Tori Hudson, N.D. See book keywords and concepts | Although most studies do not show a positive effect of calcium in reducing fracture risk, in the Women's Health Initiative (WHI) trial, hip fractures were significantly reduced in older women on the calcium supplement program.65 Calcium supplementation has also been shown to decrease bone loss in postmenopausal women.66 The effects of calcium supplementation have been greatest in women whose baseline calcium intake was low, in older women, and in women with osteoporosis. | Ann M. Coulston and Carol J. Boushey See book keywords and concepts | Both forearm and hip fractures result directly from a fall. Whether an individual fractures the arm or the hip reflects the manner of falling. Younger women with normal locomotion generally fall while walking and break a fall by arm extension. Older and more frail women often fall while transferring from a seated to a standing position. If they fail to elevate their centers of gravity sufficiently to support an upright posture, they fall backwards or to the side, directly impacting the
B: OSTEOPOROTIC TRABECULAR BONE
FIGURE 1 (A) Normal trabecular bone. | J. Douglas Bremner See book keywords and concepts | The only studies that showed that calcium and vitamin D prevented hip fractures involved French women who had osteoporosis and were living in nursing homes.17 However, these women may have had a calcium and/or vitamin D deficiency due to diet or lack of sunlight as a result of their environment.
Other studies of individuals outside nursing homes found that vitamin D and calcium supplementation had no beneficial effects in terms of hip-fracture prevention. | | In summary, for postmenopausal women with osteoporosis there is no evidence that up to three years of treatment with bisphosphonates affects what we are most concerned about, hip fractures, since that is what can lead to lasting disability. The only studies that did show such protection were in women who had extreme levels of bone mineral density loss, far beyond osteoporosis, or a past history of fracture. Therefore, treating women with risk factors for hip fracture is not useful.
And what about the side effects? | | Alendronate Phase II, FIT (without past fracture), FOSIT, and VERT showed no benefit for the more important hip fractures, which, as I mentioned before, can lead to lasting disability. There were marginally statistically significant reductions in nonvertebral fractures in the FOSIT study (nineteen vs. thirty-seven after one year) and VERT (5% vs. 8% after three years). | | In the elderly, 25% of hip fractures lead to a permanent loss of independent function. No wonder many seniors, especially frail ones, live in mortal fear of fractures that may send them to oft-dreaded nursing homes for the rest of their few remaining days (although my neighbor lived out her long life at home).
Bone Density
Bone density, that is, the thickness of your bones, is determined by a bone-mineral density (BMD) test. | | The only studies that showed that calcium and vitamin D prevented hip fractures involved French women who had osteoporosis and were living in nursing homes.9 However, it is unclear whether these women had calcium and/or vitamin D deficiency due to their nursing-home diet or lack of sunlight from their environment. Other studies of individuals outside nursing homes found no beneficial effects from vitamin D and calcium supplementation in terms of hip-fracture prevention. | Bottom Line Health See book keywords and concepts | | The difference in hip fractures is probably due to a difference in anatomy, which makes the hip less likely to break on impact.
Other evidence suggests that isoflavones do promote bone strength. The US Department of Agriculture (USDA) and the National Institutes of Health (NIH) are currently allotting significant resources—approximately $10 million—for studies to determine whether isoflavones play a role in bone health.
•Breast cancer. Asian studies indicate that women who eat soy foods three or more times weekly have a reduced risk of breast cancer. | Ann M. Coulston and Carol J. Boushey See book keywords and concepts | A hypothesis: The causes of hip fractures. J. Gerontol. 44, M107-M111.
6. Schwartz, A. V., Capezuti, E., and Grisso, J. A. (2001). In "Osteoporosis" (R. Marcus, D. Feldman, and J. Kelsey, Eds.), 2nd ed., pp. 795-807. Academic Press, San Diego, CA.
7. Lee, C. A., and Einhorn, T. A. (2001). The bone organ system, form and function. In "Osteoporosis" (R. Marcus, D. Feldman, and J. Kelsey, Eds.), 2nd ed., pp. 3-20. Academic Press, San Diego, CA.
8. Brown, E. M. (1994). Homeostatic mechanisms regulating extracellular and intracellular calcium metabolism. In "The Parathyroids" (J. P. | J. Douglas Bremner See book keywords and concepts | It is clear from the studies that the people who get hip fractures are those who become frail and inactive and thus more likely to fall. In fact, osteoporotic fractures of the hip are inversely related to exercise. Furthermore, although bone thinning contributes to the risk of fracture, the risk is primarily related to a loss of balance, which often results in falls. Exercise helps elders maintain their balance. In fact, there is no difference in bone density between those with and without fractures.
The best exercise for increasing bone mass is strength training. | Ann M. Coulston and Carol J. Boushey See book keywords and concepts | Most trials included nonvertebral or- hip fractures as an outcome, although some trials assessed vertebral fractures. In a meta-analysis of the trials [71], which numbered almost 10,000 women, there was a 23% reduction in nonvertebral fractures. When the daily vitamin D dose was only 10 pg (400 IU), there was no reduction in fracture risk. This finding is not unexpected because that low amount of vitamin D3 would result in only a small rise in serum 25(OH)D, approximately 7 to 10 nmol/ liter [65], and the subjects receiving this might not have 25(OH)D levels above 50 nmol/liter. | Elaine Magee See book keywords and concepts | Well, they had 29 percent fewer hip fractures than those who'd not followed precise instructions.
