Transcript Nutrition and Osteoporosis

Some slides adapted from University of Nebraska Lincoln (lancaster.unl.edu) and MyPyramid.gov
Project Sponsors
• USDA project funded
through the Food Stamp
Program
• School District of Philadelphia
• Nutrition Center,
Department of Biology
Drexel University
Why Worry About Calcium?
• Helps control muscle
contraction
• Need to build and maintain
strong bone throughout life
Bones are living organs
• Calcium is deposited and
withdrawn from bones daily.
• Half of the adult skeleton is formed
during adolescence.
• We need to build up a
healthy bone “account” while
young and continue to
make “deposits” with age.
** Get as much calcium as you can now to
prevent weak bones
Source: http://www.accessexcellence.org/HHQ/qow/qow06/qow061211.html
Bone Mass
• After mid-30’s, you begin
to slowly lose bone mass.
Women lose bone mass
faster after menopause,
but it happens to men too.
• Bones can weaken early
in life without a healthy
diet and regular physical
weight bear activities.
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 Overview
• Osteoporosis causes
weak bones
• In this common
disease, bones lose
minerals like calcium
• The bones become
fragile and can break
easily
• Osteoporosis can
strike at any age
female or male
Normal
Bone
Source: The 2004 Surgeon General’s Report on Bone Health and Osteoporosis:
What It Means to You at http://www.surgeongeneral.gov/library/bonehealth
Bone with
Osteoporosis
Risk factors
“Red flags” that you could be at high risk for
weak bones
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You are older than 65
You smoke
You are underweight for your height
You have never gotten enough calcium
You are not active
Poor daily nutrition
Low bone density-Osteopenia
*Remember: Prevention is the Key!
Source: The 2004 Surgeon General’s Report on Bone Health and Osteoporosis:
What It Means to You at http://www.surgeongeneral.gov/library/bonehealth
What is Osteopenia?
• Loss or decrease of bone mineral density
(BMD) that can progress to osteoporosis
• BMD is the measurement of levels of
minerals in the bone
– Indicates strength and density
• When BMD is very low compared to
normal, it is called osteoporosis
Adapted from: http://www.webmd.com/osteoporosis/tc/Osteopenia-Overview
Risk Factors
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Being of Caucasian or Asian decent
Excessive alcohol use
Family history
Being underweight
Physical inactivity
Tobacco use
Diet deficient in Calcium and Vitamin D
Decrease in bone density
Adapted from: http://www.webmd.com/osteoporosis/tc/Osteopenia-Overview
The problem in America
• 1 in 2 women and 1 in 4 men over 50 will
have an osteoporosis-related fracture
• Hip fractures account for 300,000
hospitalization annually
• 1 in 5 people with a hip fracture end up in
a nursing home within a year
• Less than ½ of teens get recommended
amount of Calcium they need for the day.
Source: http://www.accessexcellence.org/HHQ/qow/qow06/qow061211.html and National Osteoporosis Foundation Web site;
retrieved July 2005 at http://www.nof.org
The most common breaks
Breaks usually
occur 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
The good news: Osteoporosis and
Osteopenia are preventable for most
people!
• Start building
healthy bones
while young.
• Healthy diet and
lifestyle are
important for BOTH
men and women.
Simple Prevention Steps
1. Get the recommended
amount of calcium and
vitamin D
2. Get regular weight
bearing exercise
3. Avoid smoking and
excessive alcohol
What’s the recommendation for
calcium?
Calcium requirements vary by age
If this is your age
0 to 6 months
7 to 12 months
1 to 3 years
4 to 8 years
9 to 18 years
19 to 50 years
Over 50 years
Then you need
this much calcium
each day (mg)
210
270
500
800
Growth
1,300
spurt
1,000
1,200
Source: The 2004 Surgeon General’s Report on Bone Health and Osteoporosis:
What It Means to You at http://www.surgeongeneral.gov/library/bonehealth
Food and supplement labels
• Percent Daily Value is used to
show how much calcium is in a
food
100% DV for calcium = 1000
milligrams (mg)
So, for this label there is 30% DV of
Calcium
How many mg would that be?
Do the math:
300 mg  1000 mg = 30%
Eating Calcium at Every Meal
• Breakfast
– Granola bar and 6oz.
calcium fortified 100% juice
• Lunch
– Turkey, lettuce, tomato and
cheese on whole wheat roll
– Low-fat chocolate milk
• Dinner
– Grilled chicken, ½ c
spinach salad and ¾ c
macaroni and cheese
• Breakfast
– Orange juice
– Granola bar
300mg
150mg
• Lunch
– Cheese
– Chocolate milk
300mg
300mg
• Dinner
– Spinach
123mg
– Mac and cheese 300mg
Is it Enough Calcium?
