Issue Date: April 29, 2007
You can prevent osteoporosis
Taking vitamin D along with calcium keeps bones strong.
If I were to ask what's the best way of keeping your bones healthy, what would you say? You've probably heard about the role that calcium plays, but did you know that vitamin D is just as crucial?
It's not inevitable that we will end up with brittle bones.
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People who lose bone mass at an accelerated rate eventually may develop osteoporosis, a medical condition characterized by weak bones that break easily. Folks with this condition suffer not only from the pain of fractures but also from deformities that accompany a weakened skeletal frame. We've all seen elderly men and women who are stooped over so much that they can't straighten up. This represents the disease in its worst form. And really, the time to address osteoporosis is long before it gets to that stage.
Although aging is a risk factor for developing osteoporosis, it's not inevitable that we will end up with brittle bones. Let's explore two simple but effective supplement strategies that can put the odds in our favor:
Calcium. Any program to prevent osteoporosis must include adequate amounts of calcium because it's a basic component of bone. We may think of bones as stable structures, but in fact they are quite active. The two primary types of bone cells, osteoblasts and osteoclasts, work in opposition to one another. Osteoblasts build new bone, while osteoclasts tear it down through resorption. When we're under age 30 or so, bone-building osteoblastic activity rules, so bones get stronger. But as we get older, the balance of activity in our bones shifts toward the resorbing osteoclasts, making bones thinner and weaker. For some people this shift is accelerated, and the long, slow road to osteoporosis begins.
A diet that doesn't have adequate amounts of calcium contributes to the bone thinning. Recommendations have changed over time, but here's a good rule of thumb for adults: 1,000mg a day for those under 50 and 1,200mg a day for those over 50. Of course, this is for prevention, not treatment, of osteoporosis. People who already show evidence of thinning bones will require more.
Vitamin D. Until recently, vitamin D didn't receive the attention that it deserves for the role it plays in maintaining strong bones. We now know that without adequate amounts of vitamin D, our body's capacity to retain calcium is compromised. The good news is that vitamin D is manufactured by the body when our skin is exposed to sunlight. The National Osteoporosis Foundation says that when the hands, arms and face are exposed to sunlight for as little as 10 to 15 minutes two to three times a week, that's enough to do the trick. But this can be a problem for those who can't tolerate sunlight and those who live in climates where such exposure may not be feasible. And we doctors always have to exercise caution when recommending sunlight exposure be-cause of the significant risk it poses for the development of skin cancer.
For these reasons, adults are recommended to take vitamin D supplement in doses ranging from 400 to 800 IU per day. Your doctor can help determine the right dose for you.
Osteoporosis is becoming increasingly common in our aging population. Preventing the disease requires attention at as early an age as possible. Although medications available today have significantly improved our capacity to treat the problem, we still need to do everything we possibly can to prevent it from happening in the first place. A supplement regimen containing adequate amounts of both calcium and vitamin D is a good place to start.
Contributing editor Tedd Mitchell, M.D., is president and medical director of the renowned Cooper Clinic in Dallas. He writes HealthSmart every week.
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Allergies and asthma: How to breathe easily while on vacation
Planning a vacation? Don't let allergies or asthma spoil your fun. "For a safe and healthy trip, be prepared before you leave home," says Clifford W. Bassett, M.D., a vice chair of the American Academy of Allergy, Asthma and Immunology. Here, his tips:
Packing
Road trip? Go off hours to avoid air pollution.
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Got your gear? Pack all medications in original containers, in your carry-on bag. If you're asthmatic, don't forget your peak flow meter and nebulizer or "rescue" bronchodilator inhaler.
Flying? Get a letter from your doctor that explains your prescriptions, especially liquids. If you use an epinephrine auto-injector, then bring a paper prescription to help explain what it is.
Dust-mite sensitive? Take your own bedsheets.
By land
Need an allergy-friendly car? Close the windows and run the air conditioning in the "do not recirculate" mode. When renting a vehicle, ask for one that's smoke-free.
City driving? Travel during non-peak hours to avoid pollution. Also, plug in your portable nebulizer.
By air
Use supplemental oxygen? You may need it at normal cruising altitudes if you have severe chronic respiratory disease. Discuss your needs with the airline.
Food allergies? Airline food comes from a vendor, so flight staff may miss some information about ingredients. Ask in advance.
Pet allergies? Reserve a ticket on a pet-free plane. Always carry an antihistamine and meds.
Nasal allergies? Moisturize with a saline spray.
By sea
Allergies? Request an allergy-friendly cabin, which may have options such as wood or linoleum floors, blinds instead of heavy draperies, and leather furnishings in lieu of upholstered ones.
Severe allergies or asthma? Know the medical qualifications of cruise ship personnel and the availability of health care on board.
Eczema? Use a medicated ointment to minimize aggravation caused by water and sun.
-- Susan T. Lennon
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