Proper nutrition is an integral part of maintaining healthy bones and preventing falls.
Learn more about Nutrition Services at Burke:
http://www.burke.org/rehab/patientinfo/nutrition-dietician-consult
Prevent and Treat Osteoporosis 9769352147Bhupesh Kode
Osteoporosis means "porous bones." Our bones are strongest at about age 30, then begin to lose density. More than 300 million Indians have osteoporosis, which is significant bone loss that increases the risk of fracture. About half of women 50 and older will have an osteoporosis-related fracture in their lifetime.
Proper nutrition is an integral part of maintaining healthy bones and preventing falls.
Learn more about Nutrition Services at Burke:
http://www.burke.org/rehab/patientinfo/nutrition-dietician-consult
Prevent and Treat Osteoporosis 9769352147Bhupesh Kode
Osteoporosis means "porous bones." Our bones are strongest at about age 30, then begin to lose density. More than 300 million Indians have osteoporosis, which is significant bone loss that increases the risk of fracture. About half of women 50 and older will have an osteoporosis-related fracture in their lifetime.
Slide set that accompanied a public lecture on Nutrients and Bone Health held in London September 2011. The lecture focused on the importance of diet and lifestyle in maintaining healthy bone and preventing osteoporosis. Aspects of diagnosis are reviewed and the use of bone markers to indicate bone turnover are discussed in relation to monitoring the response to treatment.
Prime Fifty UK's only vitamin brand focused on the 50sRichard Chandler
We are committed to making a difference to the lives of the over 50s
Welcome to Prime Fifty, the only brand exclusively dedicated to the nutritional and wellbeing needs of the over 50s.
Calcium is an essential mineral for women to help in their bone development. Every woman needs adequate amounts of calcium, especially during her formative years to increase bone density and keep problems like osteoporosis at bay.
The relationship between food habit and osteoporosis in women is vital because with increasing age the requirements for food that can prevent osteoporosis become more vulnerable. Ca and Vit. D rich food should be consumed in a daily basis to prevent osteoporosis and a healthy food habit should build up from young stage to prevent the pitfalls of osteoporosis in older age.
Osteoporosis is estimated to affect about 200 million women worldwide with more patients from Europe, USA and Japan. Do you knwo that about 1 fracture is taking place every 3 reasons just because of this ailment. This ailment is most affected by womens who are more than 60 years of age and several factors pave the way to this condition and the main reason is the lack of physical activity and low intake of calcium rich diet during the earlier stage of life.
If a person is affected with osteoporosis he / she should take in more calcium and continue with moderate physical activity. Take in dietary products to supplement the lack of calcium in the body and use natural remedies / herbal food supplements to cure it.
Benefit-risk Assessment for Including Dairy Foods in the DietNicoleGeurin
Uploaded with permission from Melissa Nickle
Consumption of milk and milk products is an important component of a healthy diet. It is recommended by the Dietary Guidelines for Americans to consume 3 cups per day of fat-free or low-fat milk or equivalent milk products. The benefits of milk and milk products outweigh the perceived risks. If milk is avoided in a diet, careful planning and monitoring is needed to assure adequate essential nutrients such as calcium, vitamin D, potassium, and magnesium. Calcium and vitamin D adequacy is critical to bone health, especially the prevention of osteoporosis.
This slideshow is to educate people that the Best Calcium Supplement is actually Calmodulin (CaM), which is the trasporter and regulator for Calcium ions to go into the cells. Without CaM, calcium cannot be absorped into the cell which leads to calcium defiency. Serious calcium defiency will cause osteopenia and even osteoporosis. Too much of calcium causes calcification. Therefore, calcium needs to be regulated and balanced by Calmodulin.
Slide set that accompanied a public lecture on Nutrients and Bone Health held in London September 2011. The lecture focused on the importance of diet and lifestyle in maintaining healthy bone and preventing osteoporosis. Aspects of diagnosis are reviewed and the use of bone markers to indicate bone turnover are discussed in relation to monitoring the response to treatment.
Prime Fifty UK's only vitamin brand focused on the 50sRichard Chandler
We are committed to making a difference to the lives of the over 50s
Welcome to Prime Fifty, the only brand exclusively dedicated to the nutritional and wellbeing needs of the over 50s.
Calcium is an essential mineral for women to help in their bone development. Every woman needs adequate amounts of calcium, especially during her formative years to increase bone density and keep problems like osteoporosis at bay.
