build your bones, girlfriend! - barbados underground...bone loss later on. age 20 danger zone age 40...

Build Your Bones,Build Your Bones,Girlfriend!Girlfriend!

Bones are living tissue, they Bones are living tissue, they provide structural support, and provide structural support, and protect vital organsprotect vital organs

Bones are made up of:Bones are made up of: CalciumCalcium PhosphorousPhosphorous ProteinProtein MagnesiumMagnesium Vitamins and other minerals in Vitamins and other minerals in

smaller amountssmaller amounts

Facts About Our BonesFacts About Our Bones

The average adult skeleton contains The average adult skeleton contains over TWO POUNDS of calcium over TWO POUNDS of calcium more for taller peoplemore for taller people

We need calcium to develop teeth We need calcium to develop teeth and bones, and also to regulate and bones, and also to regulate heart and muscle, and clot bloodheart and muscle, and clot blood


When we are young When we are young we store and build bone we store and build bone effectively.effectively.

Most bone – 85 to 90 percent – Most bone – 85 to 90 percent – is made before age 20.is made before age 20.

As we get older – age 35 to 45 – bones begin to As we get older – age 35 to 45 – bones begin to break down faster than they are formedbreak down faster than they are formed. .


Bones and AgeBones and Age

How Much Calcium Do We Need? How Much Calcium Do We Need? What the Experts SayWhat the Experts Say

So What does So What does mg. stand for ?mg. stand for ?

Milligram = One thousandth of a gramMilligram = One thousandth of a gramOunce = 28 gramsOunce = 28 grams

Are We Measuring Up?Are We Measuring Up?

Who’s getting adequate calciumWho’s getting adequate calcium 13.5% of girls ages 12-1913.5% of girls ages 12-19 36.3% of boys ages 12-1936.3% of boys ages 12-19 About 50% of adult womenAbout 50% of adult women

Woman B Woman B had less bonehad less bonemass starting out and somass starting out and sosuffered ill effects fromsuffered ill effects frombone loss later on.bone loss later on.

Age 20Age 20

Danger zoneDanger zone

Age 40Age 40

Bon

e m

ass

Bon

e m

ass

Woman AWoman A entered adulthoodentered adulthoodwith enough calcium in herwith enough calcium in herbones to last a lifetime.bones to last a lifetime.

Age 60Age 60

OsteoporosisOsteoporosis

Life Cycle of BonesLife Cycle of Bones

Building Bones Building Bones

Ages 9 to 18 years are a key period in life for Ages 9 to 18 years are a key period in life for growth growth

In these years, you’ll grow faster than any other In these years, you’ll grow faster than any other time other than infancy. time other than infancy.

Ages 12 to 18Ages 12 to 18 About 85% of our adult bone mass is made About 85% of our adult bone mass is made Up to 80%of our adult weight is achieved Up to 80%of our adult weight is achieved

What if the materials needed for this growth are What if the materials needed for this growth are not available, what happens…an opportunity not available, what happens…an opportunity lost??lost??

Osteopenia & OsteoporosisOsteopenia & Osteoporosis

Osteopenia:Osteopenia:“Ricketts” “Ricketts” bones bend due to weaknessbones bend due to weakness

Common in the early 1900s Common in the early 1900s poor nutrition poor nutrition


Osteoporosis:Osteoporosis:“Little Old Lady Disease” “Little Old Lady Disease” bones break due to bones break due to weaknessweakness

Common NOWCommon NOW


One in 2 women and one in 8 men over age 50 One in 2 women and one in 8 men over age 50 will have an osteoporosis-related fracturewill have an osteoporosis-related fracture

The estimated cost is $38 million a dayThe estimated cost is $38 million a day

I’m Just A Teenager –I’m Just A Teenager –Why Should I Care Now ?Why Should I Care Now ? During the teen years, most of the adult skeleton is During the teen years, most of the adult skeleton is

formed formed Fewer than 15 percent of teenage girls get enough Fewer than 15 percent of teenage girls get enough

calcium! calcium! If you build your bones when you're in your teens, If you build your bones when you're in your teens,

you will be less likely to fracture your bones when you will be less likely to fracture your bones when you're older.you're older.