There could be a calcium-vitamin D cancer connection. Keep in mind that short-term studies are simply not long enough to see definitive effects on cancer incidence. Cancer is a disease that typically develops over 10 to 20 years. From this trial, though, certain interesting results were noted. The women who started the study with low blood levels of vitamin D developed colorectal cancer twice as often as those with the highest levels. | Ann M. Coulston and Carol J. Boushey See book keywords and concepts | Vitamin D3 and calcium to prevent hip fractures in the elderly women. N. Engl. J. Med. 327, 1637-1642.
25. NIH Consensus Conference. (1994). Optimal calcium intake. JAMA 272, 1942-1948.
26. Food and Nutrition Board, Institute of Medicine. (1997). "Dietary Reference Intakes for Calcium, Magnesium, Phosphorus, Vitamin D, and Fluoride." National Academies Press, Washington, DC.
27. "Recommended Dietary Allowances," 10th ed. (1989). National Academies Press, Washington, DC
28. Matkovic, V., and Heaney, R. P. (2002). Calcium balance during human growth. Evidence for threshold behavior. Am. J. | | Bone density at various sites for prediction of hip fractures. The Study of Osteoporotic Fractures Research Group. Lancet 341(8837), 72-75.
59. Johnell, O., Kanis, J. A., Oden, A., Johansson, H., De Laet, C, Delmas, P., Eisman, J. A., Fujiwara, S., Kroger, H.,
Mellstrom, D., Meunier, P. J., Melton, L. J. 3rd, O'Neill, T., Pols, H., Reeve, J., Silman, A., and Tenenhouse, A. (2005). Predictive value of BMD for hip and other fractures. /. Bone Miner. Res. 20, 1185-1194.
60. Faulkner, K. G. (2003). Improving femoral bone density measurements. J. Clin. Densitom. 6, 353-358.
61. Kanis, J. A. | Dan Buettner See book keywords and concepts | Nicoyan water has the country's highest calcium content, perhaps explaining the lower rates of heart disease, as well as stronger bones and fewer hip fractures.
Keep a focus on family.
Nicoyan centenarians tend to live with their families, and children or grandchildren provide support and sense of purpose and belonging.
Eat a light dinner.
Eating fewer calories appears to be one of the surest ways to add years to your life. Nicoyans eat a light dinner early in the evening.
Maintain social networks.
Nicoyan centenarians get frequent visits from neighbors. | | Lastly, loss of bone strength can also make older people more susceptible to hip fractures, which is one of the leading causes of death for older people. Adequate levels of calcium might explain why Nicoyans are avoiding risks that kill other populations. "But (there was always a "but" with the ever-cautious Gianni) before we can say for sure that Nicoya's water is part of the explanation of its longevity, we must do more tests."
SAFETY NETS
One night toward the end of the expedition, it was my turn to stand up after dinner and present a report to the team. | Andreas Moritz See book keywords and concepts | In humans, fluoride has been found to cause arthritis, osteoporosis, hip fractures, cancer, infertility, Alzheimer's disease, and brain damage.
Until the 1950s, European doctors used fluoride to treat hyperthyroidism (overactive thyroid). The daily dose of fluoride that people are now receiving in fluoridated communities far exceeds the dose of fluoride that was found to depress the thyroid gland. Because of fluoridation, millions of people are now suffering from hypothyroidism (underactive thyroid). This condition is currently one of the more common medical problems in the United States. | | This may lead to bone and hip fractures and even death. With more than half of all women over age 50 already affected by osteoporosis (albeit only in industrialized nations), it is obvious that the current approach of taking hormones or calcium supplements is a shot in the dark; it in no way addresses the imbalance in the liver and gallbladder caused by reduced bile output due to gallstones.
Rickets and osteomalacia are diseases that affect the calcification process of bones. In either case, the bones become soft, especially those of the lower limbs, which are bowed by the weight of the body. | James Dowd and Diane Stafford See book keywords and concepts | A recent review of research looking at vitamin D treatment for osteoporosis published in the Journal of the American Medical Association showed an average 26 percent reduction in hip fractures and a 23 percent reduction in all nonspine fractures. This magnitude of protection exceeds the benefits seen with some medications currently approved by the FDA for the prevention and treatment of osteoporosis.
These benefits were seen only in studies using 800 IU per day or more of vitamin D. Studies that looked at lower doses showed no decrease in fracture rates. | T. Colin Campbell, Ph.D. and Thomas M. Campbell II See book keywords and concepts | A recent study showed that American women aged fifty and older have one of the highest rates of hip fractures in the world.1 The only countries with higher rates are in Europe and in the south Pacific (Australia and New Zealand)1 where they consume even more milk than the United States. What's going on?
