building & keeping strong bones adult women the university of georgia cooperative extension...
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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Calcium is “withdrawn” During older adult years When do not consume enough calcium &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
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?
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
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.
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