AND…very thin girls, especially girls on diets, can AND…very thin girls, especially girls on diets, can get a type of osteoporosis while they are still get a type of osteoporosis while they are still YOUNGYOUNG

I’m Just A Teenager –I’m Just A Teenager –Why Should I Care Now ?Why Should I Care Now ? Certain people are more likely to develop osteoporosisCertain people are more likely to develop osteoporosis

Don’t exerciseDon’t exercise Thin and/or small frameThin and/or small frame CaucasianCaucasian AsianAsian Family history – your grandma, aunt, grandfather?Family history – your grandma, aunt, grandfather?

Women are 4 times more likely to develop osteoporosis Women are 4 times more likely to develop osteoporosis than menthan men

What puts you at risk NOW? What puts you at risk NOW? Being underweightBeing underweight Not getting enough calciumNot getting enough calcium

or exerciseor exercise

Three of the following foods provide Three of the following foods provide about 300 mg calciumabout 300 mg calcium

½ cup cottage cheese½ cup cottage cheese ½ cup cream soup½ cup cream soup ½ cup ice milk, frozen yogurt, or ice cream½ cup ice milk, frozen yogurt, or ice cream 2 oz. (1/2 can) canned fish with bones (salmon, mackerel)2 oz. (1/2 can) canned fish with bones (salmon, mackerel) ¼ cup almonds¼ cup almonds ½ cup bok choy, collard greens, or turnip greens½ cup bok choy, collard greens, or turnip greens 1 cup broccoli, kale, or mustard greens1 cup broccoli, kale, or mustard greens 5 figs5 figs 2 Tbsp. cream cheese2 Tbsp. cream cheese

How many servings of these foods do you eat per day?How many servings of these foods do you eat per day?

Calcium In Your DietCalcium In Your Diet

Just one of the following foods provides Just one of the following foods provides about 300mg calciumabout 300mg calcium

8 oz. glass of milk, or calcium fortified soy milk8 oz. glass of milk, or calcium fortified soy milk 8 oz. glass of calcium fortified orange juice8 oz. glass of calcium fortified orange juice 6-8 oz. carton of yogurt6-8 oz. carton of yogurt 1 ½ oz. of cheese1 ½ oz. of cheese 1 cup pudding, custard, or flan1 cup pudding, custard, or flan 1 Power Bar (or other sports bar)1 Power Bar (or other sports bar) 1 cup Total1 cup Total cerealcereal ( (or other breakfast cereal)or other breakfast cereal)

How many servings of these foods do you eat per day?How many servings of these foods do you eat per day?

Calcium In Your DietCalcium In Your Diet

FOODFOOD1 English muffin1 English muffin1 cup Total cereal1 cup Total cereal5 dried figs5 dried figs1/2 cup orange slices1/2 cup orange slices1 oz almonds1 oz almonds1 cup fortified soy milk1 cup fortified soy milk1 cup navy beans1 cup navy beans1/2 cup bok choy1/2 cup bok choy1/2 cup broccoli1/2 cup broccoli½ cup mustard greens½ cup mustard greens3 oz canned salmon, bones 3 oz canned salmon, bones 1 ½ oz milk chocolate1 ½ oz milk chocolate

CALCIUM CONTENTCALCIUM CONTENT100 mg100 mg345 mg345 mg135 mg135 mg 70 mg70 mg 80 mg80 mg350 mg350 mg135 mg135 mg 80 mg80 mg 45 mg45 mg105 mg105 mg180 mg180 mg

80 mg80 mg

Calcium That Is Non-DairyCalcium That Is Non-Dairy

What About Calcium Pills?What About Calcium Pills?

Calcium supplements are Calcium supplements are great if dairy products don’t great if dairy products don’t work for you, or work for you, or

If you don’t eat a lot of other If you don’t eat a lot of other calcium-containing foodscalcium-containing foods

Supplements come in a variety Supplements come in a variety of types and flavors, including of types and flavors, including chocolate. chocolate.

They can be pills, fizzies, They can be pills, fizzies, chewies, or shakeschewies, or shakes

What About Calcium Pills?What About Calcium Pills?

