Health and Wellness
Bone up on Bone Health By Dr. Asha Bajaj, Resident Since 1986
Osteoporosis means “Porous bones”. This is a silent disease that affects nearly 68% of American women with White Caucasian and small boned Asian (including Indian women) being most susceptible. One out of two women and 1 out of 4 men over 50 years of age will sustain a hip, spine or wrist fracture related to osteoporosis. Bone is a living tissue constantly broken down by resorption and replaced by new bone formation. However the peak density of bone is reached by 30 years of age. The rate of bone loss accelerates as women enter menopause with loss of estrogen and the reduction of testosterone in older men. Often the first symptom is back pain and the development of the typical hunchback from loss of height due to loss of bone density. The major consequence is fragility fractures that increase the rate of mortality from complications. There are 2 kinds of risk factors – modifiable and non-modifiable.
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Modifiable risk factors are: Diet; eating calcium rich foods and getting enough Vitamin D are important for good bone health. The recommended allowance for post –menopausal women is 1200-1500 mg for Calcium and 2000 iu for Vitamin D.The body can absorb only 500 mg of calcium at a time, so it is important to spread your intake through the day.
There are three ways to get vitamin D: • Sunlight • Food • Supplements and medications
Weight bearing exercise such as walking and weight lifting is important to build bone-so water exercise does not help you in this regard. Lifestyle factors such as smoking or excessive alcohol contribute to loss of bone. Non-modifiable factors are heredity, ethnicity, gender and age. Being female, 50+, Caucasian or Asian puts you at higher risk for osteoporosis. If there is a family history of fracture that puts you at a higher risk for sustaining a fracture. Increased age and small boned frame are also contributing factors to a higher risk for osteoporosis. It’s important to get a baseline bone density test done with a DXA or dual X-ray absorptptiometry. A bone density score of -2.5 puts you in the osteoporosis range, between -1 and -2.5 puts you in the range of osteopenia and a score of less than -1.0 puts you in the normal range. A new tool called the FRAX index gives you your risk of fracture over a 10 year period. Women • Under age 50 need a total of 1,000 milligrams (mg) of calcium* and 400-800 international units (IUs) of vitamin D every day.
Age 50 and older need a total of 1,200 mg of calcium* and 800-1,000 international units (IUs) of vitamin D every day.
Men • Under age 50 need a total of 1,000 milligrams (mg) of calcium* and 400-800 IUs of vitamin D every day. • Age 50-70 need a total of 1,000 mg of calcium* and 8001,000 IUs of vitamin D every day. • Age 71 and older need a total of 1,200 mg of calcium* and 800-1,000 IUs of vitamin D every day. *This includes the total amount of calcium you get from both food and supplements.
Your skin makes vitamin D from the ultra-violet light (UVB rays) in sunlight. Your body is able to store the vitamin and use it later. The amount of vitamin D your skin makes depends on time of day, season, latitude, skin pigmentation and other factors. Depending on where you live, vitamin D production may decrease or be completely absent during the winter. It is difficult to measure the amount of vitamin D that your skin makes so a daily supplement is a good bet. A multi- pronged approach that combines calcium rich diet with sufficient weight bearing exercise and a stress free and safe environment goes a long way in avoiding the complications of low bone density and fractures.
Dr. Asha Bajaj, PT/DPT has 30+years experience in a variety of settings including the management and operation of an outpatient private practice in Walnut Creek. Asha has served in Bhutan, India, Vietnam and Malawi, Africa with Health Volunteers Overseas to train and develop their Physical therapy program. Asha has a special interest in Women’s health and did her doctoral project in the area of Bone health and Osteoporosis. Her goal is to promote health and lifelong wellness. BLACKHAWK LIVING 27
