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Avoiding osteoporosis

The staggering statistics

Twenty five million Americans have osteoporosis; four out of five are women. The current yearly tab Americans spend on osteoporosis treatment is $10 to $12 million. Fifteen percent of white women over 50 will fracture a hip or wrist this year alone. Twenty percent of those women over 75 will die from complications of the fracture.

Men get osteoporosis less often. Generally their bones are stronger and men do not live as long as women, to contract the disease. They also do not experience the dramatic change in hormone levels that women do at menopause.

It is preventable

Major factors in the prevention of osteoporosis include:

  • Adequate diet to include foods high in calcium
  • Weight - bearing exercise
  • Judicious use of hormones in postmenopausal women

What actually makes bones strong?

Bone is continually being destroyed and rebuilt to adapt to mechanical strain. Thanks to the remodeling process about one-fifth of your skeleton is replaced every year. During the first few decades of life each building makes the bones denser. Somewhere between the ages of 25 and 35, the building process peaks. As we age, women's bodies build bone at a much slower rate.
With menopause women's bodies begin to dissolve old bone at an alarming rate. This hits the spine and the hips hardest.

Some people are prone to osteoporosis

The osteoporosis gene is present in people who have a different Vitamin D receptor on their cells. The receptors determine whether the body absorbs enough calcium, through the remodeling process. Over a period of time the classic honeycomb pattern of healthy bone gives way to a series of weakened fragments.

A high-risk profile for this situation includes:

  • being fair skinned
  • having a small bone structure
  • lack of weight - bearing exercise
  • limited exposure to sunlight
  • poor calcium intake
  • smoking
  • family history of osteoporosis

Protection from the osteoporosis gene may be genetically inherited. African-Americans have denser bones than Caucasians.

Nutritional factors

Beyond actual calcium intake, other possible factors that promote osteoporosis include high levels of protein, sodium and caffeine. In effect higher levels of these may lead to increased calcium excretion and therefore lower absorption of calcium.

Caffeine and protein have a greater impact when calcium intake is marginal. If you consume less than 800 milligrams of calcium daily, two or more cups of coffee may tip the calcium balance to a negative state; in other words you would be losing more than you are taking in.

The Recommended Dietary Allowance (RDA) for protein is 50 grams for women and 65 grams for men. Each gram of protein increases calcium excretion by 1-1.5 mg. If a woman consumed 65 grams of protein a day, which is typical, this would result in an extra 15 to 23 mg. of calcium lost each day.

Diets high in sodium will have a negative effect on the body's absorption of calcium. About 10 mg. of calcium is lost for every 500 milligrams of sodium you take in. The typical American diet includes about 4,000 mg. of sodium. This would result in about 40 mg. of calcium lost daily.

Estrogen and osteoporosis

For postmenopausal women, estrogen supplementation prevents bone loss and prompts the body to lay down calcium in the bone. Women generally still need additional calcium when taking estrogen supplements. Estrogen alone can not help get calcium into the bone if you do not take enough calcium in.

How much and when

The greatest impact we have on bone density is between the ages of 4 and 20. Bones gain mass only during the first three decades of life. By the age of 18 we have reached 95 percent of their maximum density. Once you hit the peak bone mass at age 25 to 35, that's all you will ever have. Studies on twins showed that by increasing daily calcium intake by 450 milligrams, bone mass was raised by 5 percent over three years.

Recommended Dietary Allowance (RDA)
Ages Recommended Daily Calcium Intake
Adults 19 - 50 1,000 mg.
Adults 51 and older 1,200 mg.

Middle age and menopause

Getting a bone mass study done may be the best indicator of your need for additional calcium. Medicare now authorizes these tests. One of the tests recommended is called the Dual-Energy X-ray Absorptiometry. Ask your physician about scheduling a test for you. Additional calcium intake will always be beneficial. Calcium needs increase significantly as we age. Sharp decline in calcium absorption occurs after the age of 60.

After menopause, bone losses incurred are from 1 to 6 percent each year. Replacement with estrogen or estrogen and progesterone is the single most important thing a woman can do to help prevent osteoporosis.

