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Medical Panel - Osteoporosis

Wednesday, 20 January 2010

Medical Panel

. Prof Moira O'Brien - President of the Irish Osteoporosis Society

. Aveen Bannon - Nutritionist

. Lucy O'Connor

Professor Moira O'Brien

Professor Moira O'Brien FRCPI, FFSEM, FFSEM (UK), FTCD is a Specialist in Osteoporosis and Sports Medicine and a consultant in Euromedic Dundrum.

What is osteoporosis?

It is a change in the architecture of the bones, making them becoming brittle and susceptible to irreparable damage.

Who can get it?

Anybody, man, woman or child. There is the perception that it is mainly a condition that older women get, this is because it is frequently diagnosed in later years. In fact anyone who is in the risk categories can have the condition at any age. It is the most common bone disease in the world, affect one in 2 people at some stage of their lives.

Symptoms:

Most symptoms are in the later stage of the condition, so it is best to be screened before any of these signs occur.

. A fragility fracture (broken bone) from a trip and fall, from a standing position or less. Other examples: a fragility fracture from a sneeze, cough, turning over in bed.

. Loss of height - more than 2cm.

. A hump developing on upper back usually associated with loss of height.

. Undiagnosed, sudden severe upper, middle or low back pain, especially if associated with loss of height.

. A change in body shape and size, Example: Hump developing, head protruding forward.

A pot belly can occur when the stomach contents are pushed outwards due to the collapse of vertebrae. This is usually associated with loss of height.

What are the risk categories?


Family History

Anyone with a family history of the condition should go for a scan. Although there's nothing you can do about your family history, this can be prevented for those who may have a parent etc with the condition if you keep up regular exersize and good diet full of calcium and Vitamin D.

Lack of Oestrogen: Irregular periods, Menopause:
People with a lack of oestrogen won't absorb calcium properly

Dieting/people with eating disorders:
When people go on a diet they tend to reduce their calcium intake (good point to discuss with Aveen also)

Gluten Intolerance:
If you are gluten intolerant it means that wheat stops the body from absorbing calcium

Smoking/Drinking:
Weakens the bones, and should be avoided especially if there is a risk of osteoporosis in the family.

Kidney Disease:
Can sometimes cause secondary Hyperparathyroidism, which can cause bone loss. (quite rare)

If you have any of these risk factors it means you need to go to a scan
When Professor O'Brien started working in Euromedic clinic she tested all the staff, and found 4 of them, although under the age of thirty, had some form of osteopenia.

What can you do to prevent it?


. Calcium and Vitamin D Supplements.

. Exercise

. Diet

. Anyone who has the risk factors should go to their doctor and request to be referred for a DXA scan.

How is it diagnosed?

. Some doctors will do a heel scan. This however only checks the bones on the heel and not in the important bones, in the hips and spine, where if fractured it could lead to a distinct reduction in the quality of life.

. Blood Tests - Blood tests are taken to identify the cause of the conditions, i.e low sex hormones, vitamin D deficiency etc.

. Treatment - Treatment is based per individual,

. In young people if the cause it treated, there is no need for bone medication.

. Low hormones - They are put on the pill or HRT
. Gluten intolerant - Celiac diet
. Family history (and all other risk factors) - Exercise and prescribed Vit D and Calcium supplements

. In older people they are likely to be treated with medication, such as Protalos and Fosamax. Medication depends on the patient, and the condition, contrary to belief, can be cured.

Aveen Bannon - Nutritionist

Diet - Calcium
Helps to give bones ridigity and strength
Recommended 3 servings a day

. 37% of girls and 28% boys have inadequate calcium.

. 42% Teen girls and 23% teen boys have inadequate calcium intake.

. 23% Women and 11%men aged 18 - 64 have inadequate calcium intake.

Top Three best foods for calcium:

. Soya Bean Curd

. Super Milk

. Low fat yogurt

Vitamin D - 75% adults only have half the daily recommendation
-Necessary for calcium absorption

Defiency risk groups are:

. The Elderly
. Those who have no exposure to sunlight
. Those with malabsorption conditions & kidney disease
. Certain medications - (steroids)


Top sources:

. Makerel
. Salmon
. Cod Liver Oil

How can diet cause weak bones?

Caffeine can increase urinary losses of calcium
- each cup of coffee removes one teaspoon of milk.
Tip: Replace black coffee with a latte or cappuccino

High Fibre foods such as wheat bran can inhibit apsorption.
Tip: Rather that avoid these foods, its best to increase your calcium intake.

Coeliac Disease :

Osteoporosis can be a complication of coelic disease, due to an apsortion of calcium in the gut when the gut is damaged.

. Stick to a gluten free diet
. Eat 1500mg calcium per day
. Do weight bearing exercises once a day

Supplements:

Supplements of calium and vitiman D are recommended in some cases, but its important that people don't use them a substitute for a healthy diet.

Dieting:

A healthy body weight is recommended for bone health
Excessive dieting or extreme thinness can lead to a negative effect on the bones

Even when following a sensible weight-loss programme, bone loss can accelerate to higher than normal. A calcium-rich diet and regular exercise contributes to bone health.
New research also suggests that calcium in dairy foods actually helps the body burn fat more effectively. Calcium is available in all forms of milk and dairy, including low-fat and skimmed milk.

A survey carried out by IUNA showed that women who drank the most whole milk (two thirds of a pint daily) had the same body weight and waist measurements as women who drank very little (about enough for two cups of tea each day).
For more info see additional info below

For more information contact the Irish Osteoporosis Society Lo Call 1890 252 751
www.irishosteoporosis.ie

Professor Moira O'Brien FRCPI, FFSEM, FFSEM (UK), FTCD is a Specialist in Osteoporosis and Sports Medicine and a consultant in Euromedic Dundrum.

To book a Scan
Call 1890 59 59 59

Euromedic Ireland:

. DXA scans are available at:
. Euromedic Dundrum
. Euromedic Northwood
. Euromedic Cork
. Also available are MRI, X-Ray, CT and OPG (dental x-ray).
. For further information or to book an appointment at Euromedic Ireland, Locall 1890 400 444 or visit www.euromedic.ie


Critical Calcium

Eliminating dairy also removes a key source of dietary calcium. Teenagers and young women are the groups most likely to exclude dairy based on the misconception that it is fattening. This can have serious health implications in later years, including an increased likelihood of osteoporosis.

New research also suggests that calcium in dairy foods actually helps the body burn fat more effectively. Calcium is available in all forms of milk and dairy, including low-fat and skimmed milk.

Even when following a sensible weight-loss programme, bone loss can accelerate to higher than normal. A calcium-rich diet and regular exercise contributes to bone health.
Research suggests that the calcium content in milk and dairy helps with body weight management. It is thought that other components in dairy such as whey proteins, conjugated linoleic acid and branched chain amino acids may also contribute.

The Research:

Additional analysis of data from The Irish Universities Nutrition Alliance (IUNA) shows that milk is not associated with a higher body weight. A survey carried out by IUNA showed that women who drank the most whole milk (two thirds of a pint daily) had the same body weight and waist measurements as women who drank very little (about enough for two cups of tea each day). These high milk drinkers also had more nutritious diets, consuming more calcium, iron, folate and fibre. International research suggests that dairy foods might make it easier to lose weight. A series of studies have found that dairy, as part of a calorie-controlled diet, benefits weight loss and plays a role in body weight management.

Irish whole milk is standardised at 3.5 per cent fat, while low-fat milk must contain 1.5 - 1.8 per cent and skimmed milk has no more than 0.5 per cent! A portion of chips can contain up to 21 per cent fat

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