The relationship between food habit and osteoporosis in women is vital because with increasing age the requirements for food that can prevent osteoporosis become more vulnerable. Ca and Vit. D rich food should be consumed in a daily basis to prevent osteoporosis and a healthy food habit should build up from young stage to prevent the pitfalls of osteoporosis in older age.
Osteoporosis is estimated to affect about 200 million women worldwide with more patients from Europe, USA and Japan. Do you knwo that about 1 fracture is taking place every 3 reasons just because of this ailment. This ailment is most affected by womens who are more than 60 years of age and several factors pave the way to this condition and the main reason is the lack of physical activity and low intake of calcium rich diet during the earlier stage of life.
If a person is affected with osteoporosis he / she should take in more calcium and continue with moderate physical activity. Take in dietary products to supplement the lack of calcium in the body and use natural remedies / herbal food supplements to cure it.
Benefit-risk Assessment for Including Dairy Foods in the DietNicoleGeurin
Uploaded with permission from Melissa Nickle
Consumption of milk and milk products is an important component of a healthy diet. It is recommended by the Dietary Guidelines for Americans to consume 3 cups per day of fat-free or low-fat milk or equivalent milk products. The benefits of milk and milk products outweigh the perceived risks. If milk is avoided in a diet, careful planning and monitoring is needed to assure adequate essential nutrients such as calcium, vitamin D, potassium, and magnesium. Calcium and vitamin D adequacy is critical to bone health, especially the prevention of osteoporosis.
This slideshow is to educate people that the Best Calcium Supplement is actually Calmodulin (CaM), which is the trasporter and regulator for Calcium ions to go into the cells. Without CaM, calcium cannot be absorped into the cell which leads to calcium defiency. Serious calcium defiency will cause osteopenia and even osteoporosis. Too much of calcium causes calcification. Therefore, calcium needs to be regulated and balanced by Calmodulin.
Calcium citrate malate is most easily absorbed by the body. Calcium is essential for many diverse processes in the body, including bone formation, muscle contraction, and enzyme and hormone functioning. Calcium is very essential in muscle contraction, oocyte activation, building strong bones and teeth, blood clotting, nerve impulse, transmission, regulating heart beat and fluid balance within cells. Calcium supplementation in pregnancy has the potential to reduce adverse gestational outcomes, in particular by decreasing the risk of developing hypertensive disorders during pregnancy, which are associated with a significant number of maternal deaths and considerable risk of preterm birth, the leading cause of early. Calcium citrate maleate and other nutrients are essential for cell growth and the production and functioning of DNA – the body's genetic blueprint. Based on clinical evidences Calsiara™ is essential for Pregnancy Mother and Fetal development. Along with to improve the mineral density of bone.
Calsiara Tablets: A Clinical Study on Calcium Citrate malate for Bone HealthAJASTJournal
Calcium citrate malate is most easily absorbed by the body. Calcium is essential for many diverse processes in the body, including bone formation, muscle contraction, and enzyme and hormone functioning. Calcium is very essential in muscle contraction, oocyte activation, building strong bones and teeth, blood clotting, nerve impulse, transmission, regulating heart beat and fluid balance within cells. Calcium supplementation in pregnancy has the potential to reduce adverse gestational outcomes, in particular by decreasing the risk of developing hypertensive disorders during pregnancy, which are associated with a significant number of maternal deaths and considerable risk of preterm birth, the leading cause of early. Calcium citrate maleate and other nutrients are essential for cell growth and the production and functioning of DNA – the body's genetic blueprint. Based on clinical evidences Calsiara™ is essential for Pregnancy Mother and Fetal development. Along with to improve the mineral density of bone.
Preliminary research conclusions on improving bone health with the additional effects by introducing radicals like Vitamin D and K within the human foodchain
Powerpoint presentation delivered around the same time as the publication of the articles (uploaded here). What is osteoporosis, how does it develop, what lifestyle factors can help reduce the risks, increase the risks?
An award winning learning package with interactive activities addressing consent, pornography, sexting, FGM and much more. Your Body Your Choices was the winner of the Gold Award for Education and Research at EWIIN in Bari, Italy 2017
Pelvic floor and bladder health information and exercises for exercise teachers
Functions of the Pelvic Floor
The pelvic floor is the inferior and integral component of the abdominal wall.
