4/25/2014. Osteoporosis. Osteoporosis. 1. Bone building nutrients. Nutrition and Bone Health

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Bones Nutrition and Bone Health Yvonne Chambers-Kozarov Registered Dietitian are

use the calcium and nutrients in the foods you eat to build new bone 90% of adult

about age 30 Osteoporosis Thinning of bone tissue and a loss of bone density over

sometimes called a "silent disease" Often, the first indication of osteoporosis

1 Bones Nutrition and Bone Health Yvonne Chambers-Kozarov Registered Dietitian are constantly under construction certain cells break down bone tissue other cells use the calcium and nutrients in the foods you eat to build new bone 90% of adult bone mass is in place by the end of adolescence Bones continue to build until about age 30 Osteoporosis Thinning of bone tissue and a loss of bone density over time After our mid-30 s, we begin to slowly lose bone mass Osteoporosis It is sometimes called a "silent disease" Often, the first indication of osteoporosis is when a bone breaks Approximately 10 million Americans have osteoporosis and 34 million are at risk 1. Bone building nutrients Get your daily recommended amounts of calcium and vitamin D Include a variety of foods containing other bone building nutrients 1

Calcium Building block of bone tissue Calcium requirements depend on the stage of life with teenagers having high requirements due to rapid growth of

19-50 years old 1,000 51-70 year old males 1,000 51-70 year old females Calcium RDA (mg/day) 1,200 > 70 years old 1,200 Sources Milk, cheese, yogurt

soy beverages Calcium Our body can best handle about 500mg of calcium at a time from food and/or supplements Steps to estimate your calcium intake So,

org/articles/542 Vitamin D Assists with calcium absorption from foods Made in our skin during the summer months from exposure to the sun s ultraviolet B

years old 600 4-8 years old 600 9-18 years old 600 19-50 years old 600 51-70 year old males 600 51-70 year old females Vitamin D RDA (IU / day) 600 > 70

2 Calcium Building block of bone tissue Calcium requirements depend on the stage of life with teenagers having high requirements due to rapid growth of the skeleton The absorption of calcium from foods decreases with age Calcium Life Stage Group 1-3 years old years old 1, years old 1, years old 1, year old males 1, year old females Calcium RDA (mg/day) 1,200 > 70 years old 1,200 Sources Milk, cheese, yogurt Broccoli, kale Canned fish with edible bones Nuts especially almonds and Brazil nuts Oranges, apricots and dried figs Fortified foods such as juices and soy beverages Calcium Our body can best handle about 500mg of calcium at a time from food and/or supplements Steps to estimate your calcium intake So, it is preferable to consume calcium sources throughout the day instead of all at one time National Osteoporosis Foundation Vitamin D Assists with calcium absorption from foods Made in our skin during the summer months from exposure to the sun s ultraviolet B rays Exposure for minutes per day outside peak sunlight hours (before 10am and after 2pm) should be sufficient Vitamin D Life Stage Group 1-3 years old years old years old years old year old males year old females Vitamin D RDA (IU / day) 600 > 70 years old 800 Sources Oily fish such as mackerel and salmon Egg yolks Liver Fortified foods such as breakfast cereals and dairy Supplements (especially important during winter months) 2

Nutrition labels FDA uses Percent Daily Value (% DV) to describe amount of calcium and vitamin D 100% DV for calcium = 1,000 mg 30% = 300mg calcium 100% DV for Vitamin D = 400 IU 25% = 100IU Vitamin

3 Nutrition labels FDA uses Percent Daily Value (% DV) to describe amount of calcium and vitamin D 100% DV for calcium = 1,000 mg 30% = 300mg calcium 100% DV for Vitamin D = 400 IU 25% = 100IU Vitamin D Adjust % DV if you eat a different serving size than on label Protein Important for building bone health during childhood and adolescence, as well as preserving bone health during aging Sources Lean red meat, poultry and fish Eggs Low fat and nonfat dairy Legumes (lentils, kidney beans) Soy Nuts and seeds Fruits and vegetables Contain vitamin K which is necessary for correct bone formation Source of magnesium which also helps form bones Vitamin A Dairy foods, fish liver oil, liver and egg yolks Contain potassium which creates an alkaline environment that reduces acidity Provide antioxidants Excessive intakes through supplements may have negative effects on bone health Sodium Can increase urinary calcium excretion 2. Exercise Engage in regular exercise Limit sodium to 2,300 mg daily 3

