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Osteoporosis at Age-Matters
Osteoporosis
By: Jonathan Cluett, M.D.
From about.com
What is osteoporosis?
The definition of osteoporosis is decreased density of normal bone.
Unlike conditions such as osteomalacia or Rickets, the mineralisation of
bone is normal in osteoporosis. Osteoporosis causes a decrease in bone
mass, often referred to as thinning of bone. When this occurs, the
patient with osteoporosis will have weaker bones and have a higher risk
of bone fracture.
There are two main categories of osteoporosis, Type I and Type II.
Type I osteoporosis occurs only in post-menopausal women, and is due to
oestrogen deficiency. Type II osteoporosis occurs in both men and women
(about two times more frequently in women), and is due to ageing, and
calcium deficiency over many years.
What causes osteoporosis?
Both men and women achieve their "peak bone mass" in the
third decade of life. After that point in time, their bone mass
gradually, but steadily decreases. In pregnant and lactating women the
rate of bone loss will temporarily increase if the increased calcium
demands are not met by dietary intake. In women, there is also a
significant decrease of bone mass in the immediate postmenopausal
period. As people age, the rate of bone loss tends to slow, but it
continues to decrease. Therefore, age and sex are the two most important
factors in determining who is at risk of developing osteoporosis.
Other important factors that can contribute to developing
osteoporosis include Northern European ancestry, hypothyroidism,
anticonvulsant medications, and a sedentary lifestyle. Americans are
especially prone to developing osteoporosis, the exact cause of this is
not known. This is not entirely related to ancestry, as studies have
shown that individuals who immigrate into the United States from other
countries develop an American's risk of osteoporosis.
How is osteoporosis diagnosed?
Osteoporosis most commonly is found either on routine examination, or
following a pathologic fracture. X-rays usually show a generalised loss
of bone density. Laboratory studies are not too helpful in showing
evidence of osteoporosis, rather they are very helpful in showing
conditions that can have symptoms similar to osteoporosis. Laboratory
studies can show evidence of osteomalacia, kidney failure, parathyroid
gland insufficiency, or other problems that can mimic osteoporosis and
cause bone weakness.
When screening for osteoporosis, or trying to detect the early stages
of the disease, the most useful test is called bone densiometry, or DEXA
scan. While these tests do require special equipment, they are safe,
expose the patient to minimal radiation, and are very useful in
detecting the early stages of osteoporosis.
Fractures are the most common problem associated with osteoporosis. A
pathologic fracture is a broken bone that occurs because of an
abnormality of the bone. When a fracture occurs in an area of
osteoporotic bone, it is called a pathologic fracture. The most commonly
fractured bones due to osteoporosis are the vertebral bones, the femur
(thighbone), the humerus (arm bone), the tibia (shinbone), and the
radius (forearm bone, usually near the wrist).
Treatment for Osteoporosis
The primary goal of treatment of osteoporosis is to reduce the risk
of fractures. The three mainstays of treatment are: exercise, calcium,
and medications. Exercise is important to maintain healthy bones.
Individuals who live a sedentary lifestyle have much weaker bones and a
subjected to a much higher risk of sustaining fractures. Strenuous
activity is not necessary. rather simple, easy forms of exercise such as
walking are the most beneficial for patients with osteoporosis.
Calcium supplement is important to ensure intake is at least 1500 mg
every day. The most important pharmacological treatment to prevent
osteoporosis is hormone (oestrogen) replacement therapy (HRT). Oestrogen
not only helps maintain, but it can even increase bone mass after
menopause. Multiple studies have shown the benefits of HRT, including a
lower risk of fracturing bones. In addition, other benefits of HRT in
the postmenopausal patient include lower risk of heart disease, lower
cholesterol, and fewer postmenopausal symptoms. HRT was shown to
increase the risk of uterine cancer, but this risk is eliminated when
the oestrogen is combined with progesterone. Also, there have been
studies showing a slight increase risk of breast cancer in some study
populations, but these reports are inconclusive.
Can I prevent progression of this condition?
