Nursing News

A Word for the Skeleton


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By Mary Ratcliff, RN, contributor

How many of us hear family or friends saying, “I need to work out more.” Or perhaps it is we whom others hear procrastinating; “I would take a walk, but it’s too hot.”

Well, the National Osteoporosis Foundation has taken steps to do away with our excuses, developing a Virtual Fitness Day. Each year, the World Osteoporosis Foundation, of which nations across the globe are members, selects a theme that the member nations can build upon to raise awareness of the debilitating disease that affects an estimated 44 million Americans. This year’s theme, “Strong bones for Healthy Living,” focuses on the role of exercise and physical fitness in bone health.

The National Osteoporosis Foundation has developed its theme to encourage individuals to “Stand Tall Against Osteoporosis” by participating in weight-bearing exercises. This is any exercise in which your feet and legs are bearing your weight.

Year round, nurse practitioner Susan Randall, of the National Osteoporosis Foundation in Washington, D.C., fields questions and supplies information to health care providers regarding risk factors and the latest in treatment modalities.  A voluntary non-profit organization, the NOF faces a major challenge; each year in the United States, 1.5 million fractures are attributed to osteoporosis.

Generally associated with aging, awareness of certain risk factors can play a part in reducing one’s predisposition to the disease. They are gender, age, family history, ethnicity, body size and lifestyle.

To keep the focus on a healthy lifestyle as health care providers we have to help patients become “bone wise.” Since women now live 30-40 years past menopause they need to, at the very least, learn to minimize the effects of menopause on the skeleton.

Nurse educators must understand, and communicate to their patients, that our bone mass peaks between the ages of 18-30. After that, more bone is destroyed than formed. For women, the balance between the rate of resorption, or destruction of bone, and new bone formation, (tissue remodeling), depends upon how much estrogen she has. When a woman completely ceases menstruation, 90 percent of her circulating estrogen is gone.

In the 5-10 years after menopause, nearly 20% of a woman’s bone mass

Men, generally, are less often afflicted with osteoporosis.  They have larger bones and the process of bone loss begins later and advances more slowly in men than in women.

The National Osteoporosis Foundation estimates that two million American men have the disease and 3 million more are at risk. Men suffer one-third of all hip fractures and one-third of those will die within a year. Death comes, not from the fractures, but complications such as pneumonia and embolic events.

As with women, treatment for men is rushing forward. Tailoring treatment to each situation, dietary and lifestyle changes plus exercise place men on the same pathway as women. Their treatment would likely include testosterone levels and replacement if necessary.

In addition to weight-bearing exercises, calcium and Vitamin D intake are high in importance. Calcium makes bones strong and Vitamin D helps the body absorb calcium. The suggested daily requirements for calcium for ages 19-50 is 1,000 mg. For those above 50, they should consume 1200 mg daily.

For those 50 and under, 400 iu of Vitamin D is the recommended dose. The dose is doubled for those over 50. Obviously, patients should be encouraged to supplement their calcium/Vitamin D intake with dairy products. Some fruits, grains and fish are also good sources. Since calcium is vital to our heart, blood clotting, muscle and nerve function, a low level equals trouble for the bones. It will be removed from them to assist in the vital life functions.

Interested participants in the Virtual Fitness Day can register online at the NOF website. For a $20 fee the participant receives a 2005 NOF Virtual Fitness t shirt along with information on steps one can take to keep healthy bones in their family for a lifetime. After performing their favorite weight bearing activity, be it running, walking, biking, etc., participants are asked to post their activity on www.nof.org. Personal information is optional.

The NOF suggests gathering with friends or family for a group activity. Those participating will be strengthening their own bones and contributing to the research and education efforts of the National Osteoporosis Foundation. 

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