• Breakfast
– Orange juice
– Granola bar
300mg
150mg
• Lunch
– Cheese
– Chocolate milk
300mg
300mg
• Dinner
– Spinach
– Mac and cheese
Total Calcium:
123mg
+300mg
1473mg
Milligrams (mg) and %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
Calcium Sources: Milk group
• Yogurt
1 cup (8 oz.) = 300mg (30% DV)
• Milk
1 cup = 300mg (30% DV)
• Cheese
1 ½ oz. natural/2 oz. processed = 300mg
(30% DV)
• Milk pudding
1/2 cup = 150mg (15% DV)
• Frozen yogurt, vanilla, soft serve
½ cup = 100mg (10% DV)
Choose fat-free
• Ice cream, vanilla
or low fat
½ cup = 80mg (8% DV)
most often
• Soy or rice milk, calcium-fortified
1 cup = varies—check label
Calcium Sources: Grain products group
• Cereal,
calciumfortified
Serving size and
amount of
calcium varies—
check label
Calcium Sources: Vegetable
group
• Broccoli, raw
1 cup = 90mg (9% DV)
• Collard greens, cooked
1/2 cup = 200mg (20%
DV)
• Turnip greens, boiled
1/2 cup = 100mg (10%
DV)
Calcium Sources: Fruit group
• Orange juice and other
calcium-fortified
beverages
6 oz. = 200mg to 300mg
(20-30% DV, varies—
check label)
Look for 100% juice
Calcium Sources: Meat & Beans
Group
• Baked beans
1 cup = 140mg (14% DV)
• Salmon, canned, with edible
bones
3 oz. = 180mg (18% DV)
• Sardines, canned, in oil, with
edible bones
3 oz. = 320mg (32% DV)
• Soybeans, cooked
1 cup = 260mg (26% DV)
• Tofu, firm, with calcium
½ cup = 200mg (20mg% DV);
check label
What’s the recommendation for
vitamin D?
Why Do I Need Vitamin D?
• Helps the body more easily absorb calcium in
the digestive tract.
• Promotes bone formation and mineralization
• Works with calcium to build a stronger more
intact bone
Source: Vitamin D Overview http://healthlink.mcw.edu/article/982088787.html
You need more vitamin D as you age
600 IU
600
500
Daily
vitamin D
needs in
International
Units (IU)
400 IU
400
300
200 IU
200
100
0
up to 50
51-70
Age
over 70
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
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
Are You Lactose-intolerant?
Some people lack the
enzyme lactase
needed to digest lactose
(milk sugar).
Here are some tips
which may help
people obtain calcium
from dairy products…
Tips for Lactose Intolerance
• Start with smaller portions
• Eat dairy in combination with meals
• Try dairy foods other than milk:
– Hard cheeses have less lactose than milk:
(ex: cheddar, Swiss, parmesan)
– Yogurt contains predigested lactose
• Try products like: Lactaid and soy milks and cheeses
I just don’t like milk
Some ideas
Add milk to coffee
Make oatmeal and
cream-type soups with
milk instead of water
Add powdered milk to food
(1 tablespoon = 50 mg calcium)
Some more ideas
Serve milk-based
desserts (puddings,
tapioca, frozen
yogurt, custard, ice
cream). Limit fat
and sugar.
Make instant
hot cocoa
with milk,
not water.
Try chocolate milk.
• 8-oz. has only 2 - 7 mg
caffeine.
• Average glass provides
only 60 more calories
than unflavored milk.
Even more ideas
Top baked potatoes
with plain yogurt;
sprinkle with chives
Enjoy plain or flavored
low fat yogurt
Use flavored yogurt as a fruit
salad dressing; experiment with
substituting plain yogurt for some
or all of the sour cream in
vegetable salad dressings
Have It YOUR Way Smoothie
(serves 2)
• 1 cup unsweetened,
frozen raspberries or
frozen fruit of choice
• 1/2 cup 100% calcium
fortified orange
• 3/4 cup fruit-flavored,
low- or non-fat yogurt
Blend all ingredients
well in blender. Enjoy!
Calcium per serving: 243 mg.
Fantastic Fruit Parfait
Layer yogurt, low-fat
granola and fruit in
whatever proportions
you’d like.
Add some nuts and
you’ve included a 4th
food group.
What about a supplement?
• Take no more than 500mg at a
time
• Calcium citrate is
recommended over calcium
carbonate
500
mg
Remember to follow the
prevention steps …
• Eat a healthy diet with
plenty of foods high in
calcium and vitamin D.
• Engage in regular
exercise.
• Avoid smoking and
excessive alcohol.
Questions ??