Osteoporosis Part I

Osteoporosis is a condition that can cause bones to thin and become weak. While osteoporosis can occur at any age, it is more common in those over age 50. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, osteoporosis is a major health threat for over 44 million Americans, 68 percent of which are women. The majority of individuals affected by osteoporosis are women. Some experts believe women may have a greater risk of developing osteoporosis due to their bones being lighter and less dense. The hormonal changes of menopause (a reduction in estrogen, which normally helps preserve calcium in the bones) may also cause an acceleration of the process. Men are also susceptible. One out or every two women and one out of every four men will have an osteoporosis related fracture in their lifetime.

Risk factors for osteoporosis include:

• Being thin or having a small frame
• Consuming a diet low in calcium
• Physical inactivity
• Overactive thyroid
• Kidney disease
• Cushing’s syndrome
• Long term consumption of strong anti-inflammatory drugs used to treat rheumatoid arthritis and asthma
• Women who have their ovaries removed before age 40
• Family history of the disease of fractures after age 50
• Smoking
• Alcohol consumption (2-3 ounces per day)

Many people with osteoporosis have no idea they have it. Thankfully, we live in a time where it is becoming routine to screen for osteoporosis. A bone mineral density test called a dual-energy x-ray absorptiometry (DXA) measures bone density. The test is very similar to having an x-ray. Many a time, individuals are diagnosed with osteopenia. Osteopenia is a condition where the bone density is found to be low. Being diagnosed with osteopenia does not necessarily mean you will develop osteoporosis, however the risk to develop it is greater. Osteopenia can be caused by a few factors including genetics, low bone mass development during adolescence, or medical conditions or treatments that can affect bone health. In the case of either osteopenia or osteoporosis, your healthcare provider will likely advise a lifestyle to include regular weight bearing exercise along with a diet to maintain good bone health. Medication may also be prescribed for prevention or treatment of either condition.

Tips for improving bone health

Weight bearing activities can improve bone density. There is consistent evidence that has shown that the risk of hip fracture alone is reduced by 20-40 percent when individuals are active versus sedentary. Regular exercise also helps build and maintain muscle mass, along with balance and reaction time. Walking, cycling, jogging, basketball, rollerblading, running, tennis, weight lifting are all examples. Swimming has been shown to have some benefit, although not as much as the weight bearing activities. Calcium, Vitamin D, magnesium, Vitamin K, and iron can all play a role in the absorption of calcium. An increased intake of Omega 3 fatty acids has also been shown to be of benefit in bone health.

Food sources of calcium include dairy products, dark green leafy vegetables (spinach, kale, turnip greens, mustard greens, collard greens), fish with bones, such as sardines, canned salmon (you can mash or puree the bones in a food processor to decrease the risk of choking), tofu fortified with calcium, along with other calcium fortified foods (e.g. calcium fortified orange juice) can contribute to the cause. Dairy products are the better absorbed form of calcium.

Another way to increase calcium consumption is the use of vinegar when making soup stock with bones. A little vinegar added to the stock will dissolve some of the calcium from the bones, thus adding an added benefit to your soup stock. While food and sunshine are the better absorbed sources of calcium, supplements with calcium carbonate (for those with normal stomach acid secretion) and calcium citrate (preferably with some added vitamin D) are also sources for those who do not eat many calcium containing foods. An important point to remember with calcium is that the body can only absorb about 400-500 mg of calcium at a time. Remember that when eating/taking supplements. Consume sources throughout the day.

Average daily recommended intake of calcium is:
1000 mg for adults 18-50
Postmenopausal women on estrogen 1200 mg
Postmenopausal women not on estrogen 1500 mg
Men and women 51 years and older 1200 mg
Pregnant/Lactating women 1200 mg

Source: National Academy of Food Science and Nutrition Board 2000, National Institute of Health

Vitamin D in particular plays a large role in the absorption of calcium. Many foods have it added. Sources include Vitamin D fortified dairy and cereal products, egg yolks, and fish such as salmon, sardines, catfish, and tuna. Another source of it is sunshine. In regards to supplements, both vitamin D2 Vitamin D3 are compatible. Those who live in sunnier climates tend to have a better chance of absorbing this vitamin, thus improving calcium absorption. Many who live in the northern climates have less exposure to sunlight, particularly in winter.

