Post-Menopausal Women
Menopause often leads to increases in bone loss with the most rapid rates of bone loss occurring during the first five years after menopause. Drops in estrogen production after menopause result in increased bone resorption, and decreased calcium absorption.
Annual decreases in bone mass of 3-5% per year are often seen during the years immediately following menopause, with decreases less than 1% per year seen after age 65. Two studies are in agreement that increased calcium intakes during menopause will not completely offset menopause bone loss.
Hormone therapy (HT), previously known as hormone replacement therapy (HRT), with sex hormones such as estrogen and progesterone, helps to prevent osteoporosis and fractures. However, some medical groups and professional societies such as the American College of Obstetricians and Gynecologists, The North American Menopause Society and The American Society for Bone and Mineral Research recommend that postmenopausal women consider using other agents such as bisphosphonates (medication used to slow or stop bone-resorption) because of potential health risks of HT if combination HT (estrogen and progestin) is solely being administered to prevent or treat osteoporosis. Postmenopausal women using combination HT to reduce bone loss should consult with their physician about the risks and benefits of estrogen therapy for their health.
Estrogen therapy works to restore postmenopausal bone remodeling levels back to those of premenopause, leading to a lower rate of bone loss. Estrogen appears to interact with supplemental calcium by increasing calcium absorption in the gut. However, including adequate amounts of calcium in the diet may help slow the rate of bone loss for all women.
Wednesday, August 15, 2007
Tuesday, August 14, 2007
Calcium absorption
Calcium absorption refers to the amount of calcium that is absorbed from the digestive tract into our body's circulation. Calcium absorption can be affected by the calcium status of the body, vitamin D status, age, pregnancy and plant substances in the diet. The amount of calcium consumed at one time such as in a meal can also affect absorption.
For example, the efficiency of calcium absorption decreases as the amount of calcium consumed at a meal increases.
Age:Net calcium absorption can be as high as 60% in infants and young children, when the body needs calcium to build strong bones [2,11]. Absorption slowly decreases to 15-20% in adulthood and even more as one ages [2,11,12]. Because calcium absorption declines with age, recommendations for dietary intake of calcium are higher for adults ages 51 and over.
Vitamin D:Vitamin D helps improve calcium absorption. Your body can obtain vitamin D from food and it can also make vitamin D when your skin is exposed to sunlight. Thus, adequate vitamin D intake from food and sun exposure is essential to bone health. The Office of Dietary Supplement's vitamin D fact sheet provides more information: http://ods.od.nih.gov/factsheets/vitamind.asp.
Pregnancy:Current calcium recommendations for nonpregnant women are also sufficient for pregnant women because intestinal calcium absorption increases during pregnancy [2]. For this reason, the calcium recommendations established for pregnant women are not different than the recommendations for women who are not pregnant.
Plant substances:Phytic acid and oxalic acid, which are found naturally in some plants, may bind to calcium and prevent it from being absorbed optimally. These substances affect the absorption of calcium from the plant itself not the calcium found in other calcium-containing foods eaten at the same time [6]. Examples of foods high in oxalic acid are spinach, collard greens, sweet potatoes, rhubarb, and beans. Foods high in phytic acid include whole grain bread, beans, seeds, nuts, grains, and soy isolates [2]. Although soybeans are high in phytic acid, the calcium present in soybeans is still partially absorbed [2,13]. Fiber, particularly from wheat bran, could also prevent calcium absorption because of its content of phytate. However, the effect of fiber on calcium absorption is more of a concern for individuals with low calcium intakes. The average American tends to consume much less fiber per day than the level that would be needed to affect calcium absorption.Calcium excretion refers to the amount of calcium eliminated from the body in urine, feces and sweat. Calcium excretion can be affected by many factors including dietary sodium, protein, caffeine and potassium.
Sodium and protein:Typically, dietary sodium and protein increase calcium excretion as the amount of their intake is increased [5,14]. However, if a high protein, high sodium food also contains calcium, this may help counteract the loss of calcium.
Potassium:Increasing dietary potassium intake (such as from 7-8 servings of fruits and vegetables per day) in the presence of a high sodium diet (>5100 mg/day, which is more than twice the Tolerable Upper Intake Level of 2300 mg for sodium per day) may help decrease calcium excretion particularly in postmenopausal women [15,16].
