Nutrition and Osteoporosis - PowerPoint PPT Presentation

Loading...

PPT – Nutrition and Osteoporosis PowerPoint presentation | free to view - id: 10052-YTQxZ



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Nutrition and Osteoporosis

Description:

Percent Daily Values are based on a 2,000 calorie diet. Example of Daily Value ... pharmacist for interactions with other prescriptions and over-the-counter drugs ... – PowerPoint PPT presentation

Number of Views:356
Avg rating:3.0/5.0
Slides: 73
Provided by: Lanca
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Nutrition and Osteoporosis


1
Nutrition and Osteoporosis
2
Alice Henneman, MS, RD Lancaster
County Extension EducatorLinda Boeckner, PhD,
RD Extension Nutrition SpecialistUniversity of
Nebraska Cooperative Extension Institute of
Agriculture and Natural ResourcesJune
2001University of Nebraska Cooperative
Extension educational programsabide with the
nondiscrimination policies of the University of
Nebraska and the United States Department of
Agriculture
3
Disclaimer
  • The following information on the dietary
    aspects of osteoporosis is provided as
    information for general healthy eating and should
    not be considered a substitute for seeking
    dietary advice from your own healthcare provider.
    The calcium and vitamin D recommendations are
    based on those developed for the United States
    and Canada. They may not be appropriate for all
    countries due to differing dietary patterns and
    environmental factors.

4
Comments from a 70 year old woman with
osteoporosis
  • Ive lost six inches in height and none of my
    clothes fit me anymore. Plus, its hard to get
    clothes that look nice when my back is so hunched
    over.

5
Comments continued
  • It seemed like it took forever for my bone to
    heal when it broke. I dont want that to happen
    again. Its so frustrating always worrying about
    falling.

6
Comments continued
  • If somebody had told me sooner what I know now
    about osteoporosis, none of this might be
    happening to me!


7
Concerns
  • 10 million Americans have osteoporosis and 18
    million have low bone mass placing them at risk
    of osteoporosis
  • - National Osteoporosis Foundation (NOF)
  • The silent disease
  • First sign may be a fracture
  • A sudden strain or bump can break a bone

8
Concerns continued
  • 80 of those affected are women
  • A womans hip fracture risk equals her combined
    risk of breast, uterine and ovarian cancer
  • 1 in 2 women and 1 in 8 men over 50 will have an
    osteoporosis-related fracture
  • 24 of hip fracture patients 50 and over die
    during the year following their fracture

9
The National Osteoporosis Foundation (NOF)
recommends a combination of 4 steps to help
prevent osteoporosis
10
4 Prevention Steps (NOF)
  • Balanced diet rich in calcium vitamin D

11
4 Prevention Steps (NOF)
  • Weight-bearing exercise

12
4 Prevention Steps (NOF)
  • Healthy lifestyle with no smoking or excessive
    alcohol use

13
4 Prevention Steps (NOF)
  • Bone density testing and medications when
    appropriate

14
Osteoporosis is preventable for most people!
  • Start building healthy bones while young
  • Healthy diet and lifestyle are important for BOTH
    men women

15
Todays presentation . . .
  • Using food and supplement labels to assess
    calcium intake
  • Recommended daily calcium and vitamin D
  • Daily Value for calcium in common foods
  • Additional dietary concerns
  • Help for the lactose-intolerant person
  • When you dont like to drink milk
  • Calcium supplements
  • Putting it all together

16
Using food/supplement labels to assess
calcium intake
17
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
  • Nutrition Facts on food labels
  • Supplement Facts on vitamin/mineral labels

18
Sample Nutrition Facts Label
Nutrition Facts Serving Size 1/2 cup (93
g) Servings Per Container 4 ---------------------
----------------------- Amount Per
Serving Calories 25 Calories from Fat
0 --------------------------------------------
Daily Value Total Fat 0 g 0
Saturated Fat 0 g 0 Cholesterol 0
mg 0 Sodium 20 mg 1 Total Carbohydrate 5
g 2 Dietary Fiber 3 g
12 Sugars 2 g Protein 3 g -----------------
--------------------------- Vitamin A 35
Vitamin C 60 Calcium 4 Iron
4 --------------------------------------------
Percent Daily Values are based on a 2,000 calorie
diet.
19
Example of Daily Value
  • If a food or supplement has 200 mg of calcium
    per serving, the "Nutrition Facts" or "Supplement
    Facts" panel shows 20 DV for
    calcium (200/1,000 20)