An excess rate of hip fractures is often used as a reliable indicator of osteoporosis, a bone disease that especially affects women after menopause. It is often claimed to be due to an inadequate intake of calcium. Therefore, health policy people often recommend higher calcium consumption. | Ann M. Coulston and Carol J. Boushey See book keywords and concepts | The potential health implications are grave and include vertebral fractures, kyphosis, hip fractures, and Colles' fracture of the lower radius in the arm [14]. These problems can begin in childhood, when radiographs may reveal delayed bone age, rickets, or osteomalacia, which left untreated may lead to osteoporosis. It is believed that early interventional therapy with a gluten-free diet may prevent progression and may even reverse bone loss [15]. | Ray D. Strand See book keywords and concepts | A study reported in the January 2, 2002, issue of the Journal of the American Medical Association indicates that vitamin A can be harmful for normal bone function, leading to an increase in hip fractures.
Women must avoid vitamin A supplementation during pregnancy. Dosages as low as 5,000-10,000 IU are believed to have caused birth defects.10
I never recommend taking straight vitamin A in supplements. We can meet the need for vitamin A within the body by simply taking beta-carotene and the mixed carotenoids. | Phyllis A. Balch, CNC See book keywords and concepts | An estimated 80 percent of the 250,000 hip fractures that occur in the United States every year are due to osteoporosis.
With a proper diet, nutritional supplements, and exercise, most of the unpleasant side effects of menopause can be minimized, if not eliminated.
The dosages given below are for adults.
NUTRIENTS supplement suggested dosage comments
Very Important Beta-1,3-D-glucan As directed on label.
Boosts bone marrow production and acts as a powerful stimulant for the immune system.
Cerasomal-cis-9-cetylmyristoleate
As directed on label. | Joseph E. Mario See book keywords and concepts | Vitamin D also lessens rheumatoid arthritis, osteoporosis, hip fractures, multiple sclerosis, psoriasis, breast cancers (in areas of low solar radiation); intestinal, colon and rectal cancers; prostate cancers, and increases Lymphocytes against Candida. Full-spectrum lights on rodents slowed tumor development. Moderate ultraviolet light stimulates metabolism; the short ultraviolet rays are germicidal; improve Immunity, trigger an anti-cancer Enzyme; stimulate Vitamin D formation, saliva, and improve Calcium and Phosphorus metabolism. | Phyllis A. Balch, CNC See book keywords and concepts | Hip fractures are by far the most troublesome fractures for older adults, and, unfortunately, many cannot live an independent life after a hip fracture.
A broken bone calls for prompt professional help. After a bone has been set, the following supplements and other recommendations will aid in healing. Unless otherwise specified, the dosages recommended here are for adults.
For a child between the ages of twelve and seventeen, reduce the dose to three-quarters the recommended amount. | Earl L. Mindell, RPh, PhD with Virginia Hopkins, MA See book keywords and concepts | | A very large study, published in the New England Journal of Medicine in 1995, studied risk factors for hip fractures in white women. After following over 9,500 women for eight years, researchers found no benefit in estrogen supplementation in women over the age of 65.
In the NEJM study, risk factors for hip fractures included:
• Being tall (they fall farther).
• Poor overall health.
• Previous hyperthyroidism (high thyroid, which would make them thin, with less bone). | Phyllis A. Balch, CNC See book keywords and concepts | Research conducted by the World Health Organization concluded that people who were given a protein supplement recovered more quickly from hip fractures than those who were not. In addition, they found that people who took protein supplements were less likely to suffer a hip fracture in the first place.
Q A study reported in the March 2000 issue of The Journal of Family Practice found that taking vitamin C can help to prevent nerve pain after a fracture.
Q Tests for bone loss are very easy and noninvasive. | Ray Moynihan and Alan Cassels See book keywords and concepts | Preventing hip fractures among the elderly becomes a narrow obsession with the bone density numbers of healthy middle-aged women. Personal distress is seen as being due largely to a chemical imbalance of serotonin in the brain, an explanation as narrow as it is outdated.
Like most everything else that happens in health care today, our ideas about sickness are being shaped in the long shadows cast by the global drug giants. Yet the narrowing of the focus is making it harder for us to see the bigger picture about health and disease, sometimes at great cost to the individual, and the community. | Russell L. Blaylock, M.D. See book keywords and concepts | It has been estimated that as many as 20 percent of hip fractures in the elderly are fatal, and that over 50 percent of survivors never leave the nursing home. Obviously, we should both respect the impact and dread the onset of osteoporosis.
Normally, bone mass peaks around age thirty and gradually falls thereafter. The rate of bone loss, especially in some women, is much faster after estrogen levels begin to decline.
Women who have had their ovaries removed before menopause often develop osteoporosis early. Hormone replacement has been shown to reduce the incidence of osteoporosis. | | To date we have over eight studies reported in peer-reviewed medical journals demonstrating increased hip fractures with fluoridation. Most studies have shown that fluoride treatments do increase the density of the axial skeleton (the spine) but clinical studies have not shown a significant reduction in spinal fractures in the elderly.
In one review of all articles reporting on the use of fluoride to treat postmenopausal osteoporosis, Dr. |
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