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  • - WELCOME TO THE THIRD SECTION IN THIS SERIES ON MINERALS.

  • THIS SECTION IS ON OSTEOPOROSIS.

  • OSTEOPOROSIS IS A LOSS OF BONE MINERAL DENSITY.

  • NOW, WHAT THAT MEANS IS THAT THERE'S A LOSS

  • OF THE MINERALS IN BONE

  • AND THAT THOSE MINERALS ARE CALCIUM AND PHOSPHATE.

  • WHAT HAPPENS IS THAT THE BONE BECOMES VERY THIN,

  • VERY RIGID, AND VERY FRAIL.

  • I'M GONNA START BY TALKING ABOUT THE MOST IMPORTANT RISK FACTOR

  • WHICH IS PEAK BONE MASS.

  • PEAK BONE MASS IS THE MAXIMUM AMOUNT

  • OF BONE MASS THAT YOU'LL ACHIEVE IN YOUR LIFETIME.

  • IT USUALLY PEAKS AT ABOUT 18 YEARS OF AGE.

  • IF WE LOOK AT BOYS AND GIRLS AND THEIR DEVELOPMENT OF BONE MASS,

  • THE ACCRUAL OF BONE MASS DURING THESE YEARS,

  • YOU CAN SEE HOW MUCH IS ACCRUED RIGHT ABOUT UP UNTIL 18.

  • NOW YOU'LL NOTICE FROM 18 TO ABOUT 30,

  • THERE'S STILL A LITTLE BIT THAT CAN BE ADDED, BUT NOT MUCH.

  • MOST OF IT IS ACHIEVED BY 18,

  • AND IT'S SUBSTANTIAL DURING THE TEENAGE YEARS.

  • FROM AGE 30--

  • SO LET'S GET TO AGE 30--

  • YOU CAN SEE IT'S PRETTY STEADY, RIGHT?

  • THERE'S NOT A LOT OF LOSS.

  • BUT ONCE YOU GET TO 50, MEN WILL HAVE A SLIGHT DECLINE,

  • AND WOMEN HAVE THIS DRAMATIC DECLINE.

  • SO YOU CAN SEE IT'S DEFINITELY A SHARPER CURVE DOWN.

  • IF YOU DON'T GET UP TO THESE HIGH

  • POINTS HERE DURING YOUR YOUNGER YEARS,

  • MEANING THAT YOU DON'T ACHIEVE YOUR PEAK BONE

  • MASS OR YOU ACHIEVE A MUCH LOWER RATE--

  • SO MAYBE YOU'RE DOWN HERE--

  • WHEN--

  • IF ESPECIALLY PARTICULARLY IF YOU'RE A FEMALE,

  • YOU'RE GONNA TAKE THE SAME DIVE.

  • BUT INSTEAD OF BEING INTO A SAFE RANGE,

  • IT'S GONNA BE INTO AN OSTEOPOROTIC RANGE.

  • THE MAIN RISK OF OSTEOPOROSIS IS FRACTURE.

  • YOU PROBABLY HEARD ABOUT THAT, HIP FRACTURES IN AN 85-YEAR-OLD.

  • A LOT OF THEM DON'T RECOVER AFTER THAT.

  • THEY WILL NEVER GET OUT OF THE HOSPITAL.

  • WE DON'T WANT TO GET TO THAT POINT.

  • THE PROBLEM IS IS THAT YOU DON'T REALLY

  • THINK ABOUT THAT WHEN YOU'RE 12 YEARS OLD.

  • SO HOPEFULLY YOUR PARENTS ARE THINKING ABOUT THAT.

  • SO AS THE BONE IS GROWING AND DEVELOPING, WHAT'S IMPORTANT?

  • WELL, THEY FOUND THERE'S A DIRECT CONNECTION TO

  • THE NUMBER OF FRUITS AND VEGETABLES THAT ARE EATEN.

  • NOW, REMEMBER, YOU CAN OBTAIN GROWTH CALCIUM FROM--

  • AND A LITTLE BIT OF PHOSPHOROUS WITH FRUITS,

  • VEGETABLES, LEGUMES.

  • YOU DON'T ALWAYS HAVE TO HAVE DAIRY.

  • THE AMOUNT OF VITAMIN D, VERY--

  • AND REMEMBER WE GET VITAMIN D FROM SUNSHINE.

  • BUT THIS ALL DEPENDS ON WHERE YOU LIVE,

  • SO IF YOU'RE NORTH OF THAT 37TH PARALLEL,

  • MEANING HUMBOLDT COUNTY, THEN IT'S UNLIKELY THAT

  • YOU'LL GET ENOUGH SUNSHINE IN THE WINTERTIME.