As stated previously, there are several methods to prevent the rapid
progression of osteoporosis. There is not a cure to this condition, but
there are good treatments. It is of utmost importance that all
individuals remain active, even in their later years, to help maintain
strong bones. Simple forms of exercise, walking, swimming, aerobics,
will all help significantly. Furthermore, maintaining adequate calcium
intake, and supplementing in times of higher need (most importantly
pregnancy and lactation) will help even more. Discuss oestrogen
replacement, and other treatment medications, with your doctor.
FRACTURES
Most people were first introduced to the orthopedic surgeon at a
young age when they were brought to the emergency room with their first
broken bone.
Fractures, broken bones are among the most common orthopedic
complaints. The average citizen in a developed country can expect to
sustain two fractures over the course of their lifetime. (Despite what
you may have heard, a broken bone is not worse than a fracture, they
both mean the same thing. In fact, the word fracture, according to the Oxford
English Dictionary is defined as "the act of being
broken").
Fractures happen because an area of bone is not able to support the
energy placed on it. Therefore, there are two critical factors in
determining why a fracture occurs: the energy of the event, and the
strength of the bone. The energy can being either acute, high-energy
(e.g. car crash), or chronic, low-energy (e.g. stress fracture). The
bone strength can either be normal or decreased due to an underlying
bone problem (e.g. osteoporosis). See, a very simple problem (the broken
bone), just became a whole lot more complicated!
Statistics
Orthopaedic surgeons treat
fractures throughout the skeletal frame, except for the skull
(neurosurgeon) and face (ENT surgeon). Extremity fractures are most
common, and usually occur in men younger than age 45, and then becoming
more common in women over age 45. The reason for the difference is that
when women go through menopause, and stop producing oestrogen, the rate
of bone loss increases. This is why women are particularly susceptible
to osteoporosis and subsequent fractures. The most common fracture prior
to age 75 is called a colles fracture (forearm); in the elderly, hip
fractures become the most common.
Alcohol and Bone Health
The negative effects of alcohol
consumption on bone have long been recognised. Chronic heavy drinking
has been identified as a significant risk factor for various diseases,
including osteoporosis.
Alcohol and Nutrition
Calcium is important for many
functions in the body, where it serves as a key nutrient in the
maintenance of bone density. More than 99 percent of the body's calcium
is stored in the bones and teeth. The remaining one percent is found in
the blood. Blood levels of calcium depend upon how much of this nutrient
is consumed in the diet, how well the nutrient is absorbed, and how much
of it is excreted. Calcium balance is regulated by many factors,
including parathyroid hormone (PTH) and vitamin D.
Alcohol disrupts calcium balance in
many ways. To begin with, alcohol exposure increases PTH levels. In
cases of chronic alcohol abuse, blood levels of parathyroid hormone can
remain elevated, resulting in a strain on the body's calcium reserves.
In alcoholics, continuous elevations in parathyroid hormone can
precipitate the condition known as secondary hyperparathyroidism, the
effects of which further deplete calcium stores.
Alcohol can inhibit the production of
enzymes found in the liver and kidney that convert the inactive form of
vitamin D to its active form. This interference in vitamin D metabolism
results in an impairment of calcium absorption. Vitamin D deficiency can
lead to osteomalacia, a bone condition associated with pain, fractures
and deformity. Alcohol also increases magnesium excretion, an effect
that can further negatively impact bone health.
Alcohol, Hormones, and Other Metabolic Effects
Chronic heavy drinking can
result in hormonal deficiencies in both men and women. Alcoholic men
tend to produce less testosterone, a hormone known for its positive
effect on bone density. Low testosterone levels have been linked to
decreased activity of osteoblasts, the cells that stimulate bone
formation.
In pre-menopausal women, chronic
alcohol exposure can result in irregular menstrual cycles, an occurrence
that increases osteoporosis risk. Conversely, in post-menopausal women,
alcohol increases the conversion of testosterone into estradiol, a
hormone commonly used to prevent bone loss after menopause. For this
reason, alcohol consumption may actually have a positive effect on bone
density in women after menopause.
Alcoholics have been shown to have high
levels of cortisol, a corticosteroid. Excessive levels of cortisol have
been linked to decreased bone formation and increased bone resorption.
