Osteoporosis
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Osteoporosis







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Osteoporosis. “No Bones About It”. No Bones About It. Typical comments from people with osteoporosis. “I’ve lost six inches in height and none of my clothes fit me anymore.”. Comments. “It’s hard to get clothes that look nice when my back is so hunched over.”. Comments.
Osteoporosis

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Slide 1

Osteoporosis

“No Bones About It”

Slide 2

No Bones About It

Slide 3

Typical comments from people with osteoporosis

“I’ve lost six inches in height and none of my clothes fit me anymore.”

Slide 4

Comments

“It’s hard to get clothes that look nice when my back is so hunched over.”

Slide 5

Comments

“What will I do if I have to give up driving?”

Slide 6

Comments

“Medications are expensive. But I can’t afford to let my condition get worse and this medicine will help stop or slow down the bone loss.”

Slide 7

Comments

“If somebody had told me sooner what I know now about osteoporosis, none of this might be happening to me!”

Slide 8

Overview

Osteoporosis causes weak bones. In this common disease, bones lose minerals like calcium. They become fragile and break easily.

Normal

Bone

Bone with

Osteoporosis

Source: The 2004 Surgeon General’s Report on Bone Health and Osteoporosis: What It Means to You at http://www.surgeongeneral.gov/library/bonehealth

Slide 9

OsteoporosisThe Most Common Bone Disease

  • Characterized by low bone mass and deterioration of bone structure

  • Not a natural part of aging

  • Increased risk for women, post-menopausal, over age 65

  • All races, sexes, and ages are susceptible

  • Preventable and treatable!

Slide 10

The “silent disease”

  • Often called the “silent disease”

  • Bone loss occurs without symptoms

    • First sign may be a fracture due to weakened bones

    • A sudden strain or bump can break a bone

Slide 11

The problem in America

  • Major health threat for an estimated 44 million (55%) of people 50 years and older

  • 10 million estimated to have osteoporosis

  • 34 million have low bone mass placing them at risk

  • 1 in 2 women and 1 in 4 men over 50 will have an osteoporosis-related fracture

Source: National Osteoporosis Foundation Web site; retrieved July 2005 at http://www.nof.org

Slide 12

A woman’s hip fracture risk equals her combined risk of breast, uterine and ovarian cancer.

Source: National Osteoporosis Foundation Web site; retrieved July 2005 at http://www.nof.org

Slide 13

Hip fractures account for 300,000 hospitalizations annually.

People who break a hipmight not recover formonths or even years.

Source: The 2004 Surgeon General’s Report on Bone Health and Osteoporosis: What It Means to You at http://www.surgeongeneral.gov/library/bonehealth

Slide 14

1 in 5 people with a hip fracture end up in a nursing home within a year.

Some people never walk again.

Source: The 2004 Surgeon General’s Report on Bone Health and Osteoporosis: What It Means to You at http://www.surgeongeneral.gov/library/bonehealth

Slide 15

The most common breaks in weak bones are in the wrist, spine and hip.

Source: The 2004 Surgeon General’s Report on Bone Health and Osteoporosis: What It Means to You at http://www.surgeongeneral.gov/library/bonehealth

Slide 16

Why Are Healthy Bones Important?

  • Strong bones support us and allow us to move

  • Bones are a storehouse for vital minerals

  • Strong bones protect our heart, lungs, brain and other organs

Slide 17

  • After mid-30’s, you begin to slowly lose bone mass.

  • Women lose bone mass faster after menopause.

  • Men lose bone mass too.

Source: The 2004 Surgeon General’s Report on Bone Health and Osteoporosis: What It Means to You at http://www.surgeongeneral.gov/library/bonehealth

Slide 18

You’re never too young or old to improve bone health!

Slide 19

Risk factors

If you have any of these “red flags,” you could be at high risk for weak bones. Talk to your health care professional.