20
Using Nutrition Facts label serving size
  • Serving size on "Nutrition Facts" panel is based
    on what people typically eatits not a
    recommended amount
  • Adjust calcium DV if you eat a different
    serving size than on label
  • Example If label states a half cup serving of
    broccoli provides 4 DV, a cup would provide 8
    DV

21
DV recommendations vary by age
  • Example
  • Individuals 51 years and older need to consume
    1,200 mg of calcium daily
  • Their daily goal should be 120 of the calcium DV

22
Example of calculating total DV for calcium
  • Food DV
  • Fruit yogurt 35
  • Oatmeal 10
  • Nachos 20
  • Turnip greens 15
  • Total DV 80

23
Recommended daily calcium and vitamin D
intakes
Calcium
Vitamin D
24
Recommended daily calcium and vitamin D intakes
  • Remember
  • The 100 DV for calcium is based on 1,000 mg
    calcium
  • The 100 DV for vitamin D is based on 400 IU
    vitamin D
  • Some people will need more or less than the 100
    DV value based on their age and reproductive
    status

25
Upper limits calcium and vitamin D
  • The National Academy of Sciences (NAS), 1997,
    suggests a tolerable upper intake level (UL) for
    persons age one and up for calcium no higher than
    2,500 mg daily and for vitamin D no higher than
    50 micrograms or 2,000 IU (40 IU 1 microgram)
    daily from foods and supplements combined.

26
Recommended Daily Value calcium vitamin D
  • Birth - 6 months210 mg calcium (21 DV)200 IU
    vitamin D (50 DV)
  • 6 months - 1 year270 mg calcium (27 DV)200 IU
    vitamin D (50 DV)
  • Values based on 1997 NAS recommendations

27
Recommended Daily Value calcium vitamin D
  • 1 - 3 years500 mg calcium (50 DV)200 IU
    vitamin D (50 DV)
  • 4 - 8 years800 mg calcium (80 DV)200 IU
    vitamin D (50 DV)
  • Values based on 1997 NAS recommendations

28
Recommended Daily Value calcium vitamin D
  • 9 - 18 years1,300 mg calcium (130 DV)200 IU
    vitamin D (50 DV)
  • 19 - 50 years1,000 mg calcium (100 DV)200 IU
    vitamin D (50 DV)
  • Values based on 1997 NAS recommendations

29
Recommended Daily Value calcium vitamin D
  • 51 - 70 years1,200 mg calcium (120 DV)400 IU
    vitamin D (100 DV)
  • 71 and older1,200 mg calcium (120 DV)600 IU
    vitamin D (150 DV)
  • Values based on 1997 NAS recommendations

30
Recommended Daily Value calcium vitamin D
  • Pregnant Lactating
  • 14 - 18 years1,300 mg calcium (130 DV)200 IU
    vitamin D (50 DV)
  • 19 - 50 years1,000 mg calcium (100 DV)200 IU
    vitamin D (50 DV)
  • Values based on 1997 NAS recommendations

31
Percent Daily Value (DV) for calcium in common
foods
Approximate DV for foods based in part on
information provided in Calcium! Do You Get
It? by U.S. FDA/CFSAN
32
DV calcium Grain products group
  • Ready-to-eat cereal, calcium- fortified. Serving
    size varies check product label.

calcium-fortified cereal
33
DV calciumVegetable group
  • Broccoli with cheese 1/2 cup 20 DV
  • Collards 1/2 cup 20 DV
  • Turnip greens 2/3 cup 15 DV
  • Kale 2/3 cup 10 DV
  • Bok choy 1/2 cup 10 DV
  • Broccoli 1 stalk 6 DV