One supplement can give up to One supplement can give up to 500 mg of calcium500 mg of calcium

Supplements may be the Supplements may be the answer if you are:answer if you are: Allergic to milk Allergic to milk Lactose intolerantLactose intolerant A picky eaterA picky eater On a calorie restricted dietOn a calorie restricted diet

Difference Between Milk Allergy Difference Between Milk Allergy and Lactose Intolerance?and Lactose Intolerance? Milk Allergy:Milk Allergy:

Mostly smaller childrenMostly smaller children Cannot eat the Cannot eat the PROTEINPROTEIN in milk products in milk products Cannot have ANY milk products because the Cannot have ANY milk products because the immune immune

systemsystem rejects them rejects them Lactose Intolerance:Lactose Intolerance:

Cannot digest the Cannot digest the SUGARSUGAR in milk products (lactose) in milk products (lactose) Usually OK to have some dairy products, especially Usually OK to have some dairy products, especially

cultured products like yogurtcultured products like yogurt

About Calcium SupplementsAbout Calcium Supplements Two main forms Two main forms

Calcium carbonate Calcium carbonate GoodGood Calcium citrate Calcium citrate BestBest

Can be taken on an empty Can be taken on an empty stomach and is more easily stomach and is more easily absorbedabsorbed

Calcium gluconate Calcium gluconate Not GoodNot Good Poorly absorbedPoorly absorbed

Read product labels carefully, Read product labels carefully, and remember that all and remember that all supplements are not the samesupplements are not the same

About Calcium SupplementsAbout Calcium Supplements

Avoid taking more than 500 Avoid taking more than 500 mg of calcium at one timemg of calcium at one time

Avoid taking calcium at the Avoid taking calcium at the same time as multivitamin-same time as multivitamin-mineral mineral interferes with interferes with iron useiron use

Avoid supplements with Avoid supplements with bone meal, oyster shell or bone meal, oyster shell or dolomite. Theydolomite. They may contain may contain lead, mercury or other toxic lead, mercury or other toxic metals.metals.

Calcium has NO CALORIESCalcium has NO CALORIES Calcium does not cause weight gain Calcium does not cause weight gain Consuming 1,000 mg of calcium may actually aid in Consuming 1,000 mg of calcium may actually aid in

maintaining or losing weightmaintaining or losing weight

Calcium and Body WeightCalcium and Body Weight

Vitamin D allows your body to Vitamin D allows your body to absorb calciumabsorb calcium

Where do we get Vitamin D?Where do we get Vitamin D? The SunThe Sun Egg yolks, saltwater fish, and liver Egg yolks, saltwater fish, and liver Fortified dairy productsFortified dairy products SupplementsSupplements

Need 400 International Units (IU) Need 400 International Units (IU) a daya day

Calcium Goes with Vitamin DCalcium Goes with Vitamin D

UV rays from the sun reach the skin UV rays from the sun reach the skin and vitamin D is made in the skin and vitamin D is made in the skin then sent to the blood circulationthen sent to the blood circulation

In Florida, 15-to-20 minutes of sun In Florida, 15-to-20 minutes of sun on the arms and face each day on the arms and face each day should do itshould do it

Sunscreens above SPF8 will block Sunscreens above SPF8 will block vitamin D formation on the skinvitamin D formation on the skin But don’t ignore sunscreens. Why?But don’t ignore sunscreens. Why?

Calcium Goes with Vitamin DCalcium Goes with Vitamin D

It’s not just calciumIt’s not just calcium It’s not just vitamin DIt’s not just vitamin D Bones also need weight and movement Bones also need weight and movement

exerciseexercise Physical activity increases bone mass by an Physical activity increases bone mass by an

average 3%average 3%

Exercise is Also Important for Exercise is Also Important for Building BonesBuilding Bones

Both weight bearing and resistance exercise Both weight bearing and resistance exercise are importantare important Resistance training strengthens existing bones Resistance training strengthens existing bones

you’ve already madeyou’ve already made Weight bearing exercise is best to stimulate Weight bearing exercise is best to stimulate

NEW bone productionNEW bone productionWalkingWalking Basketball/VolleyballBasketball/VolleyballRunningRunning GymnasticsGymnasticsTennisTennis CheerleadingCheerleadingWhat else?What else?

