taking a calcium supplement is not enough to maximize bone health. Healthy foods are needed regardless of whether a calcium supplement is used. Why not try to get most of your calcium from healthy foods first. Then, if you really cannot get enough from your diet, consider adding a supplement.

Know that your body can not take in more than about 500 mg of calcium from a supplement at one time. If you are relying on a supplement for more than this, split the dose over several times a day. With calcium carbonate, take it with food for better absorption. Calcium citrate does not require being taken with a meal. Also, be aware of any conflict between calcium and other supplements (like iron) or medications and separate when you take them by at least four hours.

Very young children need the amount of calcium found in three 8-ounce servings of milk/soy milk, or yogurt. Older children and teens should get four servings (1300mg/day). Middle age adults need about three servings a day (1000 mg/day) and older adults need about five (1500mg). Women who are pregnant or breast feeding should try for four servings a day.

Another very crucial nutrient for bone is vitamin D. Without adequate vitamin D, calcium is less well absorbed and taken up by the bones. Unfortunately, many people living in northern parts of the country are learning that they are vitamin D deficient. Sensible sun exposure in the summer months is good, but for much of the year in New England, the sun is not strong enough to make vitamin D through skin.

The American Academy of Pediatrics now recommends that during periods of growth shortly after birth until at least 18 years of age - children and teens get 400 IU of vitamin D daily. This can be from the limited vitamin D in foods such as fortified milk/soy milk, some yogurts, eggs, oily fish, and a few other fortified foods, or it can be from a multiple vitamin or separate vitamin D supplement. An easy way for children and teens to get the recommended daily intake of both calcium and vitamin D is by drinking four glasses of milk.

Many health professionals recommend that adults get at least 1000 IU vitamin D daily. It is a good idea to have your blood levels of vitamin D checked every so often. The level is probably the lowest late winter since it is the furthest time since summer sun exposure. If you are deficient, you should take a higher dose supplement recommended by your health-care provider and get retested after about 2 months.

Bones also benefit greatly from physical activity. All ages should include weight-bearing aerobic activity most days. Children and teens are encouraged to get 60 minutes of moderate to vigorous exercise most days. Healthy adults should try for 30 minutes of moderately intense exercise at least five days a week or 20 minutes of intense exercise three days a week.

People with established osteoporosis should avoid high impact exercise, side and forward bending of the spine, or twisting movements of the spine. They should also include exercises to maintain balance and flexibility.

Strength building exercises are also good for bone. They are especially important for lighter weight individuals who do not benefit as much from weight-bearing exercise (owing to less body weight imposing the positive stress that triggers the bones to stay strong). This type of exercise benefits both muscle (think reduced risk of falls) and bone. Tufts University is one of the research centers that has been working with older adults and showing a positive benefit on bone from resistance exercise even in people with established osteoporosis.

The goal for strength exercise is to challenge the major muscles two to three times a week. If free weights or machines are used, this equals about one to two sets of 12-15 repetitions, using enough weight to feel muscle fatigue.

Besides a poor diet or sedentary lifestyle, a few other factors can negatively affect bone. Two that can be the most damaging are smoking and some medications (like prednisone and related drugs). Ask your pharmacist if any of your medications affect your bones. If you are on a medication that reduces bone density, see if you can change to an alternative or at least be on the lowest possible dosage. In some cases, if you must be on a bone-depleting drug, your health-care provider may add a medication that slows bone loss. In any case, a healthy diet and regular exercise can help.

Pamela Stuppy, MS,RD,LD is a registered, licensed dietitian with nutrition counseling offices in York, Maine, and Portsmouth. She is also the nutritionist for Phillips Exeter Academy and teaches healthy cooking classes at Stonewall Kitchen Cooking School. Visit