Ensuring Better Bone Health


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Ensuring Better Bone Health

  2. 2. According to National Institute of Health Bone is a living, growing tissue, made mostly of collagen. Collagen is a protein that provides a soft framework, and calcium phosphate is a mineral that adds strength and hardens the framework.
  3. 3. And…   This combination of collagen and calcium makes bone strong and flexible enough to withstand stress. More than 99 percent of the body's calcium is contained in the bones and teeth. The remaining one percent is found in blood.
  4. 4. Why Bone Health is So Important?   Bones support body and facilitate movement. They protect brain, heart, and other organs from injury. National Institute of Health
  5. 5. What Affects Bone Health? • • The amount of calcium in diet. A diet low in calcium contributes to diminished bone density, early bone loss and an increased risk of fractures. Physical activity. People who are physically inactive have a higher risk of osteoporosis than do their more-active counterparts. Mayo clinic
  6. 6. What Affects Bone Health?  Tobacco and alcohol use.  Smoking is a key lifestyle risk factor for bone loss and fractures1. Similarly, alcohol consumption has major harmful effects on bone development and maintenance at all ages2. Reference: 1. Review article, The Effects Of Smoking On Bone Health Peter K. K. WONG, Jemma J. CHRISTIE And John D. Wark Clinical Science (2007) 2. Alcohol’s Harmful Effect on Bone, H. WAYNE SAMPSON, P, National Institute on Alcohol Abuse and . Alcoholism
  7. 7. What Affects Bone Health?  Gender and size- Woman are at greater risk of osteoporosis as they have less bone tissue than men. Similarly extremely thin people (with a BMI of 19 or less) or with small body frame are also prone, as they have less bone mass to draw from as age increases. Reference Public Health Rep. 1989 Sep-Oct; 104(Suppl): 14–20. Risk factors for osteoporosis and associated fractures. JL Kelsy
  8. 8. And The Most Important-Age   After mid-30’s, you begin to slowly lose bone mass. Women lose bone mass faster after menopause, but it happens to men too. Bones can weaken early in life without a healthy diet and the right kinds of physical activity. Source: The 2004 Surgeon General’s Report on Bone Health and Osteoporosis: What It Means to You at http://www.surgeongeneral.gov/library/bonehealth
  9. 9. Weak Bone Leads To… Osteoporosis A Series of Health Issues Arthritis Fracture
  10. 10. Consequences of Weak Bones   One out of two women and one out of eight men will be affected by osteoporosis in their lifetime- Foundation for Osteoporosis Research and Education An estimated 14 million men in the United States currently have low bone mass or osteoporosis- Foundation for Osteoporosis Research and Education  Hip fractures account for 300,000 hospitalizations annually- The 2004 Surgeon General’s Report on Bone Health and Osteoporosis
  11. 11. The National Institutes of Health-Osteoporosis and Related Bone Diseases, States
  12. 12. According to NIN study  Prevalence of osteoporosis & osteopenia In India – WHO criteria Area F Neck Spine Porosis 29% 43% Penia 52% 43% Normal 19% 14%
  13. 13. And The Situation Is More Grim For Women A woman’s hip fracture risk equals her combined risk of breast, uterine and ovarian cancer. Reference: National Osteoporosis Foundation Web site; retrieved July 2005
  14. 14. But The Good News Is Almost all these conditions are not only preventable but also treatable
  15. 15. Simple Steps towards Healthier Bone The National Osteoporosis Foundation (NOF) recommends FIVE simple steps to bone health.
  16. 16. Step 1 Get your daily recommended amounts of calcium and vitamin D. •low intake of calcium, may be responsible for the high prevalence of osteoporosisNIN •The WHO Expert Committees recommended 100 Units (2.5 µg) /d for adult males in 1988 and increased them later in 2005 to 200 Units (5 µg)/d.