Corticosteroids impair calcium absorption, which leads to an increase in
PTH secretion, which can result in further bone loss.
Bone loss is evident in a large number
of individuals that drink heavily. Alcohol appears to have a direct
toxic effect on osteoblasts, suppressing bone formation. On the other
hand, osteoclasts (cells responsible for the resorption or breakdown of
bone) may be stimulated by alcohol exposure.
Falls and Fractures
Due to the effects of alcohol
on balance and gait, alcoholics tend to fall more frequently than the
general population. Heavy alcohol consumption has been associated with
an increased risk of fracture, including hip fracture. An analysis of
alcohol use in an arm of the Framingham study concluded that heavy
alcohol consumption increased hip fracture risk in both men and women.
As expected, older alcoholics are at substantially greater risk of
fractures than younger alcoholics.
Vertebral fractures, which tend to be
uncommon in individuals under fifty years of age, are more prevalent in
those younger than fifty who abuse alcohol. Additionally, alcohol
consumption is linked to other types of fracture, including those of the
wrist and ribs.
The Benefits of Abstinence
The most effective treatment
for alcohol-induced bone changes is abstinence. Abstinence in alcoholics
seems to result in a rapid recovery of osteoblast function. Moreover,
studies demonstrate that bone loss may be partially restored when
alcohol abuse is discontinued.
Moderation May Be the Key for Postmenopausal
Women
While the toxic effects of alcohol abuse are well established, moderate
alcohol consumption may actually have a modest favourable effect on bone
density in postmenopausal women. This effect may be explained by the
fact that after menopause, alcohol enhances the conversion of
testosterone into estradiol. Moderate alcohol intake may also be
beneficial due to its ability to increase calcitonin, a thyroid hormone
that inhibits bone resorption. On the other hand, there is no evidence
to suggest that moderate alcohol intake is beneficial to bone density in
premenopausal women or in men.
Calcium content of other common foods
MILK
- 250 ml = 315 mg calcium
 FIRM CHEESE - 50 g
= 350 mg calcium
 YOGOURT - 175 ml =
275 mg calcium
See how milk products compare to these foods
Food Serving Calcium Rating
(mg)
Almonds 125 ml (1/2 cup) (200) **
Baked beans 250 ml (1 cup) (163) **
Beet greens, cooked 125 ml (1/2 cup) (87) *
Brazil nuts 125 ml (1/2 cup) 130 *
Bread, whole wheat or 1 slice 25
white
Broccoli, cooked 125 ml (1/2 cup) 38
Cauliflower, cooked 125 ml (1/2 cup) 18
Chickpeas, cooked 250 ml ( 1 cup) 84 *
Chilli con carne 250 Ml (1 cup) (66) *
Dates 60 Ml (1/4 cup) 12
Figs, dried 4 medium 61 *
Kale, cooked 125 Ml (1/2 cup) 103 *
Lentils, cooked 250 Ml (1 cup) 40
Nuts, mixed 125 Ml (1/2 cup) 48
Orange 1 medium 52 *
Prunes, dried, uncooked 60 Ml (1/4 cup) 18
Raisins 60 Ml (1/4 cup) 21
Red kidney beans, cooked 250-Ml (1-cup) (52) *
Rhubarb, cooked 125-Ml (1/2 cup) (184) **
Rice, white or brown 125 Ml (1/2 cup) 12
cooked
Rice drink (fortified) 250 Ml (1 cup) 300 ***
Salmon, pink, canned, 1/2 - 213 g can 225 **
canned with bones
Sardines, canned 1/2 - 213 g can 210 **
with bones
Sesame seeds 125 Ml (1/2 cup) (104) *
Shrimps, cooked, canned 70 g (12 large) 41
Soybeans, cooked 125 (1/2 cup) (93) *
Soy drink 250 Ml (1 cup) 28
Soy drink (fortified) 250 Ml (1 cup) 300 ***
Spinach, cooked 125 Ml (1/2 cup) (129) *
Tofu, regular processed* 100 g (1/3 cup) (150) *
White beans, cooked 250 Ml (1 cup) (170) **
Calcium from these foods is known to be
absorbed less efficiently by the body.
