We often take our health for granted, specially the health of our bones. These are what we usually say:
"Who needs to worry about their bones?"
"I've never had a broken bone, so my bones must be healthy."
"I don't really like the taste of milk."
"I take a vitamin, so I don't need calcium or vitamin D."
All of these comments are routinely heard each and every day in a physician's clinic. Disturbingly, these comments portray a potentially significant problem in this country. By not understanding the importance of developing their bone structure, many young women are not optimizing their 'bone health' when they are able. An increase in bone thinning around the time of menopause will occur. It will be much worse in women who have not developed peak bone mass and strength in their 20's and 30's. This, in turn, can lead to osteoporosis and a higher risk of fractures later in life. Over the past few years, much more information has become available regarding bone health, calcium intake and vitamin D.
Bone development occurs very early in life and peak bone density occurs by 25-30 years of age. The development of bone requires adequate building blocks to form a firm foundation for the skeletal system. In a very simple way, the bone is constantly undergoing change or remodeling. Bone building by cells called osteoblasts and bone breakdown by cells called osteoclasts, commonly occur within major bones. When a bone is being built, more bone is added for strength, while less bone is broken down. In general, bone building predominates until approximately age 30. Gradual bone loss begins to occur between age 40 and 50, and progresses rapidly after menopause.
One of the building blocks used by osteoblasts for bone development is calcium. Calcium is so important during development that a fetus extracts calcium from the mother through the placenta to aid in development. Each and every living cell in the body requires calcium to function properly and your body cannot make calcium.
Vitamin D has many functions in the body. Normally, it is produced by the skin when exposed to sunlight and aids in the absorption of calcium by the GI tract. In recent years, vitamin D research has revealed many exciting findings. Reports of new and promising studies seem to emerge almost weekly, including the potential for reduced rates of colorectal cancer, heart disease, diabetes, breast cancer and depression. Perhaps not surprisingly, in light of the other studies, one recent review of the health records of more than 13,000 Americans found that individuals with the lowest vitamin D levels were 26% more likely in an eight-year period to die than those with the highest levels.
According to the National Osteoporosis Foundation recommendations, adults under age 50 need 1,000 mg of calcium and 400-800 IU of vitamin D daily. Adults 50 and over need 1,200 mg of calcium and 800-1,000 IU of vitamin D daily. However, many leading experts believe that vitamin D levels should guide intake amounts of vitamin D. Aiming for a vitamin D level of greater than 30 to obtain the optimal health benefits of this important vitamin should be considered.
Therefore, achieving adequate nutrition, including calcium and vitamin D during childhood and beyond is vital for skeletal development, bone structure and overall health and well-being. Bone strength and density remain relatively constant until one approaches menopause, when bone loss will begin to occur. After menopause, bone loss accelerates during the first 3-5 years. This bone loss leads to more fragile bones and places a woman at greater risk for fracture. Routine counseling for all patients and their health care provider should encourage adequate calcium and vitamin D intake.
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