As such it forms an outlet for the pelvis for urination, defecation, enabling
emptying of the bladder and bowel, and enables vaginal opening for
childbirth. Contraction of the muscles enables the continence of urine
and faeces. The pelvic floor also counteracts changes in abdominal
pressure caused by coughing, sneezing, nose blowing, forced expiration
and vomiting. Reflex activity enables rapid action when required. The
conscious contraction of the pelvic floor can improve sexual enjoyment
during penetrative sex. On the downside, some women experience
involuntary excessive contraction of the pelvic floor prior to or during
penetrative sex, prohibiting sexual intercourse, or making it very painful.
This usually requires referral to specialist psychosexual services. A strong
pelvic floor is also instrumental in preventing a ‘prolapse’. The muscles also
support the contents of the pelvis and abdomen.
Pelvic floor exercises are therefore a vital component of any fitness
programme. Perhaps because results are not immediately evident,
this area has, until recently, received comparatively little attention. One
inhibiting factor for teachers may be the concept of naming the vagina,
urethra and anus in a generally acceptable manner, and so the language
and atmosphere for including the pelvic floor in a programme of exercise
can make all the difference.
Youth work reviews the six resources they consider to be the best for young people, including Barbara Hastings-Asatourian's Contraception Board Game and Safer Sex Interactive Learning Resource
Primary prevention and heart disease, a paper written by Barbara Hastings-Asatourian in 2005 as part of her role as a senior lecturer in health studies and public health.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
1. page 16
osteoporosisPresenter: Barbara Hastings-Asatourian,
MSc, BNurs, RN, RHV, RM, Cert. Ed
O
steoporosis generally has no symptoms until a
fracture occurs. People with vertebral fractures may
have back pain, increasing kyphosis or loss of height,
or low-impact wrist fractures. In younger women,
the finding of osteopaenia on routine X-rays may indicate
impending osteoporosis.
The most effective way to diagnose osteoporosis and determine
fracture risk is through testing for Bone Mineral Density. Other
diagnostic tests include urinary calcium measurement, and
spine/ hip x-rays (Wilson 2001). However, this article will
focus not on the diagnostics, but on prevention through
diet (New 2002).
During the teenage years, the sex hormones affect both bone
size and bone strength. By the age of 17, approximately 90% of
the adult bone mass has been established. By 21 years of age
calcium is no longer added to the bones and by 30, loss of
calcium from healthy bones may begin (Woolf 1998).
Girls as young as nine have been found deliberately restricting
essential foods for weight loss. For females, eating enough
calcium is essential during childhood, adolescence, and young
adulthood, when bones achieve their optimum density. Young
persons involved in competitive sports and dancing are
particularly prone to unhealthy dieting. Studies have also shown
that some women smoke to control their appetite. (Maloney et al
1989, Mellin 1988 Trowbridge and Collins 1993),
National nutrition surveys have shown that many women and
young girls consume less than half the recommended amount
of calcium needed for growing and maintaining healthy bones.
Table One illustrates calcium contents of a selection of easily
accessible foods.
In the second
part of our focus
on osteoporosis,
we look at the
effect of diet on
the condition
As well as the dietary sources listed, drinking water in hard water areas
has been found to be rich in calcium. It has been one public health
consideration that addition of calcium to drinking water may have
beneficial effects on bone.
When diet is low in calcium, supplementary calcium is recommended.
There have been two interesting recent findings about calcium
supplements. Firstly, when calcium enriched mineral water is taken in
small amounts throughout the day calcium is efficiently absorbed.
Secondly, twice daily smaller half doses of calcium supplements are
more effective in maintaining calcium levels than taking one large
dose once daily (New 2002).
fluoride
Although not yet licensed in the UK as a supplement for osteoporosis
prevention, the addition of fluoride salts to drinking water has been
shown in some international studies to have a positive effect on
spinal and femoral neck bone mass. (Food and Nutrition Board of the
Institute of Medicine 1997)
dieting
Childhood and adolescence are the most important times to ensure
adequate calcium intake. There is evidence that young girls and
teenagers are the most deficient in calcium and vitamin D. Efforts to
promote heart health have emphasised the positive aspects of
skimmed milk but have failed to highlight the need for fat-soluble
vitamins. Low fat milk may have increased calcium, but lacks these
vitamins. Teenagers often cut out dairy products because they consider
them too fatty. Milk is a good source of calcium and teenagers often
fail to make up the amount lost through other food. Weight loss has
been shown to be associated with increased bone reabsorption, as
necessary calcium is taken from the bones in the absence of sufficient
amounts in the diet (Trowbridge and Collins 1993).