Fifteen minutes of sun a few days per week (before applying sunscreen) can help the body produce Vitamin D. The recommended daily intake of Vitamin D is 200 IU ages 19-50, 400 IU ages 51-70, 600 IU 70 and older. These recommendations date back to the late 1990’s. New evidence suggests we may need higher intakes of Vitamin D. Daily intake of up to 1,000 IU has been shown to be safe for infants and adults. Excessive use of Vitamin D over 2,000 IU per day can lead to toxic levels in the blood, along with excessive calcium in blood and urine, and risk of kidney stones.

Older adults tend to have more difficulty absorbing both calcium and Vitamin D. Individuals with dark or highly pigmented skin also have difficulty with absorption of Vitamin D. Dark pigment in the skin may reduce Vitamin D synthesis from sunlight up to 95%. Vitamin D expert Michael Holick, PhD, MD states that “Darker skinned people need 5-10 times as much exposure to synthesize the same amount of Vitamin D as lighter skinned people.” Additional supplementation may be of benefit. Someone with osteoporosis may benefit with 400 IU of Vitamin D twice a day.
Sidebar: Speaking of Vitamin D, some studies suggest that Vitamin D may play a role in lowering the risk of breast cancer, multiple sclerosis, and possible other conditions. Keep on the lookout for more research on these topics.

Snack Ideas

• How about a glass of ice cold milk (or homemade chocolate milk)?
• Calcium fortified orange juice along with a few crackers and a slice of cheese
• Cup of plain yogurt with cereal and nuts
• String cheese with an apple, pear, or grapes
• Melted Brie Cheese with sliced apple or pear on toast

For more information regarding bone health, you can refer to the National Institutes for Health Osteoporosis and Related Bone Diseases. The website is http://www.osteo.org/

Sources
http://www.niams.nih.gov/Health_Info/Bone/Osteoporosis/default.asp
http://www.webmd.com/food-recipes/features/are-you-getting-enough-vitamin-d?page=2&print=true#

Spinach and Sundried Tomato Quiche

Serve this quiche with a fruit or vegetable salad and some hearty whole grain bread as pictured. Individual portions can also be frozen for an easy to grab and heat meal.

Spinach and Sundried Tomato Quiche
Serves 6
1 9-inch unbaked deep dish pie shell, thawed
½ c. thawed and drained frozen chopped spinach
¼ c. chopped sundried tomatoes (hydrated if necessary)*
*Rehydrate tomatoes according to package directions if too dry to work with
2 ounces grated parmesan or asiago cheese
3 large eggs
1 c. Land O’Lakes fat free half and half
½ c. light sour cream
¼ tsp. black pepper
¼ tsp. salt
¼ tsp. turmeric
2 tsp. dried basil
2 tsp. dried rosemary

Preheat oven to 350°F.
With fork, poke a few sets of holes in pie crust bottom and sides.
Spread spinach and chopped sundried tomatoes over bottom of pie crust.
Sprinkle half of the cheese on top of vegetable mixture.
In large bowl, beat eggs. Beat in half and half and sour cream until well blended. Add spices and herbs.
Pour mixture into pie crust and sprinkle remaining cheese on top.
Place quiche on cookie sheet and put in oven. Bake for 35-40 minutes or until quiche is set and slightly browned. If crust begins to burn, reduce oven temperature until mixture is set.
Remove from oven and let rest for 10-15 minutes before serving.

