1. Calcium, Bone Health & Osteoporosis - Introduction University of Georgia Cooperative Extension Service

2. What Is Osteoporosis? Porous bones Bones have lost calcium & other minerals Bones are fragile Spine, hip and wrist fractures are common

3. Life of Bones Functions Gives structure to body Protects internal organs Stores essential minerals Types Cortical bone Outer layer Trabecular bone Spongy inner layer

4. Life of Bones Living, active tissue Bone remodeling Osteoclasts Dissolve or break down bone tissue Stimulated by low calcium intake Osteoblasts Rebuild bone tissue Stimulated by exercise

5. Bone Architecture Normal Bone Osteoporotic bone National Osteoporosis Foundation, http://www.nof.org/osteoporosis/bonehealth.htm

6. Prevalence & Cost of Osteoporosis More than 44 million Americans affected 10 million have osteoporosis 34 million have low bone mass Called osteopenia More than 1.5 million fractures each year $17 billion in health costs in 2001

7. Osteoporosis in Georgia 1/3 people > age 50 affected by osteoporosis 75 fractures occur daily $323 million in health costs in 2000 $570 million in estimated health costs by 2025

8. Glimpse of Osteoporosis Fractures One out of two women > age 50 One out of eight men > age 50 Nearly 1/2 million hospitalized with fractures each year One out of five dies within 1 year Half never live independently again

9. Glimpse of Osteoporosis Men 80,000 hip fractures/ year Women of all ethnic backgrounds One in twenty African-American women One in ten Mexican-American women People of all ages Increasing number of women in 20s-30s

10. Risk Factors Female gender Increasing age Thin, small-boned - BMI < 19 Caucasian or Asian ethnicity Family history of fractures or osteoporosis

11. Risk Factors Abnormal menstrual history Late menarche Menstrual interruptions/irregularities Early menopause (< age 45) Past menopause Low testosterone levels (men) History of eating disorder/strict dieting

12. Risk Factors Medical conditions Bone fracture(s) after age 40 Rheumatoid arthritis Thyroid disorder Parathyroid disorder Poorly controlled Type 1 diabetes Lactose intolerance Digestion disorders

13. Risk Factors Medication use Long-term corticosteroid use High doses thyroid hormone Anti-seizure or epilepsy medications Certain diuretics Excessive aluminum-containing antacids Gonadotrophin-releasing hormone agonist

14. Lifestyle Risk Factors Inactive lifestyle Diet low in calcium Little sun exposure and diet low in vitamin D Consume few fruits and vegetables Drink excess alcohol (> 7 drinks/week) Current or former smoker Consume large amounts of caffeine

15. 5 Steps to Strong Bones Avoid harmful habits BMD testing & medications Active lifestyle Regular sunshine Healthy diet

16. Step 1: Eat a Healthy Diet for Bones Diet rich in calcium & vitamin D 2 – 4 servings milk/dairy foods Calcium-fortified foods Calcium/vitamin D supplements Foods rich in other bone healthy nutrients 5 or more servings vegetables & fruits Potassium, magnesium, zinc, copper Vitamin K & vitamin C

17. Building Bones Building bones = building a bank account Calcium is “deposited” During childhood, teen & young adult years When consume enough calcium & vitamin D Calcium is “withdrawn” During older adult years When do not consume enough calcium & vitamin D

18. Calcium & Vitamin D Matter at Any Age Children For bone growth Teens and young adults For bone growth Maximizing bone mass Adults Maximizing bone mass Minimizing bone loss

19. Calcium Recommendations 1997 National Academy of Sciences

20. Choose Calcium-rich Foods Milk, yogurt, buttermilk, ricotta cheese, hard cheeses Calcium-fortified foods Orange juice, soy drinks Breakfast cereals, cereal bars Tofu made w/ calcium sulfate Canned salmon w/bones