* The calcium content shown for tofu is an approximation based on
products available on the market. Calcium content varies greatly from
one brand to the other and can be quite low. Tofu processed with
magnesium chloride also contains less calcium.
Rating as established according to Canadian Food and Drugs Regulations
* Source of calcium
** Good source of calcium
*** Excellent source of calcium
: The
first women of the post-World War II generation, known as baby boomers,
have reached age 50, one year under the average age of menopause. By the
end of this century, more women than ever before will be experiencing
the sometimes uncomfortable symptoms that accompany the end of
menstruation and natural childbearing capacity.
For many years, doctors knew little
about and paid little attention to menopause. "About 20 years ago,
medical attitudes started changing," gynaecology,. "We used to
think that when women reached age 50, they weren’t interested in sex
anymore. But studies in retirement communities showed otherwise. We also
began to see an increase in the female life expectancy. When a woman
reaches age 50, she typically has another 30 years to live. As
physicians, we became interested not only in the quantity of her life,
but the quality of it."
The pace of medical inquiry has
accelerated over the last few years, as the first of the baby boomers
started experiencing menopausal symptoms. "It’s not uncommon to
hear it discussed these days. "This is a radical turn-around from
the way the mothers of these women treated it. Speak to a 50-year-old
woman and she’ll say, my mother never discussed it with me."
With such thinking, a new attitude
toward treatment and research has emerged.
Menopause and Osteoporosis: Facts, Fallacies,
and Therapies –
Jump back 40 years! Imagine a party (did they have
those 40 years ago?) conversation turning to hot flushes and menopause,
uh, um, I mean, shhh, "the change". It's all in your head, the
story went, and besides, it was certainly not an issue for polite
conversation.
Well, we have come a
long way. Thanks to advances in medicine coupled with unprecedented
numbers of baby boomers turning fiftyish, menopause today and its
accompanying signs are talked about, sometimes treated, often minimised,
and rarely relegated to the silent treatment.
The Hot Flushes:
Ironically, they are in a
woman’s head - but they have a very real physical cause. The hot flush
is an alteration in thermal stability, which is maintained by the
hypothalamus, a brain region located above the pituitary gland on the
brain’s floor. The hypothalamus operates the body’s temperature
regulation system. Oestrogen levels manipulate some functions of the
hypothalamus. During menopause, as the ovaries produce less oestrogen,
the hypothalamus senses and responds to the lower oestrogen levels by
rapidly changing body temperature. The result may be a hot flush.
Hormone Replacement Therapy:
Many postmenopausal women
take hormone replacement therapy. Women take oestrogen to alleviate
menopausal symptoms, especially hot flushes and also to protect bones.
There are now many approved oestrogen
drugs for long-term use to prevent osteoporosis.
Many scientists believe that oestrogen
may fight heart disease by lowering harmful cholesterol (LDL), raising
beneficial cholesterol (HDL), and strengthening the lining of the blood
vessels, but this has not been clearly proven. Some research also
suggests that oestrogen may help prevent memory loss and Alzheimer’s
disease, but the scientific evidence remains speculative. Nearly all the
studies on heart disease and cognitive function have been retrospective
or "look back" studies.
Risks of Oestrogen Therapy:
Oestrogen is most commonly
prescribed in pill form. It is also available in transdermal patches,
which allow the drug to be slowly absorbed into the bloodstream, and in
vaginal creams, which treat localised discomforts.
Oestrogen replacement therapy is not
risk-free. "There’s been much experimental evidence and patient
experience showing oestrogen given alone can lead to endometrial cancer.
"For that reason, a woman who still has a uterus is usually
prescribed progestin in addition to oestrogen. This significantly
reduces the risk of abnormal changes in the uterine lining.
Endometrial cancer is not the only risk
from oestrogen use. Gallbladder disease is another. Women who use
estrogens after menopause are more likely to develop gallbladder disease
needing surgery, than women who don’t use estrogens. The drug’s
labelling also includes a warning about abnormal blood clotting. Clots
can cause a stroke, heart attack, or pulmonary embolus, any of which can
be fatal.