Per serving: 312 calories, 11 gm PRO, 25gm CHO, 19 gm FAT, 122 mg cholesterol, 537 mg sodium, 333 mg Potassium, 221 mg Calcium, 96 mcg Vitamin K, 2196 IU Vitamin A, 2 gm fiber, 3 gm sugar

Heart Healthy Ideas

The American Heart Association, American Dietetic Association, and National Heart, Lung and Blood Institute encourage everyone to know their numbers. These numbers include total cholesterol, LDL (low density) cholesterol, HDL (high density) cholesterol, and triglycerides. LDL cholesterol is the cholesterol that tends to stick to the walls of the arteries and form plaque. HDL cholesterol is the cholesterol that helps carry cholesterol out of your body. Triglycerides are a form of fat found in our bodies and in foods. If your healthcare practitioner informs you that you have elevated blood lipids, here are a few tips that may help.

• Eat more soluble fiber. Soluble fiber can be found in beans, legumes, barley, dried plums, figs, broccoli, berries, citrus, and oats, apples, pears, carrots, and psyllium.


• Consume omega fatty rich fish, such as salmon, tuna, sardines, and mackerel. If you do not consume fish, ask your healthcare practitioner about omega fatty acid supplements.


• If you are overweight, losing weight may help lower your LDL, and potentially increase your HDL.


• Increase physical activity if possible. If you are just starting out, discuss this with your healthcare practitioner. The eventual goal is 30 minutes of activity every day. Breaking it up into smaller increments may help it happen. Additionally, smaller increments may help sustain your energy level. Exercise has been shown to raise HDL levels, which is a good thing.


• Red and purple foods, such as red or purple grapes/juice, have been shown to promote heart health.


• If you have elevated triglycerides, consuming less simple carbohydrates (white bread, white rice, sugary cereals, etc.), sweets and alcohol may assist in lowering them.


• Switch to more frequent use of olive and canola oil versus margarine, butter, or lard.


• Think about increasing fruit, vegetable and more plant proteins, such as soy or beans. Having a vegetarian meal a few days a week can be satisfying, nutritious, and potentially cheaper than having animal protein every day. A quick, easy and cheap meal can be made from either corn tortillas or brown rice with canned beans, some veggies and salsa.


• A few snack suggestions include cereal or pretzels with unsalted nuts and dried fruit, air popped popcorn (try some with unsweetened cinnamon), low or nonfat yogurt, fruit with nut butter, wheat crackers with low or reduced fat cheese, hummus or tuna.

New Anti-Obesity Coalition

In an effort to reduce obesity by 2015, a coalition of retailers, food and beverage manufacturers, educators, and non governmental organizations have joined together. A recent article in Media Post reviewed information regarding the Healthy Weight Commitment Foundation. Its efforts will focus on three areas including the marketplace, workplace, and schools.

In the marketplace, manufacturers will strive to provide improved nutrition education information on product labels, along with continuing to improve product nutritional content and quality. A few manufacturers participating include Kraft, Campbell's, Mars, Inc., General Mills, Ralston Foods/Post Foods, Nestle, McCormick & Company, Sara Lee, Coca Cola, J.M. Smucker, Hershey, PepsiCo, and Bumble Bee, cites Karlene Lukovitz. And, according to Lukovitz, retailers participating will include, "Brookshire Grocery Co., Festival Foods (Minnesota), Gonzales Northgate Market, Harris Teeter, Hy-Vee, IGA, Jax Markets, Martin's Super Markerts, Redner's Markets, Safeway, Schnuck Markets, Shop Rite of Hunterdon County, Skogen's Festival Foods, United Supermarkets Ltd., and Wakefern Food Corp."

In the workplace, efforts towards improving employee wellness will include healthier options in cafeteria food and vending machines. Additionally exercise and/or weight management programs will be offered. Tools such as health risk appraisals will be utilized to track progress.

The National Business Group on Health will evaluate these programs and share positive outcomes with other employers, which may provide encouragement for an increase in employee health and wellness programs.

