Can you give some info on bone health? Many of my friends have osteoporosis and can't tolerate Fosamax. I have osteopenia (the precursor to osteoporosis) and take Viactiv calcium supplements, which taste like real caramels! Are they ok to use instead of regular calcium pills? I know about milk and yogurt—what else has a lot of calcium? I've also heard vitamin D is important. I think that since we live in the north, we get less vitamin D from sunshine. Is there another way to get it, other than moving to Florida, which doesn't sound too bad right now! Do weight-bearing exercises help much?
Feeble BonesDear Feeble Bones:
More than half of Americans 50 years and older have osteoporosis, a condition of porous bones that become fragile and susceptible to fractures. There are ways to help or prevent this condition at any age:
Calcium. The Food and Nutrition Board recommends that both men and women 19-50 years old get 1000 mg of calcium daily, and 1200 mg over 50 years of age. You know about dairy products like milk, cheese, and yogurt, which are the richest sources of calcium, but you can also find the mineral in canned sardines or salmon (with the bones), green leafy vegetables including spinach, kale, and turnip greens, as well as a growing number of calcium-fortified products like orange juice and cereals. Some people still don't eat enough calcium and may need supplements. The two common forms are calcium carbonate and calcium citrate. Both are absorbed well, but people with low levels of stomach acid can absorb calcium citrate more easily. Calcium carbonate is less expensive and easier to find (it's found in TUMS and Viactiv chews). Whereas you should take calcium carbonate with food to improve its absorption, you can take calcium citrate on an empty stomach. With either type, taking too much at one time can lower absorption. So, for example, if you use two 500 mg pills a day, take one in the morning and one in the evening.
Vitamin D. This mineral has been making headlines lately, with early research suggesting a protective effect against certain cancers and diabetes. However, its role in bone health is definite, aiding the absorption of calcium and promoting bone growth. Many of us may not be getting enough, particularly if you live in northern climates where the sun is not as strong certain months of the year, and because most of us now regularly use sunscreen, which lowers vitamin D absorption through the skin. Another reason is that the best food sources are probably not on our daily menus: cod liver oil, salmon, mackerel, and fortified milk. Although the current recommendations for adults range from 200-400 IU daily, many experts now recommend closer to 800-1000 IU based on research findings. If you are over 50 years and have dark skin, you are at greater risk of not absorbing the vitamin effectively. It would be safe to use a supplement with at least 400 IU and eat some foods rich in vitamin D. You may want to ask your doctor to check your vitamin D levels with a blood test measuring 25-hydroxyvitamin D, which will show if you are deficient.
Exercise. When bones are challenged, they get stronger. This means using a controlled weight such as your body weight, hand weights, weight machines, or resistance exercises to strengthen your bones. Low and high impact exercises like jogging, dancing, walking, hiking, and stair climbing also help to build bones. Yoga and Pilates are excellent for improving balance, posture, flexibility, and muscle strength, which can help prevent falls and fractures. Swimming, bicycling, and stretching exercises that do not use your body weight are not good for building bone; they are best used in combination with strength-building exercises. For more information on starting a strength-building regimen visit the National Osteoporosis Foundation and Tufts University's Growing Stronger program.
Other Great Resources:
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