Exercise is Also Important for Exercise is Also Important for Building BonesBuilding Bones

You should not use tobacco to keep your bones You should not use tobacco to keep your bones healthy healthy Smoking interferes with the body’s use of calciumSmoking interferes with the body’s use of calcium

You should limit caffeine-containing foods and You should limit caffeine-containing foods and beverages, such as colas and coffeebeverages, such as colas and coffee Drink three cups of coffee or two cans of soda, per day Drink three cups of coffee or two cans of soda, per day

at mostat most Caffeine causes the body to leech out calciumCaffeine causes the body to leech out calcium

What Else is Important What Else is Important for Bones ?for Bones ?

Building strong bones before age 18 is Building strong bones before age 18 is the best defense for bones…for a the best defense for bones…for a lifetimelifetime

Choose:Choose: A balanced diet rich in calcium and A balanced diet rich in calcium and

Vitamin DVitamin D A healthy lifestyle with no tobaccoA healthy lifestyle with no tobacco Engage in weight-bearing exerciseEngage in weight-bearing exercise

Summing It UpSumming It Up

Build Your Bones,Build Your Bones,Girlfriend!Girlfriend!

You’ll never regret it!You’ll never regret it!

THANKS!THANKS!

Calcium

Calcium Sources Calcium in Milk Products

Drink milk. Eat yogurt and cheese. Add dry milk during food preparation.

Calcium

Calcium Sources Calcium in Other Foods

Tofu, corn tortillas, some nuts and seeds Mustard and turnip greens, broccoli, bok choy, kale, parsley,

watercress, and seaweed (nori) Legumes Oysters and small fish consumed with bones Mineral waters, calcium-fortified orange juice, fruit and

vegetable juices, high-calcium milk Calcium-fortified cereals and breads

The unbound ionic form of calcium– Ca2+ functions in nerve impulse transmission muscle contraction transmission of signals across membranes concentrations of intracellular and extracellular

Ca2+ tightly regulated

Dietary requirements for calcium Adults: 400 mg/day Pregnancy & lactation: 1000 mg/day Infants: 500 mg/day Children: 400 mg/day RDA: 1000 mg Many women consume far less than the RDA or the

recommended 1500 MG You need less calcium with a low protein diet.

Calcium - RDICalcium - RDI Adults Adults 1000 mg/ day1000 mg/ day

Pregnant womenPregnant women 1000 mg/ day1000 mg/ day

Lactat ing womenLactat ing women 1000 mg/ day1000 mg/ day

Post-menopausal womenPost-menopausal women 1300 mg/ day1300 mg/ day

Calcium

Calcium Recommendations and Sources Calcium Recommendations (1997 Adequate Intake)

AI Adolescents: 1300 mg/day AI Adults: 1000 mg/day if 19-50 years of age AI Adults: 1200 mg/day if greater than 50 years of age Upper level for adults: 2500 mg/day Peak bone mass is the bone’s fullest potential in size and density

developed in the first three decades of life.

Absorption

20-30% of dietary calcium is absorbed. Absorption rate for adults is 25% of calcium consumed. Calcium-binding protein is needed for calcium absorption.

Absorption is promoted and enhanced by Vit D and is better in acidic environment

Absorbtion is decreased by phytates, oxalates & fatty acids. Transported to all cells and to the blood Regulated by PTH, vitamin D, and thyroid-derived calcitonin. Mineralization and demineralization of bone involves activation of

osteoblasts and osteoclasts

CalciumCalcium

Factors that enhance absorptionFactors that enhance absorption Stomach acidStomach acid Vitamin DVitamin D LactoseLactose Growth hormonesGrowth hormones

Factors that inhibit absorptionFactors that inhibit absorption Lack of stomach acidLack of stomach acid Vitamin D deficiencyVitamin D deficiency High phosphorus intakeHigh phosphorus intake High-fiber dietHigh-fiber diet PhytatesPhytates in seeds, nuts, and grains in seeds, nuts, and grains OxalatesOxalates in beet greens, rhubarb, in beet greens, rhubarb,

and spinachand spinach

Calcium balance in bone

Calcitonin Vitamin D

• Calcitonin:

• ↑’se in extracellular calcium → secretion of calcitonin by cells among follicular cells of thyroid gland

Calcitonin → ↓’se plasma calcium levels by ↓’sing resorption of bone + ↑’sing loss of calcium and phosphate ions in urine

Physiological functions of calcium a. Essential in the formation of the bones and teeth (99% of

body calcium is in the bones) b. Essential for normal nerve and muscle function. Normal

neuromuscular irritability - transmission of nerve impulses, release of neurotransmitter and muscle contraction all require Ca.

c. Essential for blood clotting. d. Maintenance of the integrity of intracellular structures

and various membrane functions, including transport. e. Activation of certain enzymes including pancreatic lipase

and plasma lipoprotein lipase.