Source: The 2004 Surgeon General’s Report on Bone Health and Osteoporosis: What It Means to You at http://www.surgeongeneral.gov/library/bonehealth

Slide 20

1

  • I’m older than 65

  • I’ve broken a bone after age 50

  • My close relative has osteoporosis or has .broken a bone

  • My health is “fair” or “poor”

  • I smoke

  • I am underweight for my height

Slide 21

2

  • I started menopause before age 45

  • I've never gotten enough calcium

  • I have more than two drinks of alcohol .several times a week

  • I have poor vision, even with glasses

  • I sometimes fall

  • I'm not active

Slide 22

3

I have one of these medical conditions:

  • Hyperthyroidism

  • Chronic lung disease

  • Cancer

  • Inflammatory bowel disease

  • Chronic liver or kidney disease

  • Hyperparathyroidism

  • Vitamin D deficiency

  • Cushing's disease

  • Multiple sclerosis

  • Rheumatoid arthritis

Slide 23

4

I take one of these medicines:

  • Oral glucocorticoids (steroids)

  • Cancer treatments (radiation, chemotherapy)

  • Thyroid medicine

  • Antiepileptic medications

  • Gonadal hormone suppression

  • Immunosuppressive agents

Slide 24

The good news: Osteoporosis is preventable for most people!

  • Healthy diet and lifestyle are important for BOTH men and women.

  • If you have osteoporosis, your doctor can detect and treat it

Slide 25

Simple Prevention Steps

The Surgeon General recommends five simple steps to bone health and osteoporosis prevention …

Slide 26

Step 1

Get your daily recommended amounts of calcium and vitamin D.

Use MyPyramid.gov to help plan an overall healthy diet

Slide 27

Step 2

Be physically active everyday

Improve strength and balance

Even simple activities such as walking, stair climbing and dancing can strengthen bones.

Slide 28

12 oz.

5 oz.

1.5 oz.

Step 3

Avoid smoking and excessive alcohol.

MyPyramid.gov recommends no more than 1 drink per day for women and 2 for men.

Slide 29

Step 4

Talk to your doctor about bone health.

Slide 30

Step 5

Have a bone density test

and take medication

when appropriate.

Source of photo: USDA ARS Photo Unit Photo by Peggy Greb

Testing is a simple, painless procedure.

Slide 31

Food and supplement labels

Assess calcium and vitamin D intake by using food and supplement labels.

Slide 32

Calcium Requirements for 50+ Years

Goal

Source: The 2004 Surgeon General’s Report on Bone Health and Osteoporosis: What It Means to You at http://www.surgeongeneral.gov/library/bonehealth

Slide 33

Nutrition labels & calcium

  • FDA uses “Percent Daily Value” (% DV) to describe amount of calcium needed by general U.S. population daily

  • 120% DV for calcium = 1,200 mg

  • Look for this label:

    • “Nutrition Facts” on foods

    • “Supplement Facts” on vitamin/mineral supplements

Slide 34

You need more vitamin D as you age

Daily vitamin D needs in International Units (IU)

Age

Slide 35

Calcium & vitamin D recommendations

  • 51 - 70 years1,200 mg calcium (120% DV)400 IU vitamin D (100% DV)

  • 70 and older1,200 mg calcium (120% DV)600 IU vitamin D (150% DV)

Slide 36

Percent Daily Value (DV) of calcium in common foods

Approximate % DV for foods based in part on The 2004 Surgeon General’s Report on Bone Health and Osteoporosis: What It Means to You at http://www.surgeongeneral.gov/library/bonehealth

Slide 37

% DV calcium: Milk group

  • Yogurt1 cup (8 oz.) = 30% DV

  • Milk1 cup = 30% DV

  • Cheese1 ½ oz. natural/2 oz. processed = 30% DV

  • Milk pudding1/2 cup = 15% DV

  • Frozen yogurt, vanilla, soft serve½ cup = 10% DV

  • Ice cream, vanilla½cup = 8% DV

  • Soy or rice milk, calcium-fortified1 cup = varies—check label

Choose fat-free or low fat most often

Slide 38

% DV calcium: Grain products group

  • Cereal, calcium- fortifiedServing size and amount of calcium varies—check label

Calcium-fortified

Slide 39

% DV calcium: Vegetable group

  • Broccoli, raw1 cup = 9% DV

  • Collards1/2 cup = 20% DV

  • Turnip greens, boiled1/2 cup = 10% DV

Slide 40

% DV calcium: Fruit group

  • Orange juice and other calcium-fortified beverages6 oz. = 20 to 30% DV, varies—check label

Look for 100% juice

Slide 41

% DV calcium: Meat & Beans Group

  • Baked beans1 cup= 14% DV

  • Salmon, canned, with edible bones3 oz. = 18% DV

  • Sardines, canned, in oil, with edible bones3 oz. = 32% DV

  • Soybeans, cooked1 cup = 26%

  • Tofu, firm, with calcium ½ cup = 20% DV; check label

Slide 42

What about 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

Slide 43

Vitamin D from sunlight exposure

  • Vitamin D is manufactured in your 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 at http://www.nof.org

Slide 44

Help for the lactose-intolerant

Some people lack the enzyme lactase needed to digest lactose (milk sugar).

