Nutrition and Osteoporosis

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Get Enough Calcium!
And Help Prevent Osteoporosis
Some slides adapted from University of Nebraska
Lincoln (lancaster.unl.edu) and MyPyramid.gov
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Project Sponsors

• USDA project funded through the Food Stamp
  Program

• School District of Philadelphia

• Nutrition Center,
  Department of Biology Drexel University
  

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Why Worry About Calcium?

• Helps control muscle contraction
• Need to build and maintain strong bone throughout
  life

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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• Calcium is deposited and withdrawn from bones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/q
ow06/qow061211.html
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Bone Mass

• After mid-30s, 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 Generals Report on Bone
Health and OsteoporosisWhat It Means to You at
http//www.surgeongeneral.gov/library/bonehealth
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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
Bone with Osteoporosis
Source The 2004 Surgeon Generals Report on Bone
Health and Osteoporosis What It Means to You at
http//www.surgeongeneral.gov/library/bonehealth
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Risk factors

• Red flags that you could be at high risk for
  weak bones

• 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 Generals Report on Bone
Health and OsteoporosisWhat It Means to You at
http//www.surgeongeneral.gov/library/bonehealth
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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

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Risk Factors

• 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

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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/qo
w06/qow061211.html and National Osteoporosis
Foundation Web site retrieved July 2005 at
http//www.nof.org
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The most common breaks

• Breaks usually occur in the wrist, spine, and
  hip.

Source The 2004 Surgeon Generals Report on Bone
Health and OsteoporosisWhat It Means to You at
http//www.surgeongeneral.gov/library/bonehealth
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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.

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Simple Prevention Steps

• Get the recommended amount of calcium and vitamin
  D
• Get regular weight bearing exercise
• Avoid smoking and excessive alcohol

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Whats the recommendation for calcium?
Calcium
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Calcium requirements vary by age
Growthspurt
Source The 2004 Surgeon Generals Report on Bone
Health and OsteoporosisWhat It Means to You at
http//www.surgeongeneral.gov/library/bonehealth
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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
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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 300mg
• Granola bar 150mg
• Lunch
• Cheese 300mg
• Chocolate milk 300mg
• Dinner
• Spinach 123mg
• Mac and cheese 300mg

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Is it Enough Calcium?

• Breakfast
• Orange juice 300mg
• Granola bar 150mg
• Lunch
• Cheese 300mg
• Chocolate milk 300mg
• Dinner
• Spinach 123mg
• Mac and cheese 300mg
• Total Calcium 1473mg

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Milligrams (mg) and DV of calcium in common foods
Approximate DV for foods based in part on The
2004 Surgeon Generals Report on Bone Health and
Osteoporosis What It Means to You at
http//www.surgeongeneral.gov/library/bonehealth
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Calcium Sources Milk group

• Yogurt1 cup (8 oz.) 300mg (30 DV)
• Milk1 cup 300mg (30 DV)
• Cheese1 ½ oz. natural/2 oz. processed 300mg
  (30 DV)
• Milk pudding1/2 cup 150mg (15 DV)
• Frozen yogurt, vanilla, soft serve½ cup 100mg
  (10 DV)
• Ice cream, vanilla½ cup 80mg (8 DV)
• Soy or rice milk, calcium-fortified1 cup
  variescheck label

Choose fat-free or low fat most often
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Calcium Sources Grain products group

• Cereal, calcium- fortifiedServing size and
  amount of calcium variescheck label

Calcium-fortified
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Calcium Sources Vegetable group

• Broccoli, raw1 cup 90mg (9 DV)
• Collard greens, cooked1/2 cup 200mg (20 DV)
• Turnip greens, boiled1/2 cup 100mg (10 DV)

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Calcium Sources Fruit group

• Orange juice and other calcium-fortified
  beverages6 oz. 200mg to 300mg (20-30 DV,
  variescheck label)

Look for 100 juice
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Calcium Sources Meat Beans Group

• Baked beans1 cup 140mg (14 DV)
• Salmon, canned, with edible bones3 oz. 180mg
  (18 DV)
• Sardines, canned, in oil, with edible bones3 oz.
  320mg (32 DV)
• Soybeans, cooked1 cup 260mg (26 DV)
• Tofu, firm, with calcium ½ cup 200mg (20mg
  DV) check label

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Whats the recommendation for vitamin D?
Vitamin D
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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.e
  du/article/982088787.html

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You need more vitamin D as you age
Daily vitamin D needs in International Units (IU)
Age
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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

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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.
• 1015 minutes exposure of hands, arms and face
  23 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
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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
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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

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I just dont like milk
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Some ideas
Make oatmeal and cream-type soups with milk
instead of water
Add powdered milk to food(1 tablespoon 50 mg
calcium)
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Some more ideas
Serve milk-based desserts (puddings, tapioca,
frozen yogurt, custard, ice cream). Limit fat
and sugar.

• Try chocolate milk.
• 8-oz. has only 2 - 7 mg caffeine.
• Average glass provides only 60 more calories than
  unflavored milk.

Make instant hot cocoa with milk, not water.
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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
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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.
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Fantastic Fruit Parfait

• Layer yogurt, low-fat granola and fruit in
  whatever proportions youd like.
• Add some nuts and youve included a 4th food
  group.

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What about a supplement?

• Take no more than 500mg at a time
• Calcium citrate is recommended over calcium
  carbonate

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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.

Support your bones. They support you!
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Questions ??