Nutrition for Clients with Osteoporosis

Nutrition for Clients with Osteoporosis


When it comes to nutrition and bone health,
there’s quite a bit written about alkaline diets, a diet that is high in fruits and vegetables
and low in saturated fats, but what I’d like to talk about today, specifically, is some
recent research that looked at an important mineral and an important vitamin when it comes
to bone health. So let’s start with vitamin D. In the spring of 2010, the general of the
American Medical Association published an article that had just over 2,000 women in
the average age 76 years of age and they were given mega doses of vitamin D once a year
over a three to five year period. So, mega doses, 500,000 international units, once a
year. What this study found, was that these woman actually had an increased fracture risk.
The medical advisory committee from Osteoporosis Canada had a couple of theories in regards
to the increased risk of fractures. One of them was that the enzymes that are needed
to break down the active vitamin D were being produced at too great a level. Another theory
was that people were feeling so good about having all that vitamin D and their muscle
function was working so much better, that they were all of a sudden just being that
much more active and that might have increased their risk of fractures. The main outcome
of this study was that although vitamin D is a fat-soluble vitamin, we shouldn’t be
recommending to our clients that they take all their vitamin D in one day of the year,
but rather, getting it the way nature intended, a little bit every day. So, the recommendations
in Canada still stand between 800 and 2,000 international units a day. As far as calcium, there is a study that was
published in the British Medical Journal in the summer of 2010. It was actually a meta
analysis. And this meta analysis looks specifically at calcium supplementation alone in women
and it was quite alarming because they found that women that were taking high calcium supplementation
had a significant increased risk of heart attacks. And so the recommendation is that
calcium should not be taken alone because vitamin D helps with the absorption of calcium.
Another recommendation in Canada was that the recommended levels of 1,500 milligrams
per day for the adult population over the age of 50 was reduced to 1,200 milligrams
a day. And so far, as pharmaceuticals, as healthcare
professionals, it’s very important for us to be aware of the different medications that
our clients are on and the effect that it has, when we’re talking about osteoporosis,
on their bone health. And so, there are a lot of bisphosphonates. If you listen to any
of the commercials that ran the six o’ clock news, you’re going to be bombarded by commercials
on different bisphosphonates and not all bisphosphonates are created equal. Some bisphosphonates protect
against vertebral fractures, some against non-vertebral factors and some against both.
Now, all these bisphosphonates are not created equal and so, it’s important that you be aware
and that’s one thing we go into in more detail in the MelioGuide course, is the type of bisphosphates
that are available on the market. At the 2010 American Society for Bone and
Mineral Research that was held in Toronto, there was an interesting study that was presented
looking at bisphosphonates and their ability to stay within the skeleton and slowly release
over time in individuals who had been on bisphosphonates for some time. In this study, they found that
risedronate was a bisphosphonate that did not stay in the system, so they did not detect
any risedronate in the urine, even after 19 months of cessation. Alendronate, on the other
hand, did stay within the body. So within these types of bisphosphonates, some of your
clients can go on what they call drug holidays, whereas some cannot. Tomorrow, I’m going to
share with you some stories on how myself and other health professionals integrate MelioGuide
into our practice and how it can help you in your practice.

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