Employee Health Series

1. Employee Health Series Bone Health & Osteoporosis

2. Course Information Course Editor: Lynne Presley, Oklahoma Correctional Training Academy- Norman. Data Sources: Bone Health and Osteoporosis: A Report of the Surgeon General, Richard Carmona, M.D., M.P.H., FACS, Surgeon General, U.S. Dept. of Health & Human Services, October 14, 2004. Bone Health, Centers for Disease Control and Prevention, U.S. Dept. of Health & Human Services, May 22, 2007. Mike Jackson, M.D., Chief Medical Officer, Oklahoma Dept. of Corrections Deardi Wabaunsee, R.N., Nurse-Manager of Medical Services, Oklahoma Dept. of Corrections Course Released: July 1, 2008 Course Credit: 30 minutes Oracle Course # SAFI08027

3. Course Objectives At the conclusion of this course, students will be able to: • Understand the roles bones play in the body • Define the term "peak bone mass" • Recognize that osteoporosis leads to low bone mass and deterioration of bone tissue • Name the risk factors for osteoporosis • Understand the role that diet and exercise play in preventing osteoporosis

4. Introduction A healthy skeletal system with strong bones is essential to overall health and quality of life. However, many Americans suffer from bone disease and fractures, much of which could be prevented.

5. Statistics from the Surgeon General • An estimated 10 million Americans over age 50 have osteoporosis (bone disease) • 34 million Americans are at risk for osteoporosis • An estimated 1.5 million people each year suffer an osteoporosis-related fracture • 20% of senior citizens who suffer a hip fracture die within one year • One out of every two women over 50 will have an osteoporosis- related fracture in their lifetime • Due primarily to the aging of the population and the previous lack of focus on bone health, the number of hip fractures in the U.S. could double or even triple by the year 2020.

6. Statistics from the Surgeon General Hope is not lost. Over the past several decades, scientists have learned a significant amount about the prevention, diagnosis, and treatment of bone disease. Our next and most critical step is to transfer this knowledge from the research laboratories to the general population.

7. Bone Health Bones play many roles in the body. They provide structure, protect organs, anchor muscles, and store calcium. Adequate calcium consumption and weight-bearing physical activity build strong bones, optimizes bone mass, and may reduce the risk of osteoporosis later in life.

8. For many women, the risk of osteoporosis occurs around the time of menopause. Bone Health Peak Bone Mass Peak bone mass refers to the genetic potential for bone density. By the age of 20, the average woman has acquired most of her skeletal mass. A large decline in bone mass occurs in older adults, increasing the risk of osteoporosis.

9. Bone Health Peak Bone Mass It is important for children, particularly girls, to reach their peak bone mass in order to maintain bone health throughout life. A person with high bone mass as a young adult will be more likely to have a higher bone mass later in life. Inadequate calcium consumption and lack of physical activity early on could result in a failure to achieve peak bone mass in adulthood. Graph courtesy of U.S. Surgeon General, 2000.

10. Bone Health Osteoporosis Osteoporosis or "porous bone" is a disease of the skeletal system characterized by low bone mass and deterioration of bone tissue. Osteoporosis leads to an increased risk of bone fractures typically in the wrist, hip and spine. Illustration courtesy of Centers for Disease Control

11. Bone Health • Osteoporosis Risk Factors • While men and women of all ages and ethnicities can develop osteoporosis, some of the risk factors include those who are: • Female • White/Caucasian • Post-menopausal women • Older adults • Small in body size • Eating a diet low in calcium • Physically inactive

12. Bone Health • Calcium • Calcium is a mineral needed by the body for healthy bones, teeth, and proper function of the heart, muscles, and nerves. The body cannot produce calcium; therefore, it must be absorbed through food. Good sources of calcium include: • Dairy products – low fat or nonfat milk, cheese and yogurt • Dark green leafy vegetables – bok choy and broccoli • Calcium-fortified foods – orange juice, cereal, bread, soy beverages, and tofu products • Nuts - almonds

13. Bone Health Calcium The recommended amount of calcium varies for individuals. Below is a table of adequate intakes as outlined by the National Academy of Science:

14. Bone Health • Weight-Bearing Physical Activity • Like proper calcium consumption, adequate weight-bearing physical activity early in life is important in reaching peak bone mass. Some examples of weight-bearing activities include: • Walking, jogging, hiking, and running • Tennis, racquetball, basketball, and soccer • Stair climbing • Jumping rope • Dancing • Weight-lifting

15. Bone Health Weight-Bearing Physical Activity Incorporating weight-bearing physical activity into an exercise plan is a great way to keep bones healthy and meet physical activity recommendations set forth in the Dietary Guidelines for Americans.

16. Bone Health Weight-Bearing Physical Activity ADULTS Should engage in at least 30 minutes of moderate physical activity on most, preferably all, days of the week.

17. Bone Health Weight-Bearing Physical Activity CHILDREN Should engage in at least 60 minutes of moderate physical activity on most, preferably all, days of the week.

18. Medical Options So, is there something else you can do, besides diet and exercise, to help prevent and treat osteoporosis? Absolutely! Your health services professional may recommend that you undergo a bone density test, particularly if you're a member of a group that has a high risk of osteoporosis. Patient undergoing a bone density test.

19. Medical Options How does the test work? A bone density test uses special X-rays to measure how many grams of calcium and other bone minerals - collectively known as bone mineral content - are packed into a segment of bone. The higher your mineral content, the denser your bones. And the denser your bones, the stronger they generally are and the less likely they are to break. Doctors use a bone density test to determine if you have, or are at risk of, osteoporosis.

20. Medical Options • Medications are also available that can help stabilize and restore bone density, and decrease the risk of fractures. • There are two types of drugs used to treat osteoporosis: • Antiresorptive Drugs: These drugs block resorption (bone break down) and slow the rate of bone remodeling, but they cannot rebuild bone. • Anabolic, or Bone-Forming, Drugs: These drugs rebuild bone.

21. “Self-Test” Course Review

22. Course Review: Question 1 1. Bones . . . • Provide body structure • Protect organs • Store calcium • All of the above Click here for correct answer Answer: D. Click here for next question

23. Course Review: Question 2 2. For many women, the risk of osteoporosis occurs around the time of • Puberty • Childbirth • Menopause Click here for correct answer Answer: C. Click here for next question

24. Course Review: Question 3 3. Osteoporosis is a disease of the • Endocrine system • Skeletal system • Lungs Click here for correct answer Answer: B. Click here for next question

25. Course Review: Question 4 4. Men are more likely than women to suffer from osteoporosis. • True • False Click here for correct answer Answer: B. Click here for next question

26. Course Review: Question 5 5. The human body produces calcium when it is exposed to sunlight. • True • False Click here for correct answer Answer: B. Click here for next question

27. Course Review: Question 6 6. Which age group requires the highest level of calcium each day? • Birth – 6 months old • 9 – 18 years old • 19 – 50 years old Click here for correct answer Answer: B. Click here for next question

28. Course Review: Question 7 7. Stair-climbing is a weight-bearing exercise. • True • False Click here for correct answer Answer: A. Click here for next question

29. Conclusion According to the Surgeon General of the United States, individuals can significantly reduce their risk of bone disease and fractures by following the nutrition and exercise guidelines outlined in this course. Want to Learn More? Take the online "Osteoporosis Diet Quiz" to see how much you know about the care and feeding of your skeleton! http://www.healthcentral.com/osteoporosis/quizzes-254100.html?ic=4004