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Healthy Bones for Life™

Welcome and Introductions


Our Mission
To enable and empower people throughout the country
to build and maintain strong bones to prevent
osteoporosis and fractures
to live a long, healthy and independent life.

AWARENESS ADVOCACY EDUCATION


Today’s Agenda

1 Why bone health matters


2 What is osteoporosis
3 How is osteoporosis diagnosed
4 How to prevent bone loss
5 How to prevent falls
6 Treatments to prevent fractures
Osteoporosis is a Serious Problem

70%
of people over 65 with osteoporosis have never
been screened and don’t know they have
osteoporosis
Compared to Other Health Issues
2,400,000
Annual occurrences
2,000,000
2,000,000
1,600,000

1,200,000

800,000
800,000
735,000
400,000

232,924
0
Breast Cancer Heart Attacks Strokes Fractures

Centers for Disease Control & Prevention 2016


Centers for Disease Control & Prevention, 2015
Centers for Disease Control & Prevention, 2015
National Osteoporosis Foundation, 2015
Osteoporosis is a Disease

When the skeleton loses


mineral density, the
structure becomes thin
and unable to take normal
weight, leaving bones that
break easily.
Bones Are Living Tissue

Bone remodeling
means you have
the opportunity
Osteoblasts Osteoclasts to have
new bones
every
7-10 years!

Osteoblasts- build new bone


Osteoclasts- remove old or damaged bone
How the Skeleton Changes

Peak Bone Mass

Menopause

Rapid Bone
Building
Risk Factors
Risk Factorsfor Osteoporosis
for Osteoporosis

Things you can’t change


1 Gender
2 Heredity
3 Age
4 Fracture history
5 Medical conditions
6 Medications
Risk Factors
Risk Factors for Osteoporosis
for Osteoporosis

Things you can change


1 Calcium consumption
2 Vitamin D intake
3 Quit smoking or vaping
4 Alcohol consumption
5 Physical activity
6 Posture
7 Low body weight (BMI <20)
83 Some medications
Risk Factors forThat
Conditions Osteoporosis
Cause Bone Loss

Alcoholism Disordered eating


Cancers Hyperthyroidism
Celiac Disease Hypogonadism
Crohn’s Disease Liver Disease
Cushing’s Disease Malabsorption
Diabetes Type II Rheumatoid Arthritis
Risk Factors for Osteoporosis
Medications That Cause Bone Loss

Anticoagulants (Heparin) Methotrexate

Anticonvulsants (Dilantin) PPIs (Nexium, Prilosec, Zantac)

Aromatase inhibitors SSRIs (Prozac, Zoloft, Paxil)

Androgen deprivation Oral steroids (Prednizone)


therapy
Chemotherapy drugs Tamoxifen (premenopausal use)

Cyclosporine Thyroxine - high doses


(Synthroid)
Lithium
Risk Factors
How for Osteoporosis
You Might Know Your Risk

Low Impact Fracture


More than 1½” Height Loss
FORE Fracture Risk
Calculator™

The calculator gives an


estimate of your risk of
breaking a bone.
Risk Factors
How for Osteoporosis
You Know For Sure

Get a Bone Mineral Density Test


(also known as DXA)

Covered benefit for


Women age 65+
Men age 70+
Anyone younger with a risk factor

This simple and painless test takes about 15 minutes.


Risk Factors for Osteoporosis
Understanding Your DXA Results

< -2.5 T-score > -1.0 T-score

Even though you may have a low bone density,


you may not have an increased fracture risk.
Your peak bone density may never have reached the “normal” range.
Fractures Happen at all BMDs
Preventing Bone Loss

Calcium
Vitamin D
Physical activity
Fall Prevention
Risk Factors
Calcium isforthe
Osteoporosis
Principle Mineral of Bone
Vitamin D

Nerves and muscles need calcium to function;


if not available, the body will take calcium from bones

The current RDA is 1,000-1,200 milligrams per day

3-4 servings of a calcium rich food = 1,000 - 1,200 mg


Dietary Sources of Calcium

Food Item Calcium Range


Dairy Low Fat Yogurt, Milk, Cheese 150-400 mg
Proteins Tofu (with Calcium), 75 - 400 mg
Sardines (With Bones),
Garbanzo Beans, Almonds
Vegetables Collards, Bok Choy, Kale, 20-260 mg
Broccoli
Other Pizza, Lasagna, Mineral Water 120 - 450 mg
Foods (Gerolsteiner), Dried Figs
Risk Factors
How To Read for a Nutrition Label
Osteoporosis

Add a zero to the calcium %


to get milligrams per serving.