Calcium

Calcium Roles in the Body Calcium in Body Fluids

Calmodulin is an inactive protein that becomes active when bound to calcium and serves as an interpreter for hormone and nerve-mediated messages.

Ionized calcium has many functions.

Calcium

Calcium Roles in the Body Calcium and Disease Prevention

May protect against hypertension DASH diet that is rich in calcium, magnesium, and potassium May be protective relationship with blood cholesterol, diabetes, and

colon cancer Calcium and Obesity

Maintaining healthy body weight Calcium from dairy foods has better results than calcium from

supplements. More research is needed.

Calcium

Calcium Roles in the Body Calcium Balance

Works with vitamin D Works with parathyroid hormone and calcitonin Calcium rigor develops when there are high blood calcium levels and

causes the muscles to contract. Calcium tetany develops when there are low blood calcium levels and

causes uncontrolled muscle contractions. Abnormalities are due to problems with hormone secretion or lack of

vitamin D. Bones get robbed of calcium before blood concentrations get low.

Cortical bone is dense, ivory-like

bone that forms the exterior shell.

Trabecular bone is the lacy network of calcium-containing

crystals that fills the interior.

Signs and symptoms of Calcium deficiency Decrease in free calcium level leads to- Increased neuromuscular irritability Severe hypocalcemia can lead to tetany Paraesthesias, (pins and needles, tingling sensation), Bone fractures, bone pain, and loss of height

may also be the result of a vitamin D deficiency (osteomalacia). Prolonged bed rest or immobilization can cause osteoporosis.

Osteomalacia (as with vitamin D deficiency) muscle cramps/contractions carpal spasm, pedal spasm, anxiety, Convulsions or seizures, bronchospasm, laryngospasm, trousseu’s sign & lengthening of QT interval.

Excess calcium causes Anorexia Nausea Vomitting Constipation Hypotonia depression

Calcium

Calcium Deficiency Osteoporosis is the disease where the bones become porous and

fragile due to mineral losses. No obvious symptoms of mineral loss in bones appear. It is silent. Deficiency in children can present as stunted growth. Toxicity symptoms include constipation, increased risk of urinary

stone formation, kidney dysfunction, and interference with the absorption of other minerals.

CalciumCalcium

At risk:At risk:

post-menopausal post-menopausal womenwomen

female athletesfemale athletes

pregnant womenpregnant women

childrenchildren

strict vegetarians st rict vegetarians (vegans)(vegans)

fad dietersfad dieters

others who avoid dairy others who avoid dairy foods foods (eg. Lactose intolerant)(eg. Lactose intolerant)

Osteoporosis—Thinning of Bones Dietary factors that build bone

mass: Calcium Vitamin D Vitamin K Other possible dietary factors:

vitamin C, magnesium, potassium, manganese, zinc, copper, boron

Weight-bearing exercise and strength training also build and maintain bone mass

Dietary factors linked to loss of bone mass: Alcohol Sodium Caffeine Retinol Soda Protein (if intake of calcium

and vitamin D is low)

Osteoporosis: Progressive loss of bone mass in both sexes but more in postmenopausal women Characterized by frequent bone fractures; this is a major cause of disability in

elderly 1.3 million of the 2 million fractures yearly in the U.S. directly due to

osteoporosis Estrogen replacement most effective preventive measure but calcium and

vitamin D supplements → decreases risk of fracture due to osteoporosis and reduces bone loss

Recommended that average intake of 500 mg/day be supplemented with 1000 mg/day → 1500 mg/day

Calcium can be obtained from milk and milk products, calcium supplements – calcium carbonate, glucuronate or lactate also sardines with the bones

Calcium and Osteoporosis

Bone losses over time compared

©2001 Brooks/Cole, a division of Thomson Learning, Inc. Thomson Learning™ is a trademark used herein under license.

Loss of height in a woman caused by

Osteoporosis.