KELLI THOMAZIN, PHYSICIAN ASSISTANT-CERTIFIED October 29 th, 2015 Week 4, 100 miles in 100 days

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 What is osteoporosis?  What is the role of Calcium and Vit D?  What about resistant weight training?  What can walking do to help bone health and wellness?

 a disorder in which the bones become increasingly porous, brittle, and subject to fracture, owing to loss of calcium and other mineral components, sometimes resulting in pain, decreased height, and skeletal deformities: common in older persons, primarily postmenopausal women, but also associated with long-term steroid therapy and certain endocrine disorders.

 By about age 20, the average woman has acquired 98 percent of her skeletal mass. Building strong bones during childhood and adolescence can be the best defense against developing osteoporosis later. National Institute of Heath

 Osteoporosis is more common than it should be. Although we don't know how to completely stop bone loss, we can take steps to prevent many of the fractures. Shown here are the basic building blocks for stronger bones. Prevention starts in childhood, with good nutrition and exercise. Fall prevention is especially important in elderly persons. Many medical papers focus on medications that can be given to reduce the rate of bone loss. Most lay articles, on the other hand, stress life- style issues such as diet and exercise. BOTH are important!  Sometimes doctors and their patients just want to take a medication for osteoporosis, without paying attention to these basic building blocks. The medications will not be as effective if there is inadequate calcium, exercise, or nutrition.

 Calcium is absorbed better when taken through-out the day. It should be taken at least twice a day.  Possibly calcium taken at bedtime can stop bone loss that occurs at night, so one dose of the calcium should be taken late in the day  Patients with KIDNEY STONES, HYPERCALCIURIA DUE TO SARCOIDOSIS AND HYPERPARATHYROIDISM should check with their doctor  Calcium should not be taken in the morning on the same day that a patient is also taking a bisphosphonate (alendronate, Fosamax, ridedronate, Actonel, etidronate, Didronel). It can inhibit the absorption of the medication.  Calcium can also inhibit iron absorption. If a patient is iron deficient, space the iron and calcium supplements, and switch to calcium citrate.  Calcium also inhibits absorption of thyroid medication. If a patient is on thyroid, give it in the morning and delay calcium supplementation until afternoon and evening.

 Milk, Yogurt, Cheese, Ice Cream  Oysters, Sardines, Shrimp, Salmon, Eggs, Legumes  Broccoli, Kale, Collard Greens  Almonds, Tofu, Soy flours, Soy milk

 Milk: 8 ounces (1 cup) contains up to 300 milligrams of calcium.  Cheese (natural e.g. Cheddar, Mozzarella): ounces (the size of a matchbox) contains up to 300 milligrams of calcium.  Yogurt: 8 ounces (1 cup) contains up to 400 milligrams of calcium

 Vitamin D plays a major role in calcium absorption and bone health.  The relationship between calcium absorption and vitamin D is similar to that of a locked door and a key. Vitamin D is the key that unlocks the door and allows calcium to leave the intestine and enter the bloodstream.  Vitamin D also works in the kidneys to help reabsorb calcium that otherwise would be excreted.

 There are three sources of vitamin D:  natural sunlight,  fortification of dietary foods, particularly dairy products and some cereals and oily fish.  Vitamin D supplementation Children and adults with poor sunlight exposure units/day Adults older than age units/day

 Vitamin D is manufactured in the skin following direct exposure to sunlight (5-15 min / 2-4 times per week)  Sunscreen will decrease manufacturing of Vitamin D  Skin color affects Vitamin D production (fair skin= more Vitamin D)  Sunshine helps with Seasonal Affective Disorder/depression  The major food sources of vitamin D are vitamin D-fortified dairy products, egg yolks, saltwater fish and liver  Recommended daily intake is between 400 and 800 international units (IU).

 Body Pump – Les Miles (YMCA)  Active people who get more exercise have a lower risk of hip fracture than sedentary people. This may be due to effects of exercise on the skeleton. Walking is a weight-bearing activity that people can do their entire life, and it does not require any extra expensive equipment. Therefore I recommend walking for prevention of fractures and improved wellness/bone health.  Core Exercises – CX works (YMCA)  Tai Chi/yoga

 Resistant weights  Use common household items Cans of food Gallon of milk  Ankle weights and hand weights  Watch videos on computer/TV  Wellness center/YMCA Classes for weight training – Body Pump Personal training

 Bone health is dependent on some form of physical activity  Research has shown walking will help you:  strengthen the muscles, especially those of the abdomen and legs  joint flexibility, especially that of the hips, knees, and ankles  stimulates circulation, which helps prevent phlebitis and the development of stroke-causing clots  prevent constipation because the movement of the abdominal muscles stimulates the intestinal tract  prevent osteoporosis due to the mineral loss from the bones when they do not bear weight  stimulates the appetite  relieves pressure on the body and skin, helping to prevent pressure ulcers  improves self-esteem and the resident's feelings of independence  improves the resident's ability to socialize