Caffeine:Caffeine has a small effect on calcium absorption. It can temporarily increase calcium excretion and may modestly decrease calcium absorption, an effect easily offset by increasing calcium consumption in the diet [17]. One cup of regular brewed coffee causes a loss of only 2-3 mg of calcium easily offset by adding a tablespoon of milk [14]. Moderate caffeine consumption, (1 cup of coffee or 2 cups of tea per day), in young women who have adequate calcium intakes has little to no negative effects on their bones [18].
Other factors:
Phosphorus: The effect of dietary phosphorus on calcium is minimal. Some researchers speculate that the detrimental effects of consuming foods high in phosphate such as carbonated soft drinks is due to the replacement of milk with soda rather than the phosphate level itself [19,20].
Alcohol: Alcohol can affect calcium status by reducing the intestinal absorption of calcium [21]. It can also inhibit enzymes in the liver that help convert vitamin D to its active form which in turn reduces calcium absorption [3]. However, the amount of alcohol required to affect calcium absorption is unknown. Evidence is currently conflicting whether moderate alcohol consumption is helpful or harmful to bone. In summary, a variety of factors that may cause a decrease in calcium absorption and/or increase in calcium excretion may negatively affect bone health.
source-
http://www.healthinfoforyou.com/an/5aa4.htm
For example, the efficiency of calcium absorption decreases as the amount of calcium consumed at a meal increases.
Age:Net calcium absorption can be as high as 60% in infants and young children, when the body needs calcium to build strong bones [2,11]. Absorption slowly decreases to 15-20% in adulthood and even more as one ages [2,11,12]. Because calcium absorption declines with age, recommendations for dietary intake of calcium are higher for adults ages 51 and over.
Vitamin D:Vitamin D helps improve calcium absorption. Your body can obtain vitamin D from food and it can also make vitamin D when your skin is exposed to sunlight. Thus, adequate vitamin D intake from food and sun exposure is essential to bone health. The Office of Dietary Supplement's vitamin D fact sheet provides more information: http://ods.od.nih.gov/factsheets/vitamind.asp.
Pregnancy:Current calcium recommendations for nonpregnant women are also sufficient for pregnant women because intestinal calcium absorption increases during pregnancy [2]. For this reason, the calcium recommendations established for pregnant women are not different than the recommendations for women who are not pregnant.
Plant substances:Phytic acid and oxalic acid, which are found naturally in some plants, may bind to calcium and prevent it from being absorbed optimally. These substances affect the absorption of calcium from the plant itself not the calcium found in other calcium-containing foods eaten at the same time [6]. Examples of foods high in oxalic acid are spinach, collard greens, sweet potatoes, rhubarb, and beans. Foods high in phytic acid include whole grain bread, beans, seeds, nuts, grains, and soy isolates [2]. Although soybeans are high in phytic acid, the calcium present in soybeans is still partially absorbed [2,13]. Fiber, particularly from wheat bran, could also prevent calcium absorption because of its content of phytate. However, the effect of fiber on calcium absorption is more of a concern for individuals with low calcium intakes. The average American tends to consume much less fiber per day than the level that would be needed to affect calcium absorption.Calcium excretion refers to the amount of calcium eliminated from the body in urine, feces and sweat. Calcium excretion can be affected by many factors including dietary sodium, protein, caffeine and potassium.
Sodium and protein:Typically, dietary sodium and protein increase calcium excretion as the amount of their intake is increased [5,14]. However, if a high protein, high sodium food also contains calcium, this may help counteract the loss of calcium.
Potassium:Increasing dietary potassium intake (such as from 7-8 servings of fruits and vegetables per day) in the presence of a high sodium diet (>5100 mg/day, which is more than twice the Tolerable Upper Intake Level of 2300 mg for sodium per day) may help decrease calcium excretion particularly in postmenopausal women [15,16].
Caffeine:Caffeine has a small effect on calcium absorption. It can temporarily increase calcium excretion and may modestly decrease calcium absorption, an effect easily offset by increasing calcium consumption in the diet [17]. One cup of regular brewed coffee causes a loss of only 2-3 mg of calcium easily offset by adding a tablespoon of milk [14]. Moderate caffeine consumption, (1 cup of coffee or 2 cups of tea per day), in young women who have adequate calcium intakes has little to no negative effects on their bones [18].
Other factors:
Phosphorus: The effect of dietary phosphorus on calcium is minimal. Some researchers speculate that the detrimental effects of consuming foods high in phosphate such as carbonated soft drinks is due to the replacement of milk with soda rather than the phosphate level itself [19,20].