2. eating disorders
Eating disorders often start in adolescence and
more than 90% of anorexia and bulimia cases
occur among females. Anorexia nervosa
and bulimia nervosa affect as many 3% as of
adolescent and young adult females, a figure
which appears to be increasing.
Eating disorders and over-exercise syndrome may
result in suppression of oestrogen levels and
amenorrhoea if weight loss results in a body mass
index (BMI) of less than 19. This in turn may
impair the achievement of peak bone mass and
cause early bone loss. In one Danish study,
subjects with anorexia and bulimia were found to
be two to three times more likely to suffer a
fracture than subjects without an eating disorder.
The consequent increased fracture risks persisted
for up to 10 years after diagnosis and treatment
(Beals and Manore 1994, Herzog and Copeland
1985, Mellin 1988).
vitamin D
Vitamin D is a fat-soluble vitamin that enables
calcium to transfer from intestine to bloodstream
and prevents excretion of calcium in the urine.
Without sufficiant vitamin D the body begins to
draw calcium from bones.
Food sources of vitamin D include dairy
products, egg yolks, oily fish and liver. The
recommended daily intake is 400 – 800
international units (DoH 1998).
Vitamin D is also derived from exposure of
the skin to solar ultraviolet B radiation. It is
manufactured in the skin following direct
exposure to sunlight. Studies recommend that
10-15 minutes exposure of hands, arms and face
two to three times a week is normally enough,
but the efficiency of this mechanism is also
dependent on the time of day, season, latitude,
skin pigmentation, skin sensitivity, pollution levels
and sunscreens.
There is evidence of significant problems in
population groups who restrict their skin exposure
for cultural and religious reasons. Dress covering
the whole body has adverse effects on vitamin D
status and the potential for causing secondary
hyperparathyroidism in the long term.
Dark winter months in northern latitudes also
increase the risk of vitamin D deficiency and
consequent bone loss. One small German study of
a group of 10 men and 20 women found that
low-dose supplementation with 500 mg of
calcium per day and 500 IU of vitamin D per day
during the winter months effectively prevented
bone loss.
Sunscreen markedly diminishes the manufacture
of vitamin D in the skin, as do window glass,
clothing and air pollution. Skin colour also affects
vitamin D production: the fairer the skin, the
more vitamin D is manufactured. (Compston
1998, Malabana et al 1998)
fitness network
page 17
fn
part 2
food serving size calcium content mg
Skimmed milk: One glass (300g) 360
Cheddar cheese: 50g 360
Semi-skimmed milk: One glass (300g) 354
Whole milk: One glass (300g) 345
Plain yoghurt: One pot (150g) 285
Tinned sardines: 50g 275
Dried figs: Four (80g) 200
Vanilla ice cream: Two scoops 144
Plain fromage frais: 100g 89
Baked Beans: 135g 72
Sesame seeds: 10g 67
Almonds: 25g 60
Tinned salmon: 50g 47
Watercress: 20g 34
White bread: One large slice 33
Wholemeal bread: One large slice 19
Broccoli: 45g 18
Peanuts: 25g 15
(Source: DoH 1998)
Birth to six months 210
Six months to one year 270
One to three years 500
Four to eight years 800
Nine to 13 years 1300
14-18 years 1300
19-30 years 1000
1-70 years 1200
71 and over 1200
references
Compston JE. Vitamin D
deficiency: time for action.
Br Med J. 1998;317: 1466-1467.
Malabana A, Veronikis IE,
Holick MF. Redefining vitamin
D insufficiency. Lancet.
1998;351:805-806
Ghatge KD, Lambert HL, Barker
ME, Eastell R. Bone mineral gain
following calcium supplementation
in teenage girls is reversed two
years after withdrawal of the
supplement. J Bone Miner Res.
2001;16(suppl 1):S173.
Food and Nutrition Board of the
Institute of Medicine. Dietary
Reference Intakes: Calcium,
Phosphorus, Magnesium, Vitamin
D and Fluoride. Washington, DC:
National Academy Press; 1997.
table 1: dietry sources of calcium
table 2: recommended intake
of calcium mg / day