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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.

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Osteoporosis

“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
Comments

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


Comments

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


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.”


Comments

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


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


Osteoporosis the most common bone disease
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!


The silent disease
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


The problem in america
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


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


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


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


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


Why are healthy bones important
Why Are Healthy Bones Important? and hip.

  • 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


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



Risk factors
Risk factors and hip.

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


1 and hip.

  • 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


2 and hip.

  • 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


3 and hip.

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


4 and hip.

I take one of these medicines:

  • Oral glucocorticoids (steroids)

  • Cancer treatments (radiation, chemotherapy)

  • Thyroid medicine

  • Antiepileptic medications

  • Gonadal hormone suppression

  • Immunosuppressive agents


The good news osteoporosis is preventable for most people
The good news: Osteoporosis is preventable for most people! and hip.

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

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


Simple prevention steps
Simple Prevention Steps and hip.

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


Step 1
Step 1 and hip.

Get your daily recommended amounts of calcium and vitamin D.

Use MyPyramid.gov to help plan an overall healthy diet


Step 2
Step 2 and hip.

Be physically active everyday

Improve strength and balance

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


Step 3

12 oz. and hip.

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.


Step 4
Step 4 and hip.

Talk to your doctor about bone health.


Step 5
Step 5 and hip.

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.


Food and supplement labels
Food and supplement labels and hip.

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


Calcium requirements for 50 years
Calcium Requirements for 50+ Years and hip.

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


Nutrition labels calcium
Nutrition labels & calcium and hip.

  • 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


You need more vitamin d as you age
You need more vitamin D as you age and hip.

Daily vitamin D needs in International Units (IU)

Age


Calcium vitamin d recommendations
Calcium & vitamin D recommendations and hip.

  • 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)


Percent daily value dv of calcium in common foods
Percent Daily Value (DV) of calcium in common foods and hip.

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


Dv calcium milk group
% DV calcium: and hip.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


Dv calcium grain products group
% DV calcium: and hip.Grain products group

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

Calcium-fortified


Dv calcium vegetable group
% DV calcium: and hip.Vegetable group

  • Broccoli, raw1 cup = 9% DV

  • Collards1/2 cup = 20% DV

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


Dv calcium fruit group
% DV calcium: and hip.Fruit group

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

Look for 100% juice


Dv calcium meat beans group
% DV calcium: and hip.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


What about vitamin d
What about Vitamin D? and hip.

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


Vitamin d from sunlight exposure
Vitamin D from sunlight exposure and hip.

  • 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


Help for the lactose intolerant
Help for the lactose-intolerant and hip.

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




Calcium carbonate vs citrate

Calcium carbonate and hip.

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


Vitamin d necessary for calcium absorption
Vitamin D necessary for calcium absorption and hip.

  • 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.


Limit calcium to 500 mg at a time
Limit calcium to 500 mg at a time and hip.

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

Spread your calcium sources throughout the day.


Increase amount slowly
Increase amount slowly and hip.

  • 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.


Medications
Medications and hip.

  • 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.


    Osteoporosis falls break bones
    Osteoporosis and hip.Falls Break Bones

    You can prevent most falls


    Protect your bones ways to make your home safer
    Protect Your Bones and hip.Ways to Make Your Home Safer


    Protect your bones ways to make your home safer1
    Protect Your Bones and hip.Ways to Make Your Home Safer


    Protect your bones falls prevention
    Protect Your Bones and hip.Falls Prevention

    Annual medication

    review


    Hip fracture prevention falling how do younger adults fall
    Hip Fracture Prevention: Falling and hip. How do Younger Adults Fall?


    Hip fracture prevention falling how do older adults fall
    Hip Fracture Prevention: Falling and hip. How do Older Adults Fall?


    Hip fracture prevention hip protectors
    Hip Fracture Prevention: and hip. Hip Protectors



    Bone health oral health
    Bone Health & Oral Health and hip.

    • 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.


    Oral health continued

    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


    For more information
    For more information Skin Disease Steps for Healthy Bones

    • 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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