Oestrogen can produce uncomfortable
side effects such as nausea and vomiting. It can enlarge breasts and
make them tender. Women who use it can also retain excess fluid, which
can aggravate conditions like asthma, epilepsy, migraines, and heart and
kidney disease. A spotty darkening of the skin, particularly on the
face, can occur. For women who take progestin along with oestrogen,
menstrual-like bleeding and pre-menstrual symptoms often occur. Also
under study is whether adding progestin counters the potential
heart-protective effects of oestrogen.
It's not known whether oestrogen use
increases the risk of breast cancer, or what effect adding progestin
would have on this risk. In recent years, many studies on breast cancer
and oestrogen use have been conducted, with conflicting results. Doctors
urge women who receive oestrogen therapy to have regular breast
examinations by a health professional, perform monthly self-exams, and
have yearly mammograms starting at intervals recommended by their
doctors.
Before Menopause:
The medical term for the usually
gradual period of change leading into natural menopause is
"perimenopause." The two to three years following the last
period are called the "climacteric.", The average age of
menopause is around age 51. But some women go through natural menopause
as early as age 35, while others don’t experience it until their late
50s. Menopause occurs at any age with surgical removal of the ovaries.
During perimenopause, oestrogen
production is low and the ovaries stop producing eggs. As oestrogen
levels decline, certain signs may appear. The most common sign, the one
that doctors sometimes call the "hallmark" of menopause, is
the hot flush. A hot flush is a sudden rush of heat to the neck, face,
and possibly other parts of the body that may last from 30 seconds to
five minutes. Some women go from feeling hot to feeling cold. The hot
flush may begin with a sudden tingling in the fingers, toes, cheeks, or
ears.
Ironically, it is in a woman’s
head—but it has a very real physical cause. The hot flush is an
alteration in thermal stability, which is maintained by the
hypothalamus, a brain region located above the pituitary gland on the
brain’s floor. The hypothalamus operates the body’s temperature
regulation system. Oestrogen levels manipulate some functions of the
hypothalamus. During menopause, as the ovaries produce less oestrogen,
the hypothalamus senses and responds to the lower oestrogen levels by
rapidly changing body temperature. The result may be a hot flush.
Perspiration, sometimes extreme
sweating, can accompany hot flushes. Many of them typically occur in the
middle of the night, which causes some women to have trouble falling
back to sleep. How many women are affected by hot flushes has not been
clearly determined, and the reported numbers depend in part on whether
healthy populations or women in medical settings are surveyed. Some
scientists say as few as 30 percent of women are afflicted by them;
others believe the figure is much higher.
Obese women are less likely to have hot
flushes because they have more oestrogen, which is converted from
adrenal hormones by stored fat. Many women cope with hot flushes by
trying to relax until the discomfort passes and by lowering the room
temperature, dressing in light layers of clothing, avoiding spicy food,
and cutting back on caffeine and alcohol.
Vaginal dryness is another symptom of
oestrogen decrease and may lead to painful intercourse, vaginal
infections, and urinary problems. Over-the-counter vaginal lubricants
may help.
Other symptoms attributed to menopause
include difficulty concentrating, depression, headache, memory loss, a
feeling of insects crawling across the skin, and lower backaches, which
may be related to osteoporosis.
Osteoporosis:
Probably the disease with
the strongest link to menopause is osteoporosis. Scientists believe
women can help control bone loss with weight-bearing exercises,
including walking, running or weightlifting. A low-fat diet, rich in
calcium and vitamin D, is also believed to be important, as are cutting
back on alcohol and stopping smoking.
Despite the sometimes annoying,
peripheral problems, more than ever before menopause is now seen as a
natural process, not a disease. It’s healthy. It’s physiologic. It's
a hot conversation topic at cocktail parties and other places
Osteoporosis: Risk and Prevention
Osteoporosis affects mostly women past
menopause, many bone fractures each year are related to osteoporosis. It
is believed that many women/men over 50 will have an Osteoporosis
related fracture in their lifetime. Some will experience more serious
fractures, including spine and hip fractures.