  • PROTEIN, NOW PROTEIN HAS BEEN DEBATED.

  • IT'S VERY IMPORTANT DURING THE GROWING YEARS,

  • BUT TOO MUCH PROTEIN AS ADULTS HAS BEEN

  • ASSOCIATED WITH LOSS OF CALCIUM IN THE URINE,

  • BUT NOT NECESSARILY OSTEOPOROSIS.

  • SO IT'S INTERESTING.

  • YOU NEED ENOUGH PROTEIN BECAUSE YOU NEED

  • PROTEIN TO BUILD THE PROTEINS IN THE BONE.

  • AND THEN THE CALCIUM IS--

  • ACTUALLY USES THE MINERAL TO MAKE IT MORE RIGID OR STURDY.

  • THE-- WE DON'T WANT TOO MUCH PROTEIN,

  • SO THERE IS A CAREFUL BALANCE HERE.

  • AND THEN CARBONATED BEVERAGES, NOW,

  • I HAVE A QUESTION MARK BY THIS BECAUSE THERE IS A DIRECT

  • CORRELATION BETWEEN THE NUMBER OF SODAS THAT CHILDREN AND DRINK

  • AND THEIR INABILITY TO REACH AN ADEQUATE PEAK BONE MASS.

  • BUT IT'S NOT CLEAR WHETHER

  • IT'S ACTUALLY THE CARBONATED BEVERAGES--

  • AND THAT MEANS SODA.

  • MOST OF THE TIME IN THE STUDIES, IT'S BEEN SODA--

  • OR IF IT'S THE DISPLACEMENT OF MILK.

  • SO INSTEAD OF--

  • THEY WEREN'T DRINKING MILK.

  • MILK HAS CALCIUM AND IS FORTIFIED WITH

  • VITAMIN D. BUT INSTEAD THEY'RE DRINKING SODA.

  • SO THERE IS A RELATIONSHIP.

  • WE'RE JUST NOT SURE EXACTLY THE

  • CAUSAL FACTOR OF THAT RELATIONSHIP.

  • SOMETHING ELSE THAT'S INTERESTING IS WHEN

  • BONE MINERAL CONTENT OR BONE MINERAL DENSITY,

  • HOW MUCH MINERAL CONTENT IS IN THE BONE AND YOU

  • LOOK AT PHYSICAL ACTIVITY VERSUS WATCHING TELEVISION,

  • THE MORE PHYSICAL ACTIVITY, PARTICULARLY IN CHILDREN--

  • SO THIS IS THE TIME WHEN YOU WANT TO ACHIEVE PEAK BONE MASS--

  • THE GREATER THE BONE MINERAL CONTENT,

  • HOW MUCH CALCIUM AND PHOSPHOROUS IS IN THOSE BONES.

  • THE MORE TV WATCHING,

  • THE LOWER THE BONE MINERAL CONTENT--

  • DIRECT CORRELATIONS HERE. OKAY?

  • AGAIN, POSITIVE, NOT NECESSARILY SURE,

  • BUT IT'S A DEFINITELY A CONTRIBUTING FACTOR.

  • SO THERE ARE MODIFIABLE AND NON-MODIFIABLE RISK FACTORS.

  • AND WHAT DOES THAT MEAN?

  • THE NON-MODIFIABLE RISK FACTORS ARE FACTORS WE CANNOT CHANGE.

  • IF YOU'RE FEMALE, YOU CAN'T CHANGE THAT,

  • BUT YOU'RE GONNA BE AT GREATER RISK

  • FOR DEVELOPING OSTEOPOROSIS.

  • AS WE GET OLDER, WE'RE GONNA BE AT A GREATER RISK.

  • REMEMBER, RIGHT AROUND THE AGE OF 50,

  • GONNA HAVE A DECLINE IN BONE MARROW CONTENT.

  • WE CAN'T AVOID THAT AS WE GET OLDER,

  • THOSE THAT AUTOMATICALLY ALREADY HAVE A SMALLER FRAME--

  • CAUCASIANS ARE AT A GREATER RISK--

  • FAMILY HISTORY, PERSONAL HISTORY OF A FRACTURE,

  • AS WELL AS ESTROGEN DEFICIENCY.

  • MODIFIABLE RISK FACTORS--

  • NOW I ALREADY MENTIONED SOME,

  • AND THESE WERE IN CHILDREN WHEN THEY'RE GROWING--

  • BUT FOR ADULTS, SEDENTARY LIFESTYLE.

  • EXERCISE IS EXTREMELY IMPORTANT FOR BUILDING BONE MASS.

  • POOR NUTRITION DEFINITELY HAS AN IMPACT,

  • PARTICULARLY IN CHILDHOOD BUT ALSO AS ADULTS.

