2. According to National Institute of
Health
Bone is a living, growing
tissue, made mostly of
collagen. Collagen is a
protein that provides a
soft
framework,
and
calcium phosphate is a
mineral
that
adds
strength and hardens the
framework.
4. Why Bone Health is So Important?
Bones support body
and facilitate
movement.
They protect brain,
heart, and other
organs from injury.
National Institute of Health
5. What Affects Bone Health?
•
•
The amount of calcium in
diet. A diet low in calcium
contributes to diminished
bone density, early bone loss
and an increased risk of
fractures.
Physical activity. People
who are physically inactive
have a higher risk of
osteoporosis than do their
more-active counterparts.
Mayo clinic
6. What Affects Bone Health?
Tobacco and alcohol use.
Smoking is a key lifestyle
risk factor for bone loss and
fractures1. Similarly, alcohol
consumption has major
harmful effects on bone
development
and
maintenance at all ages2.
Reference:
1. Review article, The Effects Of Smoking On Bone Health Peter K. K. WONG, Jemma J. CHRISTIE And John D.
Wark Clinical Science (2007)
2. Alcohol’s Harmful Effect on Bone, H. WAYNE SAMPSON, P, National Institute on Alcohol Abuse and
.
Alcoholism
7. What Affects Bone Health?
Gender and size- Woman are
at
greater
risk
of
osteoporosis as they have
less bone tissue than men.
Similarly
extremely
thin
people (with a BMI of 19 or
less) or with small body
frame are also prone, as
they have less bone mass to
draw from as age increases.
Reference
Public Health Rep. 1989 Sep-Oct; 104(Suppl): 14–20. Risk
factors for osteoporosis and associated fractures. JL Kelsy
8. And The Most Important-Age
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 the right kinds of
physical activity.
Source: The 2004 Surgeon General’s Report on Bone Health and Osteoporosis:
What It Means to You at http://www.surgeongeneral.gov/library/bonehealth
9. Weak Bone Leads To…
Osteoporosis
A Series of
Health Issues
Arthritis
Fracture
10. Consequences of Weak Bones
One out of two women and one out of eight
men will be affected by osteoporosis in their
lifetime- Foundation for Osteoporosis Research and Education
An estimated 14 million men in the United
States currently have low bone mass or
osteoporosis- Foundation for Osteoporosis Research and
Education
Hip fractures account for 300,000
hospitalizations annually- The 2004 Surgeon General’s
Report on Bone Health and Osteoporosis
12. According to NIN study
Prevalence of osteoporosis & osteopenia In India
– WHO criteria
Area
F Neck
Spine
Porosis
29%
43%
Penia
52%
43%
Normal
19%
14%
13. And The Situation Is More Grim For Women
A woman’s hip
fracture risk equals
her combined risk of
breast, uterine and
ovarian cancer.
Reference:
National Osteoporosis Foundation Web site; retrieved July 2005
14. But The Good News Is
Almost all these
conditions are
not only
preventable but
also treatable
15. Simple Steps towards Healthier
Bone
The National Osteoporosis
Foundation (NOF)
recommends FIVE simple
steps to bone health.
16. Step 1
Get your daily
recommended
amounts of calcium
and vitamin D.
•low intake of calcium, may be
responsible for the high
prevalence of osteoporosisNIN
•The WHO Expert Committees
recommended 100 Units (2.5
µg) /d for adult males in 1988
and increased them later in
2005 to 200 Units (5 µg)/d.
18. So It’s Important To Remember
Some age groups need MORE or LESS
than 100% DV for calcium and vitamin D.
•
Calcium requirements vary by age:
•
•
More is needed as we grow older
Need is highest during rapid growth of
adolescence.
•
Vitamin D requirements increase as we age.
•
100% DV for calcium and Vitamin D are based on
1,000 mg calcium and 400 IU vitamin D.
18
19. And Also more vitamin D as you age
600 IU
600
500
400
Daily
vitamin D needs
300
in International
Units (IU)
200
400 IU
200 IU
100
0
up to 50
51-70
Age
19
over 70
20. Dairy Products Help Meet RDA
According to American Journal of Clinical
Nutrition, it is difficult to meet current
recommendations for calcium intake without
the consumption of dairy foods or
supplements therefore, there has been a
concerted effort recently by some investigators
to recommend increased dairy food
consumption, even among lactose-intolerant
persons
Reference:
American Society for Clinical Nutrition Dairy foods and bone health:
examination of the evidence Roland Weinsier & Carlos Krumdieck
21. Dairy Products Help Meet RDA
Adequate intake for calcium cannot be met
with dairy-free diets while meeting other
nutrient recommendations. To meet the
adequate intake for calcium without large
changes in dietary patterns, calcium-fortified
foods are needed.
Reference:
Journal of American Dietetic Nutrition. Meeting adequate intake for dietary
calcium without dairy foods in adolescents aged 9 to 18 years. Department
of Nutrition, Harvard University School of Public Health, USA.
22. Step 2
Exercise across the life span
should be encouraged in order to
Engage in regular maximize peak bone mass &
weight-bearing
reduce age related bone loss.
exercise.
Epidemiological
evidence
suggests that being active can
nearly halve the incidence of hip
fractures in the older populationBritish Journal of Sports Medicine
23. Step 3
Avoid smoking
& excessive
alcohol
One in eight hip fractures is
attributable to cigarette smokingWHO
Data suggest that ethanol may be
responsible
for
osteoblastic
dysfunction
resulting
in
diminished bone formation and
reduced bone mineralizationThe American Journal of Medicine
Ethanol reduces bone formation and may cause osteoporosis Departments of
Gastroenterology and Endocrinology, Royal North Shore Hospital, Australia
25. Step 5
Have a bone
density test and
take medication
when appropriate.
In contrast to National
Osteoporosis
Foundation
recommendations, only a
small minority of high-risk
women (12%-34%) get BMD
testThe Journal of American Medical Association
27. Nutrition labels & calcium
FDA uses “Percent Daily Value”
(% DV) to describe amount of
calcium needed by general U.S.
population daily
100% DV for calcium
= 1,000 mg
Look for this label:
“Nutrition Facts” on foods
“Supplement Facts” on
vitamin/mineral supplements
27
28. An easy way to meet calcium
needs is consuming 3 cups
(8 oz.) each day of fat-free or
low-fat* milk or equivalent milk
products in combination with
a healthy diet. Children ages
2–8 years need 2 cups.
* Fat-free and low-fat are for
health but not for calcium
differences
28
29. % Daily Value calcium: Milk group
Choose fat-free
or low fat
most often
Yogurt
1 cup (8 oz.) = 30% DV
Milk
1 cup = 30% DV
Cheese
1 ½ oz. natural/2 oz. processed = 30% DV
Milk pudding
1/2 cup = 15% DV
Frozen yogurt, vanilla, soft serve
½ cup = 10% DV
Ice cream, vanilla
½ cup = 8% DV
Soy or rice milk, calcium-fortified
1 cup = varies—check label
30. And These W
ould Take Care Of
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
31. Vitamin D from sunlight exposure
Vitamin D is manufactured in 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
