FIT FOR DUTY. . .FIT FOR LIFE!

“May is Bone Health Month” Submitted by: LT Kathleen R. Manning, USPHS

“What is Bone Health Month?”

In 2004, “The 2004 Surgeon General’s Report on Bone Health and Osteoporosis” was published and in May 2005, Surgeon General VADM Richard H. Carmona designated May as Bone Health Month to generate awareness of preventing bone diseases such as osteoporosis and rickets. According to the Surgeon General’s report, 10 million Americans over the age of 50 currently have osteoporosis and another 34 million Americans are at risk for developing osteoporosis. Fortunately, there are two simple steps that you can take to improve your bone health: ensure an adequate intake of calcium, vitamin D, and phosphorous and engage in weight bearing activity.

“Where can I find calcium and how much do I need?”

Calcium is best absorbed from food sources. Most Americans consume calcium primarily through dairy products, such as milk, yogurt, and cheese. Eating or drinking the recommended two to three servings of dairy products daily can help maintain healthy bones. The National Dairy Council and the American Dietetic Association (ADA) have teamed up to educate consumers about the bone-building, nutrition, and health benefits of dairy foods such as milk, cheese, and yogurt. The ADA along with the American Academy of Family Physicians, American Academy of Pediatrics, and National Medical Association support the 3-A-Day of Dairy campaign. Check it out at http://www.got-milk.com/3aday/index.html. For adults, one serving of dairy products equals one cup of milk or yogurt or 1½ ounces of natural cheese. A child’s portion may be ¼ - ½ of an adult portion size, depending on the child’s age. Choosing low-fat or non-fat dairy products provides more calcium per serving. Most children need 500-800 mg of calcium daily. Adolescents need 1300 mg daily. Adult men and adult pregnant and non-pregnant women need 1000-1200 mg of calcium daily.

“How can people who are lactose-intolerant, who have a milk allergy, or otherwise do not consume dairy products get the calcium they need?”

People who are lactose intolerant may consume lactose-reduced milk, yogurt with active cultures, and hard cheeses, depending on their tolerance. People who have a milk allergy or otherwise do not consume animal products can find many food sources rich in calcium, including calcium-fortified tofu (204 mg per ½ cup of firm tofu), calcium-fortified cereals (100-1000 mg per 1cup), spinach (120 mg per ½ cup cooked), Chinese cabbage (74 mg per 1 cup raw), and corn tortillas (42 mg per 1 medium tortilla). Individuals with lactose intolerance or milk allergies may consider taking a calcium-vitamin D supplement to ensure adequate daily intake of these nutrients.

“Why do I need vitamin D, how much do I need, and where can I find it?”

Calcium needs vitamin D to be absorbed to build and maintain bone tissue. Vitamin D is not found naturally in the body. It must be taken in either through the diet or it can also be synthesized through 10¬15 minutes of sun exposure, depending on the season, geographic latitude, time of day, cloud cover, smog, and sunscreen use.

Most children, adolescents, young adult men and women, and pregnant women need 5 micrograms (200 IU—International Units) of vitamin D daily. In children, vitamin D is important to prevent vitamin D related rickets. Adult men and women ages 50-70 need 10 micrograms (400 IU) of vitamin D daily. Over age 70, both men and women need 15 micrograms (600 IU) of vitamin D daily. Most dairy products are fortified with vitamin D, but people who do not consume dairy products can find vitamin D in cod liver oil (1360 IU per 1 tablespoon), fatty fish such as salmon (360 IU per 3½ oz cooked), mackerel (345 IU per 3½ oz cooked), and tuna (200 IU per 3oz canned in oil), eggs (20 IU per whole egg—the vitamin D is in the yolk). People who do not eat animal products can find vitamin D in fortified cereals (40 IU per ¾ -1 cup, depending on the cereal).

“Why Is phosphorous important, how much do I need, and where can I find it?”

Calcium and phosphorous both help to build bone tissue, but compete against each other. If the body has too much phosphorous, calcium is released from the bones to balance the two minerals. This may cause brittle bones. By ensuring a balance of our dietary intake of phosphorous with our dietary intake of calcium, we can improve bone health.

Most children need 460-500 mg of phosphorous daily and most adolescents need 1250 mg daily. Adult men and women and adult pregnant women need 700 mg of phosphorous daily.

The American diet is typically rich in phosphorous, but can be low in calcium. Some phosphorous rich beverages such as sodas (some have as much as 500 mg per serving) are replacing calcium-rich beverages such as milk in children’s diets. Rich sources of phosphorous include yogurt (383 mg per 8 oz), lentils (356 mg per ½ cup cooked), nonfat milk (247 mg per 8 oz), salmon (252 mg per 3 oz cooked), beef and turkey (both 173 mg per 3 oz cooked) and almonds (139 mg per 1oz).

“Do I need supplements?”

Calcium, vitamin D, and phosphorous from food are most safe and well absorbed and are least expensive. However, some people do not consume enough dietary sources of calcium and vitamin D and may need supplements. If you do not know if your diet contains enough of these nutrients, ask a Registered Dietitian. A simple multivitamin taken daily will normally provide the necessary amount of vitamin D. Calcium supplements are found in many forms. It is important to read the label and investigate what is in the product. For example, calcium supplements containing oyster shell, bone meal, or dolomite may also contain lead. Calcium supplements from ‘calcium carbonate’ or ‘calcium citrate’ are preferred. Choose a calcium supplement that has vitamin D added. Remember, if you take any type of dietary supplement, it is important to let your healthcare provider know what you are taking, how much, and how often because these nutrients can interact with certain medications and it is possible to get too much.

“What is weight bearing activity?”

Weight bearing activity relies on gravity pulling our body mass to help increase bone density. There are many different types of weight bearing activities that you can do to maintain bone health, such as weight training, running, aerobics, dancing, skating, or walking. Choose an activity you enjoy and start any new activity slowly and gradually increase your time and intensity.

Food for thought:

This month, take the time to see what healthier food and activity choices you can make to ensure bone health. To learn more about “The 2004 Surgeon General’s Report on Bone Health and Osteoporosis,” log on to . To learn more about how to make healthier food choices to improve bone health, log on to the American Dietetic Association Web site at http://www.eatright.org to locate a Registered Dietitian near you.

 

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