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Bone Health: Is a Fracture in Your Future?

Osteoporosis is a condition of weak bones, which makes them more likely to break. Ten million Americans have osteoporosis and 44 million have thinning bones, according to the National Osteoporosis Foundation (NOF), a health organization dedicated to preventing osteoporosis and broken bones though awareness, education and research.

In the United States, one out of every two women and one in four men over age 50 will have an osteoporosis-related fracture in their lifetime. Twenty-four percent of seniors who suffer a hip fracture will die within one year of the event. If you are female your risk of having a bone break from osteoporosis is equal to your risks of breast, uterine and ovarian cancer COMBINED.

My mother died of complications from osteoporosis. She broke her left wrist when she was 74 years old, tripping in downtown Seattle when trying to catch a bus. Four years later she fell onto her right when getting out of bed in the middle of the night. Her right knee swelled up and she insisted it was “just my knee”, refusing to go to the doctor. Nearly 2 weeks later when the pain hadn’t gone away she finally agreed to get it checked but by that time the ends of her broken bones had slipped down and were already knitting back together. She suffered from the discomfort and inconvenience of her right leg one inch shorter than her left one for the rest of her life.

Although its complications show up in old age, osteoporosis starts in childhood. Nearly 90 percent of our peak bone mass is built before we turn 20 years old. At middle age that begins to reverse and we lose 1% of our bone mass per year, doubling to 2% per year for women after menopause. The thinner your bones are to start with, the more likely you’ll eventually experience a fracture.

Here are 5 tips to help keep your bones healthy and strong:

  1. Get the calcium and vitamin D you need every day. Eating a variety of foods rich in calcium is a critical step to building and maintaining strong bones. Green leafy vegetables like broccoli, Brussels sprouts and kale are good sources of calcium, as are dairy products like milk and yoghurt. Calcium and Vitamin D supplements are also helpful.
  1. Do regular weight bearing and muscle-strengthening exercises. Getting up and moving is one of the best things you can do for your bones. Weight-bearing activities like walking, cycling or dancing help signal your body to keep your bones strong.
  1. Don’t smoke.My mother smoked since she was 18 years old. Quitting smoking could have helped her avoid the fractures that plagued her final years.
  1. Talk to your doctor about your chances of osteoporosis and ask about bone density testing.If you have passed menopause or have taken certain drugs, especially prednisone or corticosteroids, you may have thin bones without knowing it. Testing your bone density helps determine how likely you are to have a bone break in the future and if you are at risk, your bone loss can be slowed with medicine and other strategies. My mother never realized she had thin bones until she broke her wrist. With screening and the bone-building drugs available today she may have avoided the hip fracture that shortened her life.
  1. Try eating prunes every day. A recent study showed that eating prunes every day could make your bones stronger. The study participants ate 100 grams (about 10 prunes) every day for a year. Luckily,   you don’t have to eat quite that many to benefit your bones. I suggest taking it slowly and building up to what you can manage, as prunes are a natural stool softener. I weighed out 100 gm of dried plums (prunes) and found that 100 grams is 9 of the Mariani® brand of dried plums sold by Costco. With my family history, I decided to eat at least 5 prunes a day, and see if I could work up from there.

Is there a fracture in your future? Keeping your bones strong and healthy includes getting enough calcium and Vitamin D, doing some weight bearing exercise every day, quitting smoking and asking your doctor or medical provider about bone density testing. If you do have osteoporosis, there are bone building drugs available, from tablets you take every week or every month like alendronate (Fosamax®), Actonel® or Boniva®, to injections given daily, every 6 months or even once a year. And even prunes!

To find out more about osteoporosis and how you can prevent it, check out the National Osteoporosis Foundation website at www.nof.org.

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Are You Getting Enough Calcium?

Q: Which calcium supplement? Which one is best?

This issue strikes close to home with me because my mother fractured her wrist, then her hip and eventually died from complications from osteoporosis. Those of us who are over 50 years of age, female, post menopausal, have a family history of osteoporosis or a slight build are more likely to develop thinning bones that could lead to fractures along with permanent disability, like my mother suffered.

Many Americans are aware that calcium and vitamin D are critically important for building strong bones but may not realize how our muscles, nerves and blood vessels also depend on calcium in order to work properly. If your body doesn’t have enough calcium it will go looking for more, and the easiest place to get it is from your bones. Without adequate calcium in your diet or in supplements your body will use your skeleton as a calcium ATM until something gives – your hip breaks or your backbone collapses.

Most bone-building medicines work by reversing this process, strengthening your bones by putting calcium back into them. If you are taking a prescription medicine such as alendronate (Fosamax®), Actonel® (risendronate) or Boniva® it’s important to have enough calcium in your body so these medicines can do their job.

How much calcium is enough? The Institute of Medicine recommends 1000mg daily of calcium for men and women up to age 50, and 1200mg for adults older than 50 years of age. The National Institutes of Health used to recommend more for postmenopausal women but backed off when increased heart attacks started showing up in older women taking daily calcium supplements.

Do you even need a calcium supplement at all? Unlike taking calcium in a pill, eating calcium-rich foods does not increase your chances of having a heart attack. Most Americans get about 300mg of calcium daily from their diet, mostly from beans, nuts, and green vegetables. In addition, you’ll get an additional 300mg of calcium for every 8-ounce glass of milk, fortified orange juice, yogurt, or 1.5 ounces of cheese you consume.

Broccoli, cabbage, kale, turnip greens, and salmon are good sources of calcium. Eating spinach can interfere with calcium absorption, so it isn’t a good choice if you are trying to increase calcium in your diet.

If you are over 50, you’ll probably need a little help from a calcium supplement to protect your bones from becoming calcium ATM. Calcium citrate and calcium carbonate are the most common calcium supplements to choose from.

6 Tips To Improve Your Calcium Intake:

1.    Eat more servings of vegetables.  8 ounces of broccoli has 60mg of elemental calcium and 8 ounces of kale has nearly 100mg. Spinach is not a good choice for calcium because it also contains oxalates that interfere with calcium absorption. Eating foods rich in calcium reduces your risk of heart attack, while taking supplements can increase it.

2.    Take supplemental Vitamin D to help your body absorb calcium.
Vitamin D is recommended as 600 IU daily for folks up to 70 years of age and 800 IU daily for those over 70. You can also get Vitamin D from salmon (800 IU per 3 ounces), canned tuna (150 IU per 3 ounces), fortified milk (about 120 IU per 4 ounces), and fortified orange juice (80 IU per 4 ounces). Most calcium supplements also contain Vitamin D.

3.    Choose calcium citrate if you take any medicines for stomach acidity, heartburn or stomach ulcer. Taking Prilosec® (omeprazole), Prevacid® (lansoprazole), Zantac® (ranitidine) and other medicines like these reduces the acid level in your stomach. Calcium carbonate needs plenty of stomach acid to be absorbed but calcium citrate doesn’t.

4.    If you have trouble with constipation, avoid calcium carbonate.

5.    Always take a calcium supplement with meals. Calcium is better absorbed when it is in your food (like broccoli) or if you take your supplement with food.

6.    Maintain an adequate water or fluid intake to avoid kidney stones.  Calcium is not very soluble in water, and taking calcium supplements can cause painful crystals or stones inside your kidney. Calcium citrate is less likely to do this than other calcium supplements. If you’ve had kidney stones in the past talk to your doctor before starting a calcium supplement.

May is National Osteoporosis Month. More information about calcium in your diet and how to keep your bones strong is available from the National Osteoporosis Foundation at www.nof.org.

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