1. Bone Up on Health

2. Objectives Define osteoporosis and why it is a problem. Discuss the importance of knowing your bone health. Discuss osteoporosis prevention techniques: –Calcium –Strength training

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

4. Osteoporosis is More Common than Breast Cancer Women are more at risk for developing osteoporosis than they are for developing breast cancer. 10 million Americans have osteoporosis. Men are also at risk for osteoporosis.

5. Osteoporosis leads to complicated fractures 1 in 2 women and 1 in 8 men over age 50 sustain an osteoporosis-related fracture. Of these: 1 in 5 die within 1 year. 1 in 2 will need assistance with daily activities.

6. It’s What’s Inside that Counts… Bones feel hard to the touch but inside they may be weak and porous – think of a cantaloupe… http://islamic-world.net/children/fruit/melon/pic/cantaloupe.gif

7. How can you tell if your bones are healthy? Get the picture! -Heel scan -DEXA – Duel Energy X-ray Absorptiometry Don’t wait until symptoms, like stooped posture, develop. Check your bone health now!

8. Who is at risk? Women – 1 of 2 women over 50 (1 of 8 men) Small-boned people Caucasian or Asian Family history Low calcium intake as a child High sodium/salt diet Anyone who is getting older

9. Medical Conditions Increase Risk Rheumatoid arthritis Thyroid disorders Parathyroid disorders Type 1 diabetes Lactose intolerance Digestion disorders

10. Medications Can Increase Risk Long-term corticosteroid use High doses of thyroid hormone Anti-seizure or epilepsy medications Certain diuretics Excessive aluminum-containing antacids

11. 5 Steps to Strong Bones Make healthy lifestyle choices Discuss bone health with doctor Physical activity Regular sunshine Healthy diet

12. Step 1: Eat a Healthy Diet Diet rich in calcium & vitamin D –Calcium-fortified foods –3 – 4 servings milk/dairy 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

13. Calcium & Vitamin D Recommendations –19 - 50 years 1,000 mg calcium 200 IU vitamin D –51 - 70 years 1,200 mg calcium 400 IU vitamin D 300 mg calcium & 100 IU vitamin D in 8 oz. milk Tofu made w/ calcium sulfate Canned salmon Fortified orange juice Supplements

14. Upper Limits Calcium: 2500 mg/day Vitamin D: 2000 IU/day 1997 National Academy of Sciences

15. Step 2: Get Regular Sun Exposure Vitamin D is produced by the skin Expose arms and/or legs for 10 - 15 minutes daily, without sunscreen Apply sunscreen after this time

16. Step 3: Maintain an Active Lifestyle Regular weight-bearing exercises Strength-training exercises Balance & stretching exercises

17. Weight-bearing Exercises 30 minutes daily, > 3 times weekly –Walking, running or jogging –Stair climbing, jumping rope, skating –Aerobics, tennis –Basketball, soccer, volleyball

18. Keep Your Balance! Research from Tufts has found that strength training improves balance 1 out of 3 adults over 65 falls each year 95% of hip fractures are attributable to a fall!

19. Step 4. Discuss Medications with Your Physician and Check Bone Mineral Density Calcium/vitamin D supplements Hormone replacement therapy (HRT) Bisphosphonates Alendronate (Fosamax ® ) Risedronate (Actonel ® ) Calcitonin (Miacalcin ® ) Parathyroid hormone (PTH)

20. Step 5. Decrease Lifestyle Risks! Get active! Eat a well balanced diet! Get a little sun! Avoid excessive alcohol (> 7 drinks/week). Stop smoking.

21. Take Charge of Your Bone Health! It’s never too late to protect your bones Make a plan today!

22. What Have I Learned? True or False. Usually a person will have symptoms of osteoporosis before she breaks a bone. Name two ways to strengthen your bones. Name two medicines that can weaken your bones.