20% + 0 = 200 mg
If Risk
YouFactors
Need foraOsteoporosis
Supplement
If you don’t eat 2-3 servings of a calcium-rich food
every day, you may need a supplement.

Two types of calcium supplement


1 Calcium citrate 2 Calcium carbonate
i.e., Citracal i.e., Caltrate
Easier on stomach, Less expensive,
Take with or without food Take with food

Body can only absorb 500-600 mg at a time


Do not take more than 1,500 mg/day
Risk Factors
Vitamin D for
is Osteoporosis
Essential
Calcium needs vitamin D to get absorbed in the intestine
Sunshine alone is not a reliable source of vitamin D
RDA varies from 600- 2,000 International Units per day
Food Item Vitamin D Range
Fatty Fish Salmon, Sardines, 150-500 IU
Dairy Milk, Fortified with D 100-125 IU
Other Foods Fortified Cereals, Juices 50-75 IU
Protein Egg Yolk 44 IU
It’s very hard to get enough vitamin D through diet!
Supplements are not expensive.
Bones Like a Load

To build bone density, you must


do activities that “surprise” and
add weight to the bone.

Activities that strengthen muscles,


strengthens bone.
Loads Vary by Activity Levels of Load by Body Weight

4+ Jump, strength train

3 Run, jog

1-2 Brisk walk

Increasing effect on
Swim, cycle <0 bone density
Load Safely

The spine is most


VULNERABLE
when rounding forward.

AVOID compression
fractures.
ALWAYS bend at the hips
with a straight spine.
Support the Spine Bones

1 Practice great posture


2 Use great body mechanics
3 Expand chest muscles
4 Strengthen back muscles
5 Strengthen abs
(plank is great!)
Improve Posture

Strengthen back muscles

Standing “W” Exercise


1 Raise arms parallel to floor

2
Pull arms backwards,
pinch shoulder blades
3 Hold for 3 seconds. Breathe.
4 Repeat as often as you can!
Improve Leg Strength

Reduce falls and fractures

Modified Squat
1 Stand close to chair – feet hip
distance apart
2 Keep a straight back, hinge at hip

3 Squat back and hover over chair

4 Hold as long as you can, work up to 30 seconds


Balance to Prevent Falls
Risk Factors
Prevent for Osteoporosis
Falls to Prevent Fractures

1 Stop multi-tasking
2 Remove trip hazards
3 Get your eyes checked
4 Keep a night light on
5 Get your medications checked

2 million people land in the emergency room


from a fall. 500,000 falls result in hospital stays.
If you are at high risk
for fracture,
you may benefit from
treatment.
Determine your risk.
Discuss your options.
Decide what’s best.
Treatment Options

Bisphosphonates
Alendronate, Actonel, Atelvia, Boniva, Fosamax, Reclast, Zometa

SERM (Selective Estrogen Receptor Modulators)


Evista, Duavee

Denosumab
Prolia
Parathyroid Hormone
Forteo

Knowing your fracture risk can help you decide


if you will benefit from a treatment.
Risk Factors Things
Important for Osteoporosis
to Remember

1 Get calcium and vitamin D daily.


Food is best, supplement if
needed.
2 Do weight-bearing and balance
exercises everyday.

3 Know your risk for fractures, get


screened and diagnosed.
4 Know your T-scores and keep a
copy of all your bone density tests.
How YOU can help!

DONATE VOLUNTEER TEACH


Make a Let’s end Become a
difference in your osteoporosis, trained
community. together. presenter!

americanbonehealth.org
Bone Health Hotline 1-888-266-3015

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