34
DV calciumFruit group
  • Orange juice, calcium-fortified 1 cup 30
    DV

35
DV calciumMilk group
  • Yogurt 8 oz. 35 DV
  • Milk, whole, 2, 1, skim, chocolate 1 cup 30
    DV
  • Cheese 1 oz. 20 DV
  • Milk pudding 1/2 cup 10 DV
  • Frozen yogurt 1/2 cup 10 DV
  • Ice cream 1/2 cup 6 DV
  • Soy milk, calcium-fortified 1 cup 30 DV

36
DV calciumMeat Beans Group
  • Tofu prepared with calcium sulfate 3 oz. 60
    DV check Nutrition Facts label
  • Baked beans with sauce 1/2 cup 8 DV
  • Pork beans with sauce 1/2 cup 6 DV

tofu with added calcium
37
Vitamin D dietary sources
  • The main dietary sources of vitamin D are
    fortified milk (400 IU per quart), some fortified
    cereals, cold saltwater fish (for example
    salmon, halibut, herring, tuna, oysters and
    shrimp) and some calcium and vitamin/mineral
    supplements.
  • Also, vitamin D can be manufactured in your skin
    following direct exposure to sunlight. The amount
    varies according to such factors as time of day,
    season and latitude.

38
Additional dietary concerns
39
ConcernsFood is best calcium source
  • There may be other factors found in calcium food
    sources that also affect absorption and
    utilization by the body

40
ConcernsCalcium load at one time
  • Body can best handle about 500 mg at one time
    from food and/or supplements
  • Consume calcium sources throughout day vs. all at
    one time

41
ConcernsFiber
  • Excessive fiber can interfere with absorption
  • Example sprinkling extra fiber on food at time
    of consuming a calcium source
  • Natural fiber that is part of a food is probably
    not a problem

42
ConcernsExcessive caffeine
  • Can increase urinary calcium excretion
  • Limit to about 400 mg daily
  • About 100 mg/6 oz. coffee
  • About 40 mg/6 oz. regular brewed tea may be less
    for green tea
  • Some soft drinks comparable to tea
  • Some medications have caffeine

43
ConcernsExcessive sodium
  • Can increase urinary calcium excretion
  • Food and Nutrition Board recommends limit of
    2,400 mg daily
  • Sodium given on Nutrition Facts panel on foods

44
ConcernsAlcohol
  • Consuming more than 7 drinks per week is
    associated with greater risk of
  • low bone density
  • falls
  • fractures

45
ConcernsOxalic acid
  • In foods such as spinach, chard, beet greens and
    chocolate
  • Binds calcium
  • Doesnt seem to affect calcium in other foods,
    including chocolate milk
  • These greens still good for you may help calcium
    absorption in other ways

Chocolate milk is OK!
46
ConcernsHigh protein
  • Unbalanced, excessively high protein diets could
    increase urinary excretion of calcium

47
ConcernsSoy
  • Not all soy milk is calcium-fortified check
    Nutrition Facts panel
  • 4 8-oz. glasses of soy milk is usually equal to
    3 8-oz. glasses of cows milk in availability of
    calcium

Know your numbers
48
ConcernsFruits and Vegetables
  • Contribute to maintenance of bone mineral density
  • Food Guide Pyramid recommendations
  • 2 to 4 fruits daily
  • 3 to 5 vegetables daily

49
Help for the lactose-intolerant person
Some people lack the enzyme needed to digest
lactose (milk sugar) but still may be able to
obtain calcium from dairy products
50
Help for the lactose- intolerant person
  • Start with small portions of foods such as milk
    and gradually increase serving size

51
Help for the lactose-intolerant person
  • Eat dairy foods in combination with a meal or
    solid foods

52
Help for the lactose-intolerant person
  • Try dairy foods other than milk
  • Many cheeses (Cheddar, Swiss, Parmesan) have less
    lactose than milk
  • Yogurt made with live, active bacteria

53
Help for the lactose-intolerant person
  • It may be easier to digest lactose that is
    pre-digested or broken down to its simple sugar
    components (glucose and galactose)
  • Lactose-hydrolyzed milk and dairy products
  • Commercial lactase preparations