Slide 45

When you don’t like to “drink” milk

Slide 46

Calcium supplement considerations

Slide 47

Calcium carbonate

Needs acid to dissolve and for absorption

Less stomach acid as we age

Often taken at meals when more stomach acid

Calcium citrate

Doesn’t require stomach acid for absorption

May be taken anytime—check with your healthcare provider

May cost more

Calcium carbonate vs. citrate

Slide 48

Vitamin D necessary for calcium absorption

  • Choose a supplement with vitamin D unless obtaining vitamin D from other sources.

  • Follow age group recommendation. Avoid goingover a daily combined total of 2,000 IU or 50 mcg from foodand supplements.

  • It’s not necessary to consume calcium and vitamin D at the same time to get the benefit of enhanced calcium absorption.

Vitamin D is like a key that unlocks the door and lets calcium into the body.

Slide 49

Limit calcium to 500 mg at a time

Our bodies can best handle about 500 mg calcium at one time from food and/or supplements.

Spread your calcium sources throughout the day.

Slide 50

Increase amount slowly

  • Start supplements with 500 mg calcium daily for about a week, gradually adding more.

  • Gas and constipation can be side effects:

    • Increase fluids and high fiber foods if diet is low in whole grains and fruits and vegetables.

    • Try a different type of supplement if side effects continue.

Slide 51

Medications

  • Bisphosphonates

    • (Fosamax®) - Alendronate &

      Alendronate with Calcium

    • (Boniva®) - Ibandronate (Updated 2006)

    • (Actonel®) - Risedronate & Risedronate with Calcium

  • (Miacalcin®) Calcitonin

  • Estrogen Therapy/Hormone Therapy

  • Parathyroid Hormone (PTH 1-34)

  • Selective Estrogen Receptor Modulator (SERM)

    • (Evista®) Raloxifene

  • Source:

    Physician’s Guide to Prevention and Treatment of Osteoporosis. 2nd ed. Washington, DC: National Osteoporosis Foundation; 2003.

    Slide 52

    OsteoporosisFalls Break Bones

    You can prevent most falls

    Slide 53

    Protect Your Bones Ways to Make Your Home Safer

    Slide 54

    Protect Your Bones Ways to Make Your Home Safer

    Slide 55

    Protect Your BonesFalls Prevention

    Annual medication

    review

    Slide 56

    Hip Fracture Prevention: Falling How do Younger Adults Fall?

    Slide 57

    Hip Fracture Prevention: Falling How do Older Adults Fall?

    Slide 58

    Hip Fracture Prevention: Hip Protectors

    Slide 59

    Bone Health Building Blocks

    Slide 60

    Bone Health & Oral Health

    • Oral health care is important.

    • Bone loss in the jaw and osteoporosis have been linked

    • The loss of bone supporting the jaw and anchoring our teeth can lead to loose teeth, tooth loss and ill fitting dentures.

    • Your dentist may be the first health professional to suspect osteoporosis.

    • Women with osteoporosis have been reported to have 3 x more tooth loss than women without the disease.

    Slide 61

    The National Institute of Arthritis and Musculoskeletal and Skin Disease Steps for Healthy Bones

    Eat a well-balanced diet rich in calcium and vitamin D.

    Live a healthy lifestyle. Don’t smoke, and if you choose to drink alcohol, do so in moderation.

    Engage in regular physical activity or exercise. Weight-bearing activities, such as walking, jogging, dancing, and lifting weights, are the best for strong bones.

    Report any problems with loose teeth, detached or receding gums, and loose or ill-fitting dentures to your dentist and doctor.

    ORAL HEALTH Continued

    Slide 62

    For more information

    • The 2004 Surgeon General’s Report on Bone Health and Osteoporosis: What It Means to Youhttp://www.surgeongeneral.gov/library/bonehealth

    • National Osteoporosis Foundation http://www.nof.org

    Thanks to University of Nebraska–Lincoln Extension educational programs


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