Weight-bearing exercise Weight-bearing exercises help build bones and keep them strong Muscle-strengthening exercise These exercises include activities where you move

impact aerobics Stair machine Fast walking on treadmill or outside Resistance Lifting weights Using elastic exercise bands Lifting your body weight Yoga and pilates

legs and test your balance, such as Tai Chi How much exercise Posture exercises that improve your posture and reduce rounded or sloping shoulders can help you decrease

chance of falling and breaking a bone. For example, if you have trouble getting up from a chair or climbing stairs, you could do these activities as exercises.

org/articles/238 Starting a new exercise program If you haven t exercised regularly for a while, check with your healthcare provider If you re at high risk of breaking

4 Weight-bearing exercise Weight-bearing exercises help build bones and keep them strong Muscle-strengthening exercise These exercises include activities where you move your body, a weight or some other resistance against gravity High impact Dancing High impact aerobics Hiking Jogging and running Tennis Low impact Elliptical Low impact aerobics Stair machine Fast walking on treadmill or outside Resistance Lifting weights Using elastic exercise bands Lifting your body weight Yoga and pilates Non-impact exercises Non-impact exercises can help you to improve balance, posture and how well you move in everyday activities Balance exercises that strengthen your legs and test your balance, such as Tai Chi How much exercise Posture exercises that improve your posture and reduce rounded or sloping shoulders can help you decrease the chance of breaking a bone, especially in the spine Functional exercises that improve how well you move can help you with everyday activities and decrease your chance of falling and breaking a bone. For example, if you have trouble getting up from a chair or climbing stairs, you could do these activities as exercises. National Osteoporosis Foundation Starting a new exercise program If you haven t exercised regularly for a while, check with your healthcare provider If you re at high risk of breaking a bone, you should work with a physical therapist to develop a safe exercise program Start slowly once you have your healthcare provider s approval 3. Harmful Avoid smoking and excessive alcohol Moderate alcohol consumption is defined as having up to 1 drink per day for women and up to 2 drinks per day for men 4

4. Follow your doctor s recommendations Talk to your doctor about bone health Have a bone density test and take medication when advised Lactose intolerance?

solid foods (add to soup, blend with fruit etc.) Try hard cheeses (cheddar, Swiss, Colby) which are low in lactose Yogurt with live and active cultures may be easier to digest Don t like milk?

shredded low fat cheese Don t like milk?

5 4. Follow your doctor s recommendations Talk to your doctor about bone health Have a bone density test and take medication when advised Lactose intolerance? Some people lack the enzyme lactase needed to digest lactose Tips: Start with small portions of dairy such as milk and gradually increase serving size Eat dairy foods in combination with a meal or solid foods (add to soup, blend with fruit etc.) Try hard cheeses (cheddar, Swiss, Colby) which are low in lactose Yogurt with live and active cultures may be easier to digest Don t like milk? Make hot cereals and soup with milk instead of water Serve milky desserts such as frozen yogurt, pudding, custard, tapioca Make hot chocolate with milk Enjoy a spinach omelet made with milk and shredded low fat cheese Don t like milk? Add plain yogurt and shredded low-fat cheese to baked potatoes Add powdered milk to foods such as soup, smoothies, mashed potatoes (50mg calcium per tablespoon) Snack on yogurt with almonds Try a smoothie! Chocolate Banana 1 banana 6 oz low fat vanilla yogurt 1 tablespoon drinking chocolate powder 2/3 c 1% milk Place in blender and whiz until smooth! Try a yogurt parfait! Layer low fat yogurt, low fat granola, berries and nuts 5

Food vs supplements Supplements can't provide what foods offer naturally Many foods that are rich in one bonebuilding nutrient also contain other helpful nutrients Supplements Calcium Vitamin D Dairy

6 Food vs supplements Supplements can't provide what foods offer naturally Many foods that are rich in one bonebuilding nutrient also contain other helpful nutrients Supplements Calcium Vitamin D Dairy Calcium Vitamin D Potassium Magnesium Vitamin A However, always follow your doctor s advice Summary Get your daily recommended amounts of calcium and vitamin D Enjoy a variety of foods Include regular exercise Avoid smoking and excessive alcohol Talk to your doctor about your bone health; have a bone density test and take medication when advised Learn more Go to and enter S618 in the search box to learn more about "Preventing Osteoporosis: After Your Visit National Osteoporosis Foundation Academy of Nutrition and Dietetics Shape Your Future 6

Healthy Bones. How much calcium do I need each day? What can I do to keep my bones strong and healthy? How much vitamin D do I need each day?

Healthy Bones. How much calcium do I need each day? What can I do to keep my bones strong and healthy? How much vitamin D do I need each day? Healthy Bones Building and keeping strong, healthy bones continues throughout a person's life. Bones have many important roles in the body. They support your body, protect organs, help muscles work, and