Week 8 - Bone Health, Osteoporosis

Question 1

What % of Americans >65 yo have osteoporosis?

What % of women >80 yo have osteoporosis?

Answer 1

16% everyone over 65 yo

35% women over 80 yo

Question 2

Where are osteoprotic Fx most common?

Answer 2

Femur neck

Lumbar spine

Question 3

What is a normal T-score?
Low bone density?
Osteoporosis?

Answer 3

> -1 to +4 is normal
-2.5 to -1 is low bone density / osteopenia
< -2.5 to -4 is osteoporosis

Question 4

Absolute risk vs relative risk

Answer 4

Let’s say women have a 2 in 20 risk of developing Disease X by the time they’re 60. Then, research shows that a new treatment reduces the relative risk of getting this disease by 50%. The 50% is the relative risk reduction, and is referring to the effect on the 2. 50% of 2 is 1.

So, this means that the ABSOLUTE risk is reduced from 2 in 20 (10%), to 1 in 20 (5%). Absolute risk reduction expressed as a percentage is 5%. (10-5 = 5).

50% reduction [relative] risk sounds better than 5% reduction [absolute] risk

Question 5

___ in 5 people with hip Fx enter a nursing home within a year

Answer 5

1

Question 6

Medication that increase Fx risk (8)

Answer 6

Glucocorticoids
Cancer treatment
Thyroid meds
Antiepileptic meds
Gonadal hormone suppression
Immunosuppressive agents
PPIs (e.g. GERD meds)
SSRI antidepressants

Question 7

How to maintain bone density?

Answer 7

Calcium and vitamin D
Whole Foods diet
Weight-bearing exercise
Avoid smoking
Avoid excessive alcohol

Question 8

Plant-based sources of calcium

Answer 8

Dark leafy greens
Tofu, navy, pinto beans
Blackstrap molasses
Corn tortillas
Figs
Almonds

Question 9

Animal-based sources of calcium

Answer 9

Milk
Yogurt
Cheese
Bones of fish and other animals

Question 10

Can you take calcium citrate on empty stomach?

Answer 10

Yes.

Does not require extra stomach acid for absorption; hence can take it anytime in a day, even on an empty stomach.

Question 11

What condition do you not want to use Calcium citrate?

Answer 11

Acid reflux

Question 12

What vitamin D source lasts longer: sunlight or supplementation?

Answer 12

Sunlight

“Endogenous Vitamin D (produced in the skin on exposure to sunlight) lasts at least two to three times longer in the circulation vs. supplement as source.”

Question 13

> 20-30 ng/mL is adequate serum vitamin D

Answer 13

Broad mainstream agreement, so yes.

Ph 117-122 of Nutritional Medicine, 2nd Edition for Dr. Gaby’s writing on supplementation and testing.