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Nutrition and Bone Health
 

Nutrition and Bone Health

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Proper nutrition is an integral part of maintaining healthy bones and preventing falls.

Proper nutrition is an integral part of maintaining healthy bones and preventing falls.

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    Nutrition and Bone Health Nutrition and Bone Health Presentation Transcript

    • NUTRITION and BONE HEALTH November 7, 2012Deborah McInerney, MS, RD, CDN Clinical Nutritionist Hospital for Special Surgery
    • Why is Nutrition Important?  Helps maintain weight and soft tissue which protects and cushions your bones, especially in the event of a fall  Ensures adequate intake of crucial nutrients
    • Small changes in diet, exercise and medication can helpprevent a broken bone.
    • Assessing Your Diet 24-Hour Recall  Well-balanced diet  Too much/little of certain nutrients  Overall caloric intake  Diet restrictions/intolerances  Calcium and vitamin D
    • Calcium and Vitamin DRecommendations
    • Why are Calcium andVitamin D Important? Calcium – helps build and maintain strong bones Vitamin D – plays major role in calcium absorption, therefore bone health; may increase muscle strength to help prevent falls in older adults
    • November 30, 2010Institute of Medicine (IOM) announcednew reference values for calcium and vitamin D
    • Please note that your doctor may prescribe much more vitamin D than the “recommended” amounts if you are at risk for (or have) a low vitamin D level.
    • Why So Much Vitamin D? High risk of deficiency for those with:  Advanced age  Malabsorptive issues  Chronic renal insufficiency  Housebound individuals  Chronic illness  Limited sun exposure
    • MEETING NEEDS FOOD AND SUPPLEMENTS
    • Food First Preferred source of calcium for body Dairy foods are richest sources of calcium Improved dietary patterns Nutrient density
    • Dairy Foods Milk 1 cup (8 oz) 300 mg*Yogurt, plain 1 cup (8 oz) 300-400 mg Cheese 1 ounce 200 mgMilk pudding, ½ cup (4 oz) 55 mgready-to-eatFrozen yogurt ½ cup 100 mg Ice cream ½ cup 84 mg
    • Non-Dairy Foods Almonds 1 ounce 70 mg Broccoli 1 cup 40-80 mg Kale ½ cup 90 mgSalmon, canned 3 ounces 180 mg with bonesSardines, in oil 3 ounces 325 mg with bones Soybeans, 1 cup 260 mg cooked
    • Calcium-Fortified Foods Juices  Rice/soy milk Cereals  Waffles Breakfast  Hot chocolate bars  Cottage Sports bars cheese Granola bars  Tofu
    • Dietary Challenges Lactose intolerance Dairy Allergy Vegetarianism
    • Lactose Intolerance Inability to digest lactose, the milk sugar Know degree of intolerance Choose lactose-free/reduced, soy or rice milk Try smaller portions or take with other foods May tolerate cultured and aged products such as yogurt and/or hard cheese
    • Dairy Allergy or Vegetarianism Calcium-fortified soy/rice products Non-dairy, calcium-fortified beverages Non-dairy, calcium-rich foods
    • Sources of Vitamin D Eggs Fortified foods Fatty fish Vitamin supplement Sunlight – limited benefit
    • Vitamin D Food Sources  Eggs  Fatty fish  mackerel, salmon, sardines  Fortified milk, juice, cereals
    • Vitamin D Food ContentFOOD VIT D (IU)Cod liver oil, 1 Tbsp 1360Swordfish, cooked, 3 oz 566Sockeye salmon, cooked, 3 oz 447Tuna, canned in water, 3 oz 154Milk, 1 cup (8 oz) 115-124Orange juice, fortified, 1 cup 100-137Egg, 1 25-40
    • D – The Sunshine Vitamin Limitations of sun exposure • Age (over 70) • UV protection Suncreen/spf clothing 8 blocks • • Cloud cover/air pollution/season • Skin pigmentation • Amount of skin exposed
    • Supplements Not monitored by the FDA Look for calcium with vitamin D (D2 or D3) Most common types – carbonate, citrate  Take carbonate with food; citrate on empty stomach Calcium chews or liquid if problems swallowing Divided doses of ≤500-600 mg each Drink plenty of fluids Start slowly
    • Excessive Supplementation More is not necessarily better Calcium – try not to exceed 2000 mg OR 2500 mg food and supplements ? whether >1500 mg calcium is beneficial Excessive calcium may affect zinc, iron and magnesium absorption Possible vitamin D toxicity >2000 IU for adults*
    • Choosing a Supplement Common brand namess that contain both calcium & vitamin D  Citracal, Oscal, Caltrate, Nature Made Look for a USP symbol  Indicates supplement has been tested to ensure it contains ingredients listed on label, that it is pure from lead and other metals, and that it is dissolvable in your stomach
    • To test dissolvability, drop supplement into a glass of clear vinegar, stirring occasionally. If it disintegrates within 30 minutes, it should do so in your stomach too.
    • Nutrients to Consider  Protein  Sodium  Fiber  Caffeine  Oxalates  Phytates
    • Where To Begin Assess your diet for adequacy Focus on calcium and vitamin D  How much do you currently get from food and/or supplements? Find out what you need to change  Increase/decrease specific nutrients
    • Reading Food LabelsCalcium % based on 1000 mg 30% = 300 mg
    • Estimating Calcium IntakePRODUCT AMT OF CALCIUMMilk (8 oz) 300 mgYogurt (6-8 oz) 300 mgCheese (1 oz/1” cube) 200 mgFortified orange juice 300 mg(1 cup)TOTAL 1100 mg
    • Additional ResourcesNew York State OsteoporosisPrevention & Education Program(NYSOPEP)SUNY Upstate Medical Universityhttp://www.upstate.edu/nysopep/
    • Additional ResourcesNational Osteoporosis Foundation (NOF)1232 22nd Street NWWashington, D.C. 20037-12021.800.231.4222http://www.nof.org/
    • Additional ResourcesThe National Institutes of Health (NIH)Osteoporosis and Related BoneDiseases – National Resource Center2 AMS CircleBethesda, MD 20892-36761.800.624.BONEhttp://www.niams.nih.gov/Health_Info/bone/
    • Additional ResourcesOffice of Dietary SupplementsNational Institutes of Health6100 Executive Blvd., Room 3B01,MSC 7517Bethesda, MD 20892-7517301.435.2920http://ods.od.nih.gov/