Throughout life bones go through a
constant state of loss and regrowth, however as people age the loss
accelerates to the point that regrowth cannot keep up and osteoporosis
may develop. Osteoporosis causes the bones to become thin and fragile,
increasing the chance of breaking with even minor injury.
As women age oestrogen levels decrease
and the risk of osteoporosis increases. Women who take birth control
pills during their reproductive years may reduce their risk of
osteoporosis developing later in life, probably because of the oestrogen
that many oral contraceptives contain. Oestrogen replacement therapy
helps to protect women against bone loss. Symptoms of bone loss include
back pain or tenderness, a loss of height, and a slight curvature or
'hump' of the upper back.
Are You at Risk for Osteoporosis?
During menopause the level of
oestrogen produced by the ovaries greatly decreases causing the risk
of bone loss to increase significantly.
Surgical menopause with the removal of
the ovaries accelerates the process of bone loss to a rapid level
unless oestrogen replacement therapy is begun.
An inadequate intake of calcium
throughout life increases the chance of bone loss since calcium is one
of the main components in bone.
White women and Asian women face the
greatest risk of osteoporosis.
An inactive lifestyle puts women at a
higher risk for developing osteoporosis.
Women with a slender build experience
more bone loss than other women.
A history of eating disorders
increases the risk of osteoporosis.
Women whose family history includes
osteoporosis have a higher risk of developing this condition.
Some medications such as diuretics,
steroids, and anticonvulsants increase the risk.
Women who smoke or drink alcohol
experience a higher incidence of osteoporosis.
Preventing Osteoporosis
Because it is hard to replace bone that
is lost, prevention is key. Beginning a lifelong commitment to exercise
and healthy nutrition while you are still young will reduce your risk of
developing this condition later in life. Remember, you are never too
young to think about preventing osteoporosis.
Exercise increases bone mass before
menopause and helps to reduce bone loss after menopause. Bone strength
increases with regular exercise--to help prevent bone loss
weight-bearing exercise such as walking, low-impact aerobics, or tennis
work best.
An adequate calcium intake is essential
in the prevention of osteoporosis. Good sources of calcium include dairy
products, leafy green vegetables, nuts, and seafood. Most women get only
about half of the calcium they need everyday so taking a calcium
supplement is often advisable. The best form of calcium for preventing
bone loss is calcium carbonate. If you choose to use supplements it's
important that you understand that the body can only absorb up to 750 mg
of calcium at one time, so you will need to divide your dose if the
amount of calcium supplement you take exceeds that amount.
Vitamin D is necessary for the body to
absorb calcium--milk that is fortified with Vitamin D is one of the best
sources. Sunlight also is an excellent source of Vitamin D--being in the
sun for just 15 minutes a day helps the body produce and activate
Vitamin D.
How much calcium do you need?
Calcium is important throughout a
woman's life, although the amount necessary varies with age. Talk to
your Doctor who will advise on the amounts suitable for you.
Younger women who experience the
symptoms of pre-menstrual syndrome (PMS) may be pleasantly surprised to
find their symptoms are reduced by employing these osteoporosis
preventing techniques. Studies show that calcium supplementation may
reduce or prevent up to 50% of all PMS symptoms, and exercise is often
effective for reducing PMS symptoms.
If you feel that you are at risk for
osteoporosis, talk with your Doctor. Your Doctor may order a bone
density scan which is a simple and painless tool that measures bone
density. Women who do not take oestrogen after menopause have other
options for preventing osteoporosis including drugs such as calcitonin,
which slows bone loss. Your Doctor can help you determine what is best
for you.
Bone Builders
Unearthed skeletons from ancient times
testify to the durability of bone long after other bodily tissue turns
to dust. Living bone in the body, however, can lose mineral and fracture
easily if neglected--a disorder called osteoporosis, or porous bones.
One in two women and one in eight men over 50 suffer such fractures,
including sometimes life-threatening hip fractures.
But during your preteen and teenage
years, you can reduce your risk of fractured bones later in life with
calcium-rich foods and physical activity.
