MilkI am a full-time nurse practitioner (NP), and I am also a fitness and health enthusiast. Many of you may not know what a nurse practitioner is – the easiest way to explain is to say that it’s between being a nurse and a doctor.

I work in a busy hospital unit with patients suffering from a wide array of chronic diseases, the most prevalent amongst them being osteoporosis, high blood pressure, and type 2 diabetes. One common trait of these diseases is that they can be very debilitating. Take for example, osteoporosis (OP) – a woman with OP is at higher risk for fracturing her bones such as her vertebrae or hip bones. This can lead to surgery and/or chronic pain.

One other key feature of these diseases is that in many cases they can be prevented and or treated through simple lifestyle modifications. Some changes now can make a huge impact on one’s health in the future. So what are some of these lifestyle modifications?

Let's first talk osteoporosis. This is of special interest to me because OP affects more women than men, and, in medicine, I feel women’s health issues can be overlooked at times.

OP is a disease in which the mass or the density of the bone is decreased and the structural integrity of trabecular bone is impaired. This leads to bones becoming porous and thinner and, therefore, weaker, and may place a person at higher risk for a fracture. It can also manifest in bone deformity, pain, “hunchback” appearance, and diminished height. Some risk factors for developing OP are family history, menopause, age (65 and older), glucocorticosteroids use greater than three months, excess alcohol, hyperthyroidism, excess caffeine, weight less than 57kg, smoking, and low dietary calcium intake.

The most important tools in preventing OP are calcium, vitamin D, and weight-bearing exercises. Calcium is important to bone health as it is vital to bone formation and growth. Adequate amounts of vitamin D are required for calcium absorption. Vitamin D is a fat-soluble vitamin available through dietary supplementation as well as ultraviolet rays and sunlight.

The Canadian Clinical Practice Guidelines recommend 1000mg of calcium daily for women and men age 19-50, and 400-1000 IU of vitamin D. For women and men over 50, 1200mg to 1500mg of calcium and 800-1000 IU of vitamin D are recommended daily. The easiest way to get these ideal values is through supplements or through diet. For foods rich in calcium see the chart below. Regular moderate weight-bearing exercise can slow down bone loss.

Gorretti Francisco
SAF Elite Pro

Calcium-rich foods

  • 1 cup milk (with added calcium): 430mg
  • 1 cup milk (whole, 2%, 1% skim): 300mg
  • 50gm hard cheese: 360mg (average)
  • 2 cups cottage cheese (1% or 2%): 310mg
  • 2 cups cottage cheese (<0.1%): 156mg
  • ¾ cup yogurt (plain): 290mg (average)
  • ¾ cup yogurt (fruit bottom): 233mg (average)
  • 1 cup frozen yogurt: 218mg
  • ½ cup orange juice fortified with calcium and vitamin D: 165mg
  • ½ cup broccoli: 33mg
  • 1 medium orange: 52mg
  • ¼ cup almonds (dry roast): 93mg
  • 2 tbsp almond butter: 88mg
  • ¼ cup dried sesame seed kernels: 50mg
  • 75gm Atlantic sardines (canned with bones): 286mg
  • 75gm Pacific sardines (canned with bones): 180mg
  • 75gm salmon (canned with bones): 208mg

References:

Uphold, C.R. & Graham, M. V. (2003). Clinical Practice Guidelines in Family Practice (4th Edition). Barmarrae Books, Inc.
Greenberg, D. E. & Muraca, M. (editors). Canadian Clinical Practice Guidelines (2008 Edition). El Selvier.