Alcohol: Alcohol can affect calcium status by reducing the intestinal absorption of calcium [21]. It can also inhibit enzymes in the liver that help convert vitamin D to its active form which in turn reduces calcium absorption [3]. However, the amount of alcohol required to affect calcium absorption is unknown. Evidence is currently conflicting whether moderate alcohol consumption is helpful or harmful to bone. In summary, a variety of factors that may cause a decrease in calcium absorption and/or increase in calcium excretion may negatively affect bone health.
source-
http://www.healthinfoforyou.com/an/5aa4.htm
Monday, August 13, 2007
Meet your calcium needs
The following are strategies and tips to help you meet your calcium needs each day:Use low fat or fat free milk instead of water in recipes such as pancakes, mashed potatoes, pudding and instant, hot breakfast cereals.Blend a fruit smoothie made with low fat or fat free yogurt for a great breakfast.Sprinkle grated low fat or fat free cheese on salad, soup or pasta.Choose low fat or fat free milk instead of carbonated soft drinks.Serve raw fruits and vegetables with a low fat or fat free yogurt based dip.Create a vegetable stir-fry and toss in diced calcium-set tofu.Enjoy a parfait with fruit and low fat or fat free yogurt.Complement your diet with calcium-fortified foods such as certain cereals, orange juice and soy beverages.
Wednesday, August 8, 2007
One minute quiz
Assess your risk: If you are concerned you may be at risk of osteoporosis, fill out the IOF One-Minute Osteoporosis Risk Test, and if you answer 'yes' to any of the questions, talk to your doctor about whether you need to undergo further testing.
Tuesday, August 7, 2007
Hip fractures
Poor nutritional status, especially with respect to protein intake, is an important risk factor for hip fracture, and can also contribute to poor recovery.
Sunday, August 5, 2007
Osteoporosis Facts
· Calcium and vitamin D supplementation reduces rates of bone loss and also fracture rates in older male and female adults, and the elderly. In institutionalized elderly women, this combined supplementation reduced hip fracture rates.
· A three-year study in healthy young women aged 30-42 years showed that enriching the diet with dairy foods prevented bone loss in the spine, compared with control subjects who did not increase their dietary calcium intake.
· Supplementation with both vitamin D and calcium, compared with calcium alone, reduced body sway in elderly women, suggesting that correction of vitamin D deficiency may improve neuromuscular function and reduce the propensity to fall.
· A three-year study in healthy young women aged 30-42 years showed that enriching the diet with dairy foods prevented bone loss in the spine, compared with control subjects who did not increase their dietary calcium intake.
· Supplementation with both vitamin D and calcium, compared with calcium alone, reduced body sway in elderly women, suggesting that correction of vitamin D deficiency may improve neuromuscular function and reduce the propensity to fall.
Thursday, August 2, 2007
Nutrition and Osteoporosis Facts
· Dairy foods, calcium-set tofu, some green vegetables, and small canned fish with soft bones (e.g. sardines) provide the most readily-available sources of dietary calcium.
· Studies in children and adolescents have shown that supplementation with calcium, dairy calcium-enriched foods, milk or a calcium-enriched milk powder, enhances the rate of bone mineral acquisition.
· Adequate levels of calcium intake can maximize the positive effect of physical activity on bone health during the growth period of children.
· Studies in children and adolescents have shown that supplementation with calcium, dairy calcium-enriched foods, milk or a calcium-enriched milk powder, enhances the rate of bone mineral acquisition.
· Adequate levels of calcium intake can maximize the positive effect of physical activity on bone health during the growth period of children.
Wednesday, August 1, 2007
Treatment
It is estimated that osteoporosis causes approximately 1.5 million fractures (broken bones) every year in the U.S. Not only can these fractures be painful and disfiguring, they may reduce a person’s ability to lead an active life. Osteoporosis affects every bone in the body, but the most common places where fractures occur are the back, hips, and wrists.
Because osteoporosis thins bones, weakening them and making them more susceptible to fractures (broken bones), it is essential that you talk to your healthcare provider about osteoporosis treatment options upon diagnosis. The disease is particularly serious because you don’t see or feel your bones thinning, putting you at increased risk of experiencing a fracture from ordinary activities like bending and lifting or from a more traumatic event like falling.
Because osteoporosis thins bones, weakening them and making them more susceptible to fractures (broken bones), it is essential that you talk to your healthcare provider about osteoporosis treatment options upon diagnosis. The disease is particularly serious because you don’t see or feel your bones thinning, putting you at increased risk of experiencing a fracture from ordinary activities like bending and lifting or from a more traumatic event like falling.
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