Jumat, 12 Mei 2017

how serious is osteoporosis

how serious is osteoporosis

- welcome to the third sectionin this series on minerals. this section is on osteoporosis. osteoporosis is a lossof bone mineral density. now, what that means isthat there's a loss of the minerals in bone and that those minerals arecalcium and phosphate. what happens isthat the bone becomes very thin, very rigid, and very frail. i'm gonna start by talking aboutthe most important risk factor

which is peak bone mass. peak bone mass isthe maximum amount of bone mass that you'llachieve in your lifetime. it usually peaks atabout 18 years of age. if we look at boys and girls andtheir development of bone mass, the accrual of bonemass during these years, you can see how much is accruedright about up until 18. now you'll noticefrom 18 to about 30, there's still a little bit thatcan be added, but not much.

most of it is achieved by 18, and it's substantialduring the teenage years. from age 30-- so let's get to age 30-- you can see it's pretty steady,right? there's not a lot of loss. but once you get to 50,men will have a slight decline, and women have thisdramatic decline. so you can see it's definitelya sharper curve down.

if you don't getup to these high points here duringyour younger years, meaning that you don'tachieve your peak bone mass or you achievea much lower rate-- so maybe you're down here-- when-- if especially particularlyif you're a female, you're gonna take the same dive. but instead of beinginto a safe range,

it's gonna be into anosteoporotic range. the main risk ofosteoporosis is fracture. you probably heard about that,hip fractures in an 85-year-old. a lot of them don'trecover after that. they will neverget out of the hospital. we don't want toget to that point. the problem is isthat you don't really think about that whenyou're 12 years old. so hopefully your parentsare thinking about that.

so as the bone is growing anddeveloping, what's important? well, they found there'sa direct connection to the number of fruits andvegetables that are eaten. now, remember, you can obtaingrowth calcium from-- and a little bit ofphosphorous with fruits, vegetables, legumes. you don't alwayshave to have dairy. the amount ofvitamin d, very-- and remember we getvitamin d from sunshine.

but this all dependson where you live, so if you're north ofthat 37th parallel, meaning humboldt county,then it's unlikely that you'll get enough sunshinein the wintertime. protein, now proteinhas been debated. it's very importantduring the growing years, but too much proteinas adults has been associated with loss ofcalcium in the urine, but not necessarilyosteoporosis.

so it's interesting. you need enough proteinbecause you need protein to build theproteins in the bone. and then the calcium is-- actually uses the mineral tomake it more rigid or sturdy. the-- we don't wanttoo much protein, so there is acareful balance here. and then carbonated beverages, now, i have a question mark bythis because there is a direct

correlation between the numberof sodas that children and drink and their inability to reachan adequate peak bone mass. but it's not clear whether it's actually thecarbonated beverages-- and that means soda. most of the time in the studies,it's been soda-- or if it's thedisplacement of milk. so instead of-- they weren't drinking milk.

milk has calcium andis fortified with vitamin d. but insteadthey're drinking soda. so there is a relationship. we're just not sure exactly the causal factor ofthat relationship. something else that'sinteresting is when bone mineral content orbone mineral density, how much mineral contentis in the bone and you look at physical activityversus watching television,

the more physical activity,particularly in children-- so this is the time when youwant to achieve peak bone mass-- the greater the bonemineral content, how much calcium andphosphorous is in those bones. the more tv watching, the lower the bonemineral content-- direct correlations here.okay? again, positive,not necessarily sure, but it's a definitelya contributing factor.

so there are modifiable andnon-modifiable risk factors. and what does that mean? the non-modifiable risk factorsare factors we cannot change. if you're female,you can't change that, but you're gonnabe at greater risk for developing osteoporosis. as we get older, we'regonna be at a greater risk. remember, rightaround the age of 50, gonna have a declinein bone marrow content.

we can't avoid thatas we get older, those that automaticallyalready have a smaller frame-- caucasians are ata greater risk-- family history, personalhistory of a fracture, as well as estrogen deficiency. modifiable risk factors-- now i already mentioned some, and these were in childrenwhen they're growing-- but for adults,sedentary lifestyle.

exercise is extremely importantfor building bone mass. poor nutritiondefinitely has an impact, particularly in childhoodbut also as adults. remember i talked abouthow we want to keep that-- our body keeps blood calciumin very tight control. if the blood calcium's low,absorption rate increases, and our bone startsgetting broken down to release calciumin the bloodstream. so if you need calcium forother functions and you're

not taking in any in your diet,your body's just gonna be pulling thatcalcium out of bone. vice versa is also true. if you're taking ina lot of calcium, then your absorptionrate might decrease. but you're also gonna takethat calcium and put it into the bone creating more bone,stronger bone, even in your later years. now, one important factoris that you can't catch up.

you're always gonnabe on a decline, but you can slowthe declination, the decrease ofbone mineral loss. so you're not gonnabe building up bone after age 50 oreven after age 30, but you can slow thatprogressive loss that is inevitable by consuming adequateamounts of calcium and vitamin d. remember vitamin d increasesthe absorption of calcium. adequate amounts of protein,not too much,

and limiting the amountof sodium 'cause too much sodium has been associatedwith losses of calcium. smoking, using tobacco, definitely associated with anincreased risk of osteoporosis, as well as excessivealcohol use. now, when you think aboutyour risk of osteoporosis, think about, did youachieve peak bone mass? that's probably the singlemost important risk. and then what areyou doing today?

and what type of changes can youmake to help reduce your risk? are you getting enough calcium? are you gettingenough vitamin d? do you have asedentary lifestyle? could you exercise more? are you getting enough fruitsand vegetables in your diet? can you limit your smoking? and then have moderatealcohol intake. i want to talk a littlebit about a controversy of

calcium supplementation becausethe u.s. preventative task force actually doesn't recommendcalcium supplementation unless someone is at risk forosteoporosis or has osteopenia. now, this is based onresearch that individuals who have taken calcium,with or without vitamin d, ended up with a greaterrisk of heart disease. so-- and this interesting. i mean, here we're doing agood job protecting our bones, but now i end updeveloping heart disease.

and so this is researchthat came out in 2011. there have beensome other studies. some have supported this. some have not. but a lot of the research issuggesting that there is a concern about supplementingwith calcium 'cause the calcium is ending upin the wrong place. when calcium comesinto the body-- and we'll just say thatthis guy here is calcium--

it doesn't know where to go. does it go to the heart? does it go to soft tissues,the tendon, the bone? it doesn't reallyknow where to go. so there might beanother factor here. we think, oh, you'regetting adequate calcium, but it's gotta goto the right place. if you're supplementing,maybe it's going to the heart. and here's something thatwe talked about earlier,

is vitamin k2 and how vitamin k2and vitamin d work together in bringing calcium into the bodyand then telling it where to go. remember, vitamin dregulates blood calcium. it increases theabsorption of calcium. you need vitamind to have calcium be absorbed intothe bloodstream. but once it's in thebloodstream, where does it go? this is wherevitamin k2 comes in. vitamin k2 is necessary tobuild the proteins which

help direct calciumto the right place, basically tell it,pull it out of the soft tissues, and then bring it into the bone. that's an importantfactor and where we had talked aboutvitamin k2 in the past. but this is somethingnew and something we'll be seeingfurther research on. and this is the end of oursection on osteoporosis. รข 

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