The role of exercise

Bones stay stronger with regular exercise. Bone loss is prevented best with exercises you do on your feet. Some studies show that exercises resulting in intermittent impact to your bones, such as tennis, may place the best form of stress to the bone to help reduce your chances of osteoporosis. The impact to the bone due to walking or jogging makes them great bone saving exercises as well. In addition, resistance exercises such as weight lifting and strength training will help stay bone deterioration. Whatever exercise you chose, you should do it regularly, ideally for 20 to 60 minutes, three to five times each week.

Workouts for osteoporosis

A key step to preventing osteoporosis is regular, weight-bearing exercise to build bone density. Walking and aerobics are excellent weight-bearing exercises. Personal trainers at the Baptist East/Milestone Wellness Center can help a program for women at risk for osteoporosis or who have already been diagnosed. Options include walking, aerobics classes (both land and water) and resistive exercise in either of the Wellness Center's two exercise rooms equipped with the latest Cybex, Nautilus and Keiser equipment.

Use of the facility for osteoporosis-related exercise is limited to members only. Call (502) 896-3900 for a tour.

The role of weight

A significant risk factor for osteoporosis is to be small-boned and thin. Studies show that most osteoporotic patients frequently have a low intake of all nutrients, not only calcium. Vitamin supplementation and weight gain have been positively associated with strong bone supplementation.

The bone bank diet

Calcium rich sources come primarily from the dairy foods. Other sources include greens, beans, nuts, molasses and soy products, just to name a few. To get the required amount of calcium, you would need to include three to four milk products in your daily diet. Including milk in this quantity is difficult for many of us. A better way to approach the issue may be to consider fortifying your diet with calcium rich-sources as snacks, with meals and as a substitute for other foods. For example, use yogurt in place of sour cream. Add nonfat dry milk to soup and use molasses instead of jelly on toast. It all adds up.

Added benefits of a calcium rich diet

We have established that calcium is a mineral that helps builds strong bones. But did you know that calcium also

  • Helps your muscles contract and relax
  • Helps your heart beat
  • Helps your blood clot
  • Helps your nerves send messages

When you don't supply your body with enough calcium to perform these important functions, your body takes the calcium it needs from your bones.

High Calcium Granola    

3 cups old-fashioned oatmeal
1 1/2 cups All Bran cereal
2 cups whole grain cereal flakes
1/2 cup molasses, brown sugar or honey
1 cup nonfat dry milk
1/2 cup sunflower seeds
1/2 cup oatbran
1/2 cup wheat germ
1/2 cup chopped or slivered almonds
1 tbsp. cinnamon
6 tbsp. vegetable oil
1 cup raisins

Combine all ingredients except oil in 9 x 13 inch baking pan. Stir together until well blended. Drizzle oil over dry mixture. Using fingers, blend in oil until mixture is coated.

Bake at 250 degrees for 30 minutes. Turn off oven. Add raisins, stirring entire mixture to blend. Leave pan in oven for 1 hour or until cool. Store in plastic bag, jar or can. Granola freezes well.

The beauty of this recipe is that you can leave out one or two of the ingredients or add your own and it will still taste great.

Makes 20 (about 1/2 cup) servings.

Calories: 200
Calcium: 118 mg.

  Peach Yogurt Smoothie  

1 peach, peeled and chopped
1 cup plain non-fat yogurt
2 tsp. honey
4 ice cubes
1/8 tsp. cinnamon or nutmeg

Puree all ingredients in blender until smooth. Serve immediately.

Options: Any fruit can be substituted or added with peaches. Try frozen berries or a banana for an interesting combination.

Add an additional tablespoon of nonfat dry milk for calcium fortification.

Serves: 2
Calories: 108
Fat: 0 grams
Calcium: 493 mg.

    Orange Yogurt Nog

2 (8 oz.) cartons fat free vanilla or plain yogurt
1 ½ cups skim milk
¾ cup orange juice concentrate (calcium-fortified if available), thawed

Combine all ingredients in blender. Blend until smooth.

Serves: 4 (about 9-ounce servings)
Calories: 200
Fat: Less than 1 gram
Calcium: 355 mg.

  Banana Berry Blend  

1 cup plain nonfat yogurt
½ cup orange juice (fortified with calcium if available)
1 ripe banana, sliced
2 tbsp. honey
1 tbsp. wheat germ (optional)

Combine all ingredients in blender. Blend until smooth.

Serves: 2 (8-ounce servings)
Calories: 212
Fat: Less than 1 gram
Calcium: 255 mg.