  17. 17. NIN Recommendation for calcium (mg/day)
  18. 18. So It’s Important To Remember Some age groups need MORE or LESS than 100% DV for calcium and vitamin D. • Calcium requirements vary by age: • • More is needed as we grow older Need is highest during rapid growth of adolescence. • Vitamin D requirements increase as we age. • 100% DV for calcium and Vitamin D are based on 1,000 mg calcium and 400 IU vitamin D. 18
  19. 19. And Also more vitamin D as you age 600 IU 600 500 400 Daily vitamin D needs 300 in International Units (IU) 200 400 IU 200 IU 100 0 up to 50 51-70 Age 19 over 70
  20. 20. Dairy Products Help Meet RDA According to American Journal of Clinical Nutrition, it is difficult to meet current recommendations for calcium intake without the consumption of dairy foods or supplements therefore, there has been a concerted effort recently by some investigators to recommend increased dairy food consumption, even among lactose-intolerant persons Reference: American Society for Clinical Nutrition Dairy foods and bone health: examination of the evidence Roland Weinsier & Carlos Krumdieck
  21. 21. Dairy Products Help Meet RDA Adequate intake for calcium cannot be met with dairy-free diets while meeting other nutrient recommendations. To meet the adequate intake for calcium without large changes in dietary patterns, calcium-fortified foods are needed. Reference: Journal of American Dietetic Nutrition. Meeting adequate intake for dietary calcium without dairy foods in adolescents aged 9 to 18 years. Department of Nutrition, Harvard University School of Public Health, USA.
  22. 22. Step 2 Exercise across the life span should be encouraged in order to Engage in regular maximize peak bone mass & weight-bearing reduce age related bone loss. exercise. Epidemiological evidence suggests that being active can nearly halve the incidence of hip fractures in the older populationBritish Journal of Sports Medicine
  23. 23. Step 3 Avoid smoking & excessive alcohol One in eight hip fractures is attributable to cigarette smokingWHO Data suggest that ethanol may be responsible for osteoblastic dysfunction resulting in diminished bone formation and reduced bone mineralizationThe American Journal of Medicine Ethanol reduces bone formation and may cause osteoporosis Departments of Gastroenterology and Endocrinology, Royal North Shore Hospital, Australia
  24. 24. Step 4 Talk to your doctor about bone health.
  25. 25. Step 5 Have a bone density test and take medication when appropriate. In contrast to National Osteoporosis Foundation recommendations, only a small minority of high-risk women (12%-34%) get BMD testThe Journal of American Medical Association
  26. 26. Also… 26 Assess calcium and vitamin D intake by using food and supplement labels.
  27. 27. Nutrition labels & calcium    FDA uses “Percent Daily Value” (% DV) to describe amount of calcium needed by general U.S. population daily 100% DV for calcium = 1,000 mg Look for this label:  “Nutrition Facts” on foods  “Supplement Facts” on vitamin/mineral supplements 27
  28. 28. An easy way to meet calcium needs is consuming 3 cups (8 oz.) each day of fat-free or low-fat* milk or equivalent milk products in combination with a healthy diet. Children ages 2–8 years need 2 cups. * Fat-free and low-fat are for health but not for calcium differences 28
  29. 29. % Daily Value calcium: Milk group      Choose fat-free or low fat most often   Yogurt 1 cup (8 oz.) = 30% DV Milk 1 cup = 30% DV Cheese 1 ½ oz. natural/2 oz. processed = 30% DV Milk pudding 1/2 cup = 15% DV Frozen yogurt, vanilla, soft serve ½ cup = 10% DV Ice cream, vanilla ½ cup = 8% DV Soy or rice milk, calcium-fortified 1 cup = varies—check label
  30. 30. And These W ould Take Care Of Vitamin D Main dietary sources of vitamin D are: • Fortified milk (400 IU per quart) • Some fortified cereals • Cold saltwater fish (Example: salmon, halibut, herring, tuna, oysters and shrimp) • Some calcium and vitamin/mineral supplements
  31. 31. Vitamin D from sunlight exposure     Vitamin D is manufactured in skin following direct exposure to sun. Amount varies with time of day, season, latitude and skin pigmentation. 10–15 minutes exposure of hands, arms and face 2–3 times/week may be sufficient (depending on skin sensitivity). Clothing, sunscreen, window glass and pollution reduce amount produced. Source: National Osteoporosis Foundation Web site; retrieved July 2005
  32. 32. Conclusion Bone Health Building Blocks
  33. 33. Thank You