The Silent Stalker

This is 11th and final article on osteoporosis, summarized from Dr. Lieberg’s book, “The Silent Stalker: A Patient’s Guide for Understanding Osteoporosis”. Statistics cited in this article are footnoted in the book and therefore will not be footnoted here.

The long journey

I have stressed how osteoporosis affects all of us. In this final article, I want to stress that whether one is a patient, parent, or grandparent, we need to be aware that our lifestyle affects our bone health and can be summarized in the following categories.

Expectant, new mothers

It is important to recognize the family history of osteoporosis and the family history of previous fractures.

Stop smoking and drinking alcohol because it affects the bone health of the mother and newborn.

The mother has to ensure an adequate calcium intake, at least 1200 mg, in divided doses in the form of calcium maleate or calcium citrate.

Since almost everyone is vitamin D deficient, have your doctor obtain a vitamin D blood and then take 4000 IU and repeat the blood level in three months. The level should be close to 70mg/ml. A low vitamin D level can result in a low birth weight and pre-eclampsia.

Post pregnancy, if breast feeding, mothers need more calcium because breast feeding deletes calcium out of a mother’s bones.

A 1200 mg of calcium as well as vitamin D should be continued for the rest of their life. There are numerous articles that many disease and cancers are associated with low levels of these supplements.

Childhood: Ages 1 to 10

Children need a healthy start consisting of a good diet and good eating habits.

The family needs to eat together at specific times at the dinner table. This will avoid eating quickly and snacking.

This also usually assures that children eat a more appropriate diet.

A diet should include a healthy serving of fruit, fresh or cooked vegetables, protein, and cow’s milk or fortified non-dairy milk.

Sodas should be avoided because of high sugar and phosphorus content.

Fast foods should be limited because of their sugar, fat and salt content.

Limit electronics. Kids should play outdoors to stress their bones.

Supplement their diet with calcium, magnesium, and vitamin D in the form of vitamins.

Teens: Ages 11 to 20

Teen years are essential because over half of the adult bone mass is obtained during these years.

More calcium is necessary than any other time in life and should be supplemented with the adult dose of 1200 mg of calcium per day as well as an adequate dose of magnesium (400 mg) and vitamin D (2,000 IU).

Absorption of calcium and magnesium depends on an adequate amount of vitamin D.

Activity is also vital. Encourage sports. Activity increases bone strength and muscle mass and maintains healthy weight.

Avoid smoking.

After these years only 5 to 10 percent of bone is added.

Young adults: Ages 21 to 35

a. These are stressful years because of career building, marriage and family.

b. Exercise on a regular basis.

c. Maintain good diet

d. Avoid smoking and limit alcohol intake.

e. Limit caffeine because it will increase excretion of calcium.

f. Limit salt intake to 2300mg/day (one teaspoonful).

Supplement diet with calcium, magnesium and vitamin D.

Adults: Ages 36 to 45

a. Maintain a healthy lifestyle of exercise and healthy diet of half vegetables and fruit.

b. Limit protein, especially red meat.

c. Avoid dieting.

d. Limit alcohol and caffeine.

e. Continue with regular exercise program at least four to five times per week.

f. Exercise should consist of 45 to 60 minutes of walking, muscle maintenance and cardio.

g. Women will be going through menopause, consult your doctor to obtain accurate height and weight measurement.

h. Because of high risk in family history request a DXA scan.

i. Continue with supplements of calcium, magnesium and vitamin D.

Postmenopausal women, ages 46 to 60

Will experience estrogen levels decreasing and loss of bone mass.

Important to maintain good nutrition and supplements of Vitamin D, calcium and magnesium.

Increase calcium intake in divided doses with each meal to avoid constipation.

Maintain exercise such as Pilates or moderate Zumba class; good for lower and upper body, core strength and maintenance of balance.

Limit calorie intake; avoid snacking.

Grandparents: Ages 61 & up

Everyone should have had or get a DXA scan to provide an idea of bone health.

Check height annually to see if you are shrinking, which could mean silent back fractures.

Keep up exercise, work on balance.

Challenge mind and body by staying active and volunteering.

Maintain healthy diet, increase amount of vegetables and fruit.

Keep weight down.

Supplement diet with calcium, magnesium and vitamin D.

Get annual vitamin D levels.

Insist on the actual number of vitamin D level and not that it was normal.

Ideal blood level of vitamin D is 50 to 70 mg/ml.

It is my hope these short synopses of my book have helped you, the patient, to understand this important disease that will affect every one of us. I hope its understanding will lead all of us to a better and healthier life.

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