1. Diet and Osteoporosis

2. What Is Osteoporosis? Osteoporosis means “porous bones,” and leads to weak bones that are easily broken normal bone osteoporotic bone Images are copyright of University of Glasgow http://www.anatomy.gla.ac.uk/fab/

3. How Does It Happen? Bone is a living tissue It is constantly being built up and broken down Bone tissue production slows at age 30-40 and bone mass starts to decline with age

4. How Does It Happen? When dietary calcium is insufficient, it is taken from the bones Bones serve as a source of stored calcium

5. Is Osteoporosis Common? 25 million people are affected 1.5 million broken bones annually $10 billion in healthcare costs yearly

6. What Are the Symptoms? Silent disease – no symptoms until far-advanced A broken bone is often the first clue that bones are dangerously weakened

7. What Are The Risk Factors? Age Menopause Genetic Sedentary Dietary Low body weight Smoking Some drugs

8. What Are The Risk Factors? Age Menopause Genetic Sedentary Dietary Low body weight Smoking Some drugs These are the factors you can control

9. What Can I Do to Lower My Risk? Increase the lifestyle & dietary factors that build bones Decrease the lifestyle & dietary factors that deplete or weaken bones

10. Increase the Lifestyle & Dietary Factors That Build Bones

11. What Helps Build Bones? Resistance exercise: Some calisthenic exercises Free weights or machines Rubber exercise bands Resistance exercises are the most effective

12. What Helps Build Bones? Weight bearing aerobic exercise: Walking & jogging Basketball Aerobic classes Dancing Cross country skiing Skating Mowing lawn Volley ball Tennis Racquet ball NOTE: biking and swimming are less effective

13. What Nutrients Help Build Bones? Calcium Vitamin D Vitamin K Potassium Trace minerals: boron magnesium zinc copper manganese fluoride

14. Does This Mean I Need A Lot of Supplements? Not necessarily – let’s take a look at an easy way to get all of these essential vitamins and minerals

15. Heart Healthy Calcium Nonfat DairyBroccoli, Kale

16. Heart Healthy Calcium Sardines & salmon with bones Almonds

17. Calcium Fortified Foods Some calcium-fortified foods are also good sources of other nutrients

18. Calcium Fortified Foods Some calcium-fortified foods are low in fiber and calorie-dense

19. High in Calcium But Poorly Absorbed Spinach, rhubarb, beet greens and Swiss chard all contain oxalate which inhibits absorption of the calcium they contain

20. Adequate Daily Intake for Calcium Source: U.S. National Academy of Science, 1997 Babies: 0-6 months210 mg 6-12 months270 mg Children: 1-3 years500 mg 4-8 years800 mg 9-13 years1300 mg Adults: 14-18 years1300 mg 19-50 years1000 mg 51+ years1200 mg

21. Adequate Daily Intake for Calcium Source: U.S. National Academy of Science, 1997 Pregnant Women: 18 years or less1300 mg 19-50 years1000 mg Nursing Mothers: 18 years or less1300 mg 19-50 years1000 mg Post-menopausal women On estrogen1200 mg Not on estrogen1500 mg

22. Easy Way to 1000 Mg Calcium Per Day 1 cup fortified orange juice350 1 cup nonfat flavored yogurt350 1 cup skim milk or fortified soymilk300 1 cup cooked beans80 Dark green salad70 1 cup broccoli42 Total1192

23. A Cup With Every Meal

24. Know the Terms A “good” source of calcium contains at least 10% of the daily value or 100 mg

25. Know the Terms An “excellent” source of calcium contains at least 20% of the daily value or 200 mg

26. Know the Terms 10% of the daily value for calcium means that a food contains around 100 mg of calcium This product contains 400 mg calcium

27. Who Should Take Calcium Supplements? People who don’t get enough calcium from food sources Average daily intake for American women is only 500 mg/day

28. Which Calcium Supplement? Best-absorbed and least constipating Good for older people who have low stomach acid Calcium citrate:

29. Which Calcium Supplement? Best for children & young adults who absorb it as efficiently as calcium citrate Calcium carbonate:

30. Calcium Supplement Tips Take them at meal time when there is acid present in stomach Drink plenty of water Avoid salt, excessive animal protein, soda, coffee and other sources of caffeine for better use of dietary calcium

31. Won’t Prevent Fractures The US Preventive Task Force he Task Force recommends against daily supplements of less than 400 IU of vitamin D3 and less than 1,000 mg of calcium for the prevention of fractures in postmenopausal women.

32. Won’t Prevent Fractures The Task Force found that the current evidence is insufficient to make a recommendation on daily supplements greater than 400 IU of vitamin D3 and greater than 1,000 mg of calcium for the prevention of fractures in postmenopausal women.

33. Won’t Prevent Fractures The Task Force found that the current evidence is also insufficient to make a recommendation on vitamin D and calcium supplements for the prevention of fractures for men and premenopausal women.

34. Vitamin D From the sun (10-20 minutes, 3 times per week) Also in fortified food: milk, some soy milk, fish with bones and cereals

35. Vitamin K Helps maintain strong bones It is found in fruits & vegetables

36. Potassium Helps maintain strong bones It is abundant in fruits & vegetables

37. Trace Minerals: Boron Helps maintain strong bones Found in fruits and vegetables, also in legumes and nuts

38. Trace Minerals: Magnesium Helps maintain strong bones Found in whole grains, leafy green vegetables and beans

39. Trace Minerals: Zinc Helps maintain strong bones Found in seafood, milk, wheat germ, whole wheat, tofu, almonds, black eye peas, peanut butter

40. Trace Minerals: Copper Helps maintain strong bones Found in nuts, seeds, seafood

41. Trace Minerals: Manganese Helps maintain strong bones Found in whole grains, fruits, vegetables and tea

42. Trace Minerals: Fluoride Helps maintain strong bones Found in fish with edible bones, fluoridated water, tea

43. Decrease the Lifestyle & Dietary Factors That Deplete or Weaken Bones

44. What Weakens Bone? Excess dietary salt One study found that an extra 2000 mg of sodium ingested required about 1000 mg of calcium more to maintain the body’s calcium stores

45. Read the Label Purchase foods that contain equal to or fewer mg of sodium than calories

46. What Weakens Bone? Excessive soft drinks and caffeine

47. What Weakens Bone? Excessive meat & animal protein

48. What Weakens Bone? Rapid weight loss: Crash diets High protein diets Fad diets

49. What Weakens Bone? Excessive Vitamin A A

50. What Weakens Bone? Excessive fluoride Fluoride

51. What Weakens Bone? Cigarette smoking & heavy drinking

52. A Diet That Builds Bone Plenty of fruits and vegetables Whole grains Legumes (beans and peas) Nuts, seeds Fish and seafood Nonfat dairy, fortified soy or calcium fortified foods Don’t forget: Vitamin D (sunshine, skim milk or supplements) & weight bearing exercise!

53. Cooking for Your Bones Add kale and broccoli to pasta dishes, soups and stir fry dishes

54. Cooking for Your Bones Use calcium-fortified orange juice to cook vegetables such as sweet potatoes and carrots

55. Cooking for Your Bones Use pureed beans to thicken soups

56. Cooking for Your Bones Cook and bake with calcium- fortified milk or soymilk

57. Cooking for Your Bones Use dark green lettuce such as romaine for salads