Lowfat Pimento Cheese Spread    

1 (12 oz.) package fat free shredded cheddar cheese
1 (3 oz.) package Velveeta low fat cheese, shredded
1 (8 oz.) jar chopped pimentos
1 cup fat-free mayonnaise or salad dressing

Combine all ingredients in resealable plastic container. Chill. Serve on crackers or as a sandwich.

Serves: 8-10
Calories: 85
Fat: Less than 1 gram
Calcium: 545 mg.

  Ricotta Cheese Spread  

1 (12 oz.) package fat free ricotta cheese
4 tbsp. non-fat dry milk
2 tbsp. honey
1 tsp. vanilla

Combine all ingredients together. Serve chilled. Store in resealable plastic container. This spread is great on bagels or toast.

Serves: 8-10
Calories: 67
Fat: 0 grams
Calcium: 114 mg.

    Spiced Cheese

1 cup fat-free cottage cheese or ricotta cheese
3 tbsp. plain fat free yogurt
1 tbsp. chives or scallions
1/4 tsp. thyme
Freshly ground pepper

Place all ingredients in blender. Blend until smooth. Serve chilled with crackers Store in resealable plastic container.

Serves: 8 (2 tablespoons per serving)
Calories: 12
Fat: 0 gram
Calcium: 13 mg.

  Cucumber and Yogurt Dip  

1 cucumber
1 (8 oz.) container plain, lowfat yogurt
1/4 tsp. garlic powder or minced garlic
Dash Worcestershire sauce

Scrub cucumber to remove wax. Grate cucumber and drain on paper towel until almost dry. Combine other ingredients. Serve with crackers

Serves: 8 (2 tablespoons per serving)
Calories: 5
Fat: 0 gram
Calcium: 12 mg.

Con Queso Delgado    

1 lb. Velveeta Light processed cheese
1 (14 1/2 oz.) can chopped tomatoes, drained
¼ cup commercially prepared salsa
1 tsp. chili powder
¼ tsp. cayenne pepper
¼ tsp. cumin
2 tbsp. fresh cilantro (optional)
Baked tortilla chips

Combine cheese, tomatoes, salsa and spices in 1 qt. microwave-safe bowl. Cover with vented plastic wrap. Microwave on high 4 minutes or until cheese melts, stirring every 60 seconds. Stir in cilantro, if desired. Serve with chips

Serves: 10
Calories: 95
Fat: 1.5 gram
Calcium: 243 mg.

  Honey of a Chicken Salad  

4 cups baked chicken, chopped into bite size pieces
1 1/3 cup seedless green grapes or cubed papaya
1/3 cup pecans, chopped
1/3 cup fat-free mayonnaise
1/3 cup fat-free yogurt, plain or vanilla
2 tbsp. honey
1 tbsp. poppy seeds
¼ tsp. white pepper
1 tbsp. lime juice or balsamic vinegar

Combine all ingredients except chicken in resealable plastic container. Stir to blend well. Fold in chicken pieces, stirring to coat with dressing. Serve on crackers or as a filling for stuffed tomatoes or as a sandwich.

Serves: 8
Calories: 155
Fat: 5 grams
Calcium: 32 mg.

TIP: Use a combination of yogurt and salad dressing as a basis for potato salads, pasta salads, and meat salads to add calcium to those dishes.


1 cup dark molasses
1/2 cup brown sugar
1/4 cup vegetable oil
1/4 cup applesauce
1/2 tsp. cinnamon
1/2 tsp. nutmeg
1/2 tsp. ground cloves
1 tsp. ginger
1 cup boiling water
2 1/4 cups all-purpose flour
1/2 cup nonfat dry milk
1 tsp. baking soda

Combine first seven ingredients in medium mixing bowl. Stir in boiling water. Mix in flour and nonfat dry milk. Dissolve baking soda in 2 tablespoons hot water; add to batter. Pour into greased 9x9 inch baking pan. Bake at 350 degrees for 25 minutes.

Serves: 12
Calories: 230
Fat: 5 grams
Calcium: 177 mg.

  Super Quick Lemon Sauce  

1. Top gingerbread with fat-free lemon yogurt and a dollop of fat free whipped topping.

2. Prepare l package of fat-free vanilla or lemon pudding, adding 2 tablespoons extra liquid. (Use lemon juice with vanilla pudding or milk with lemon pudding.) Spoon over gingerbread.