54
When you dont like to drink milk
55
When you dont like to drink milk
  • Make oatmeal with milk instead of water
  • Add milk to your coffee
  • Make soups (tomato, chowders and cream-type) with
    milk instead of water
  • Add powdered milk to food (1 tablespoon 50 mg
    of calcium)
  • Make instant hot cocoa with milk

56
When you dont like to drink milk
  • Make instant hot cocoa with milk, not water
  • Serve milk-based desserts (puddings, tapioca,
    frozen yogurt, custard, ice cream)
  • Enjoy chocolate milk
  • 8-oz. has only 2 - 7 mg caffeine
  • Average glass of chocolate milk has only 60 more
    calories than unflavored milk

57
When you dont like to drink milk
  • Use plain/flavored yogurt as salad dressing
  • Top baked potatoes with yogurt
  • Enjoy smoothies for snacks
  • Add 1/2 to 1 cup frozen fruit to 1 cup milk
    blend. Sweeten with 1 - 2 teaspoons sugar or
    honey, or use an artificial sweetener. Can add
    about 1/4 teaspoon vanilla. Drink right away.

58
Calcium supplement considerations
59
SupplementsCalcium carbonate vs. citrate
  • Calcium carbonate
  • Needs acid to dissolve and for absorption
  • Less stomach acid as we age
  • Often taken at meals when more stomach acid
  • Calcium citrate
  • Doesnt require stomach acid for absorption
  • May be taken anytimecheck with your healthcare
    provider
  • May cost more

60
SupplementsVitamin D
  • Vitamin D
  • Choose a supplement with vitamin D unless youre
    getting vitamin D from other sources
  • Consider amount for your age group
  • Avoid going over a daily combined total of 50
    micrograms (2,000 IU)

61
SupplementsTime of Day
  • If you take calcium once daily, evening may be
    best. Miriam Nelson (author, Strong Women, Strong
    Bones) advises calcium carbonate at dinner time
    and calcium citrate before bed. Check with your
    healthcare provider.

62
SupplementsCalcium load at one time
  • Limit calcium intake at one time to about 500 mg
    from food and supplements combined
  • Consume food and supplements throughout the day

63
SupplementsAbsorption
  • Absorption test put a calcium tablet in a cup of
    vinegar. Stir every 5 minutes. If it doesnt
    dissolve in 30 minutes, it probably wont
    dissolve in your stomach either.

64
SupplementsIncrease amount slowly
  • Start with 500 mg daily for about a week,
    gradually adding more
  • Gas and constipation can be side effects
  • Increase fluids and fibrous foods
  • Try a different form if problems continue

65
SupplementsCheck for interactions
  • Check with physician or pharmacist for
    interactions with other prescriptions and
    over-the-counter drugs

66
SupplementsFood is still important
  • High calcium foods also contain other KEY
    nutrients that are important in the diet
  • Try to obtain at least some of your calcium from
    your diet

67
Putting it all together
  • List foods/supplements you ate yesterday or in a
    typical day
  • Determine DV of calcium/vitamin D
  • Adjust DV if serving size was different than
    on label
  • Total amounts compare score to recommended DV
    for age

68
Putting it all together
  • Consider also
  • Other dietary factors
  • Weight-bearing exercise
  • A healthy lifestyle with no smoking or excessive
    alcohol use
  • Getting recommended bone density tests and
    medications when appropriate

69
Related materials
  • For more information and/or a handout about
    the points discussed in this presentation, refer
    to the article Nutrition and Osteoporosis by
    Alice Henneman, MS, RD and Linda Boeckner, PhD,
    RD at
  • lancaster.unl.edu/food/ftm-j01.htm

70
For More Information
  • National Osteoporosis Foundation www.nof.org
  • Strong Women, Strong Bones by Miriam Nelson, Ph.D.

71
Further questions?
  • Alice Henneman, MS, RD Lancaster County
    Extension Educator
  • ahenneman1_at_unl.edu
  • Linda Boeckner, PhD, RD
  • Extension Nutrition Specialist
  • lboeckner1_at_unl.edu
  • University of Nebraska Cooperative Extension
  • Institute of Agriculture and Natural Resources

72
Support your bones. They support you. -
Massachusetts Osteoporosis Awareness Program
About PowerShow.com