|By Diane Conrad, MD
Midwest Community Health Associates
Osteoporosis is a bone disease of which leads to an increased risk of fracture.
Osteoporosis is a major public health threat for an estimated 44 million Americans, or 55 percent of the people 50 years of age and older, according to the National Osteoporosis Foundation. In the U.S., 10 million individuals are estimated to already have the disease and almost 34 million more are estimated to have low bone mass, placing them at increased risk for osteoporosis.
Of the 10 million Americans estimated to have osteoporosis, eight million are women and two million are men. While osteoporosis is often thought of as an older person's disease, it can strike at any age.
One in two women and one in four men over age 50 will have an osteoporosis-related fracture in her/his remaining lifetime. The disease is responsible for more than 1.5 million fractures annually.
One of the simplest methods for prevention of osteoporosis is to take calcium.
All postmenopausal women, and men over 65 years old, should take in 1000-1300 mg. of calcium daily, from food sources when possible. (Eight ounces of skim milk and 6 ounces of low-fat yogurt each contain about 300 mg, and the overall non-dairy diet contains 250-300 mg.)
It is best to get your calcium in your regular diet but if you don’t, add a supplement. Subtract from 1200 mg the amount of calcium you have as average in your diet and this is the amount you should take as a supplement daily. You should not take in more than 600 mg. of “elemental” calcium” (“elemental” refers to dietary calcium, as opposed to calcium metal) in a single sitting because that is about the most the body can handle at a given time. Amounts larger will not be utilized and will be “wasted”.v
Both calcium carbonate and calcium citrate are excellent forms of calcium supplements. Calcium carbonate needs to be taken with food to optimize absorption. Calcium citrate can be taken with or without food. If you take medication regularly to decrease stomach acidity, consider using calcium citrate, as its absorption is better.
Other examples of high calcium foods include orange juice with added calcium, which contains 300 mg of calcium in 8 ounces; and broccoli, which contains 90 mg in an 8-ounce serving.
Vitamin D is also critical to the prevention of osteoporosis. Mild vitamin D deficiency is very common in the United States. The best source of vitamin D is sunshine on the skin, which allows our bodies to make vitamin D. However, many people live in the wrong part of the country for year-round sunshine on the skin or use sunscreens to prevent skin cancer. Even with adequate sun exposure, some people cannot use the sunshine to make vitamin D because of changes as skin ages.
Experts now recommend daily intakes of vitamin D (as D3 or cholecalciferol) of 800-1200 units per day. Vitamin D2 (or ergocalciferol) is less potent than D3. Four hundred units of D2 (often found in multivitamins) is equal to only about 150 units of D3. You can buy vitamin D3 as a separate supplement and it is also added to many brands of calcium. Read the labels on your supplement bottles to find out how much vitamin D is available and whether it is D2 or D3. Milk is the best dietary source of vitamin D, containing 100 units per cup.
Good sources for additional information:
Diane Conrad, M.D. is a doctor of Family Medicine at MCHA, serving the Bryan office.
- Osteoporosis and Related Bone Diseases National Resource Center (ORBD- NRC), 1232 22nd Street, NW, Washington, DC 20037-1292; phone toll-free (800) 624-BONE (2663); e-mail email@example.com; website www.osteo.org
- National Osteoporosis Foundation, 1232 22nd Street NW, Washington, DC 20037-1292; phone (202) 223-2226; e-mail firstname.lastname@example.org; website www.nof.org
- Osteoporosis Society of Canada, 33 Laird Drive, Toronto, Ontario M4G 3S9; phone toll-free (800) 463-6842; website www.osteoporosis.ca/