  • REMEMBER I TALKED ABOUT HOW WE WANT TO KEEP THAT--

  • OUR BODY KEEPS BLOOD CALCIUM IN VERY TIGHT CONTROL.

  • IF THE BLOOD CALCIUM'S LOW, ABSORPTION RATE INCREASES,

  • AND OUR BONE STARTS GETTING BROKEN DOWN

  • TO RELEASE CALCIUM IN THE BLOODSTREAM.

  • SO IF YOU NEED CALCIUM FOR OTHER FUNCTIONS AND YOU'RE

  • NOT TAKING IN ANY IN YOUR DIET, YOUR BODY'S JUST

  • GONNA BE PULLING THAT CALCIUM OUT OF BONE.

  • VICE VERSA IS ALSO TRUE.

  • IF YOU'RE TAKING IN A LOT OF CALCIUM,

  • THEN YOUR ABSORPTION RATE MIGHT DECREASE.

  • BUT YOU'RE ALSO GONNA TAKE THAT CALCIUM AND PUT IT INTO

  • THE BONE CREATING MORE BONE, STRONGER BONE,

  • EVEN IN YOUR LATER YEARS.

  • NOW, ONE IMPORTANT FACTOR IS THAT YOU CAN'T CATCH UP.

  • YOU'RE ALWAYS GONNA BE ON A DECLINE,

  • BUT YOU CAN SLOW THE DECLINATION,

  • THE DECREASE OF BONE MINERAL LOSS.

  • SO YOU'RE NOT GONNA BE BUILDING UP BONE

  • AFTER AGE 50 OR EVEN AFTER AGE 30,

  • BUT YOU CAN SLOW THAT PROGRESSIVE LOSS THAT IS

  • INEVITABLE BY CONSUMING ADEQUATE AMOUNTS OF CALCIUM AND VITAMIN

  • D. REMEMBER VITAMIN D INCREASES THE ABSORPTION OF CALCIUM.

  • ADEQUATE AMOUNTS OF PROTEIN, NOT TOO MUCH,

  • AND LIMITING THE AMOUNT OF SODIUM 'CAUSE TOO MUCH

  • SODIUM HAS BEEN ASSOCIATED WITH LOSSES OF CALCIUM.

  • SMOKING, USING TOBACCO,

  • DEFINITELY ASSOCIATED WITH AN INCREASED RISK OF OSTEOPOROSIS,

  • AS WELL AS EXCESSIVE ALCOHOL USE.

  • NOW, WHEN YOU THINK ABOUT YOUR RISK OF OSTEOPOROSIS,

  • THINK ABOUT, DID YOU ACHIEVE PEAK BONE MASS?

  • THAT'S PROBABLY THE SINGLE MOST IMPORTANT RISK.

  • AND THEN WHAT ARE YOU DOING TODAY?

  • AND WHAT TYPE OF CHANGES CAN YOU MAKE TO HELP REDUCE YOUR RISK?

  • ARE YOU GETTING ENOUGH CALCIUM?

  • ARE YOU GETTING ENOUGH VITAMIN D?

  • DO YOU HAVE A SEDENTARY LIFESTYLE?

  • COULD YOU EXERCISE MORE?

  • ARE YOU GETTING ENOUGH FRUITS AND VEGETABLES IN YOUR DIET?

  • CAN YOU LIMIT YOUR SMOKING?

  • AND THEN HAVE MODERATE ALCOHOL INTAKE.

  • I WANT TO TALK A LITTLE BIT ABOUT A CONTROVERSY OF

  • CALCIUM SUPPLEMENTATION BECAUSE THE U.S. PREVENTATIVE TASK FORCE

  • ACTUALLY DOESN'T RECOMMEND CALCIUM SUPPLEMENTATION

  • UNLESS SOMEONE IS AT RISK FOR OSTEOPOROSIS OR HAS OSTEOPENIA.

  • NOW, THIS IS BASED ON RESEARCH THAT INDIVIDUALS

  • WHO HAVE TAKEN CALCIUM, WITH OR WITHOUT VITAMIN D,

  • ENDED UP WITH A GREATER RISK OF HEART DISEASE.

  • SO-- AND THIS INTERESTING.

  • I MEAN, HERE WE'RE DOING A GOOD JOB PROTECTING OUR BONES,

  • BUT NOW I END UP DEVELOPING HEART DISEASE.

  • AND SO THIS IS RESEARCH THAT CAME OUT IN 2011.

  • THERE HAVE BEEN SOME OTHER STUDIES.

  • SOME HAVE SUPPORTED THIS.

  • SOME HAVE NOT.