How You Can Maintain Good Bone Health

Excerpted from A Framework and Strategy for the Prevention and Management of Osteoporosis Report of the Strategic Action Working Group on Osteoporosis, Ontario Women's Health Council. November, 2000)

Healthy Diet

Bone, like all tissues, requires total nutrition for health. Adequate intake of protein, calcium, Vitamins C and D, phosphorus, magnesium, and minerals throughout life are essential to good bone health, and can be obtained from a healthy, balanced diet (Heaney 2000). Of particular importance to bone health are adequate intakes of calcium and Vitamin D throughout life. However, people may not be aware of their requirements for calcium and Vitamin D. The recommended daily intakes for healthy people have recently been updated as shown in the table below:

Age Group	Calcium	Vitamin D
9 - 18 years	1300 mg/day	200 IU (5ug/day)
19 - 50 years	1000 mg/ day	200 IU (5ug/day)
51 - 70 years	1200 mg/ day	400 IU (10ug/day)
70 + years	1200 mg / day	600 IU (15ug/day)

Young people can be at risk for calcium and Vitamin D deficiencies if their diets are not well balanced. In particular, a low intake of dairy products, a low level of fruit and vegetable consumption and a high intake of low calcium beverages like carbonated drinks are detrimental to the development of health bones.

Those with lactose intolerance who avoid dairy products can be at risk for calcium deficiency, especially if they turn to soy based products to increase their calcium intake. Only soy products labeled "fortified with calcium" provide the anticipated benefits.

Likewise, individuals who elect to follow vegetarian diets need to ensure that they have adequate calcium intake.

Healthy Lifestyle Options:

Regular exercise builds and maintains strong bones throughout life.
Get adequate calcium and Vitamin D. Vitamin D is necessary for the absorption of calcium. In fact, 80 per cent to 90 per cent of requirements for Vitamin D can be met through exposure to sunshine. The rest can be acquired from food sources, such as milk, and/or through supplements.
If you have children, you should know that childhood is a critical time for the development of strong bones and good lifestyle habits.
Maintain a healthy weight, not too thin or too heavy. Speak to your doctor about what your optimal Body Mass Index (BMI).
Avoid smoking, excess caffeine and alcohol.
Share your concerns with your physician.

Fracture and Falls Prevention

The risk of falling and fracturing increases with age. The risk factors for falling require an assessment, which can be done by physicians and other health care professionals during routine physical examination. The assessment includes an evaluation of gait and balance, feet and footwear, muscle strength, vision and hearing as well as a medication review. Women at risk of falling should also be counseled about household hazards, and in many cases, have an environmental safety assessment, whether they live in the community or in a nursing home. Environmental hazards, for example throw rugs, have been estimated to be the cause of a third to a half of falls (Sattin 1992). Of particular concern to Ontarians, hip fractures increase as much as 15 percent in the winter, in part because of slipping due to ice and snow (Papadimitropoulos et al. 1997) .The risk of falls and fracture, especially hip fracture, are highest for women residing in institutions.

Osteoporosis Resources

POWER (Promoting Osteoporosis Wellness through Education, Exercise and Resources). The POWER program is an education, nutrition and exercise wellness program for seniors with osteoporosis. Offered by three participating Toronto facilities:

- Baycrest Centre for Geriatric Care (416) 785-2500, ext. 2395
- North York General Hospital Seniors Health Centre (416) 756-6050
- Yee Hong Centre for Geriatric Care (416) 321-6679

Osteoporosis Society of Canada

- Toronto telephone: (416) 696-2663
- Web site address: http://www.osteoporosis.ca/