In schools, a number of organizations including the American Dietetic Association, PE4Life, and the American Council for Fitness and Nutrition Foundation, formed a Healthy Schools Partnership. This program will promote a healthy lifestyle to include nutrition and exercise.

For more information go to http://www.healthyweightcommit.org/

Susan's Confetti Casserole

Susan’s Confetti Casserole©

This side dish adds color and flavor to any meal. It can accompany beef, poultry, game, pork or seafood. It also packs a bounty of antioxidants and nutrition!

I small onion, chopped
2 cloves garlic, chopped
1 Tbsp. olive oil
4 c. fresh broccoli florets, cut in small pieces
3 large carrot stalks, chopped
1 large red bell pepper, seeded and chopped
1 recipe Herbed White Sauce (below)
2 ounces bread, dried and crumbled
2 Tbsp. shredded parmesan cheese

In large frying pan heat oil, garlic, and onion over medium heat. Add broccoli, carrots, and pepper. Stir mixture to coat vegetables with oil, garlic and onion. Cook 3-5 minutes. Remove from heat. Stir in herbed white sauce. Pour into 2 quart casserole dish. Top with bread and sprinkle cheese over bread mixture. Bake at 350°F for 20 minutes or until mixture is bubbling. Let sit for 5 minutes. Serves 6.

Per serving: 130 calories, 6 gm Pro, 16 gm Cho, 6 gm Fat, 8 mg Chol, 216 mg sodium, 2 gm Dietary Fiber, 5 gm Sugar

Herbed White Sauce
1 Tbsp. Butter
1 ½ -2 Tbsp. All Purpose Flour
1 cup 1% milk
1 Tbsp each fresh basil, oregano, rosemary finely chopped (or 1 ½ tsp each dried)
¼ tsp. turmeric
¼ tsp. salt
¼ tsp. black pepper

In medium saucepan, heat butter until melted over low heat. Add flour and stir until flour is well blended. Slowly stir in milk and continue to stir until sauce begins to thicken and is smooth and hot. Add herbs and seasonings. Take off heat.

Oxycholesterol poses a risk for Heart Health

Most of us are aware of the association between cholesterol and heart health. Scientists are now revealing the effects of a little known form of cholesterol called oxycholesterol.

At the 238th National Meeting of the American Chemical Society, scientists from the Chinese University of Hong Kong presented the effects of oxycholesterol on heart health. Hamsters fed a diet high in oxycholesterol elicited a 22% higher blood cholesterol level than those fed non-oxidized cholesterol. Additionally, there was a greater deposition of cholesterol and plaque formation in the arteries, along with reduction of artery elasticity of those hamsters consuming oxycholesterol.

Oxycholesterol is formed when oxidation occurs between fats and oxygen. Sources include fried and processed foods, partially hydrogenated vegetable oils, and trans-fatty acids.

To counter the effects of oxycholesterol, the researchers suggest consuming foods high in antioxidants, which can help counter the effects of the oxidation process (hence the name "anti" oxidants). Fruits and vegetables rich in color, such as orange, red, dark green, yellow, blue, purple are all antioxidant rich.

Another reason to eat fruit

A study conducted at the Institute of Food Research in Norwich, England revealed that fruit may contain a higher level of antioxidants than previously thought. The researchers studied nonextractable polyphenols (natural antioxidants found in foods) that have been overlooked in many studies. These polyphenols are found in the cell wall of the fruit versus the flesh. They are more difficult to extract, thus the benefit of the polyphenol may lie in consuming the fruit itself.

Many in the food and nutrition community caution taking antioxidant supplements, as in some cases, they may be of no benefit or potentially interfere with medications and certain health conditions. The feeling stems from taking a supplement does not necessarily capture what is in the natural food itself.

Additional information can be found in the July 28, 2009 Journal of Agricultural and Food Chemistry.