Bone Behaviour
Your body's 206 living bones
continually undergo a build-up, breakdown process called remodeling.
The body starts to form most of its
bone mass before puberty, the beginning of sexual development, building
75 to 85 percent of the skeleton during adolescence. Women reach their
peak bone mass by around age 25 to 30, while men build bone until about
age 30 to 35. The amount of peak bone mass you reach depends largely on
your genes. Then gradually, with age, the breakdown outpaces the
build-up, and in late middle age bone density lessens when needed
calcium is withdrawn from bone for such tasks as blood clotting and
muscle contractions, including beating by the heart.
"You can't do anything about the
genes you're dealt, As a teenager, though, you can make the most of
things you do control that can build your bones and help reduce the risk
of fractures when you are older."
Supporting the skeleton with healthy
habits now so it can support you later in life is especially important
if you have an increased risk of osteoporosis, for example, if you're
female or have a thin, small-boned frame. These habits are proper diet,
exercise, and avoiding bone risks lifestyle choices that are bad for
bone, like smoking.
Eat Your Way to Strong Bones
The main mineral in bones is calcium,
one of whose functions is to add strength and stiffness to bones, which
they need to support the body. To lengthen long bones during growth, the
body builds a scaffold of protein and fills this in with calcium-rich
mineral. From the time you're 11 until you're 24, you need plenty of
calcium each day.
Adolescent bodies are tailor-made to
"bone up" on calcium. With the start of puberty, "your
body is at a higher capacity to absorb and retain calcium."
Bone also needs vitamin D, to move
calcium from the intestine to the bloodstream and into bone. You can get
vitamin D from short, normal day-to-day exposure of your arms and legs
to sun and from foods fortified with the vitamin. Also needed are
vitamin A, vitamin C, magnesium and zinc, as well as protein for the
growing bone scaffold.
Mother Nature provides many foods with
these nutrients. One stands out, however, as "almost a perfect
package," "Milk is rich in calcium and high-quality protein.
Nearly all milk has vitamins D and A added. And it has magnesium and
zinc."
Still, as excellent as milk is for
bones, it and other dairy products are not the only foods that contain
calcium. The importance of choosing calcium sources from the different
food groups is that each group offers its unique package of other
nutrients as well.
To learn how much calcium is in a food,
you can read the food label's Nutrition Facts panel.
Because many foods are now fortified
with calcium, your investigation of labels may turn up surprising
sources. An easy daily plan is to drink a calcium source at every meal
and eat one calcium food as a snack.
If the lactose sugar in dairy products
causes problems like gas, bloating or diarrhea, try lactose-reduced or
lactose-free milk. Also available are lactase drops and tablets, which
can help you digest dairy products like milk, yoghurt, and cheese.
Get Enough Weight-Bearing Exercise
Growing bone is especially sensitive to
the impact of weight and pull of muscle during exercise, and responds by
building stronger, denser bones. That's why it's especially important
when you're growing a lot to be physically active on a regular basis.
And as far as bone is concerned, impact
activity like jumping up and down appears to be the best. "But the
important thing is to get off the couch and get moving at some activity.
It really is a matter of 'Use it now, or lose it later'."
Such activities include sports and
exercise, including football, basketball, baseball, jogging, dancing,
jumping rope, inline skating, skateboarding, bicycling, ballet, hiking,
skiing, karate, swimming, rowing a canoe, bowling, and weight-training.
And when your parents make you mow the lawn, rake leaves, or wash and
wax the car, they're doing your muscles and bones a favour.
"Day-to-day activities that start
in the teen years, like walking the dog or using stairs instead of
lifts, can become life-long habits for healthy bones."
Avoid Bone Risks
Some habits in the teenage years can
steal calcium from your bones or increase the need for it, weakening the
skeleton for life.
Skipping meals is risky for bone. In
our three-meal-a-day society, skipping a meal may reduce by a third your
chance of getting your calcium, simply by eliminating one occasion to
eat.
Replacing milk with non-dairy drinks
like fizzy drinks, tea or coffee is another eating habit that prevents
bones from getting the calcium and other nutrients they need.
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