woman is smaller than the average man. Therefore, women start out in life with less bone mass than men. As we age, the rate of bone loss occurs about equally between men and women. However, if you start with less, you end with less. (This is the “money in the bank” metaphor at work again. For example, if person A starts out in life with more money in the bank than person B, and both person A and person B withdraw the same amount of money each year, the one who started with more (person A), ends with more.) The statistics bear this out, since wrist and hip fracture rates are known to be higher in woman over age fifty than men over age fifty. The osteoporosis- related fracture ratio of women to men is 3:1. In my practice, between 2012 and 2017, I operated on hip fractures in women compared to men at the rate of 3 ½ :1, which is consistent with this statistical ratio. Further, in the past five years, I have treated wrist fractures in women compared to men (over age 50) at a ratio of almost 5:1. Calcium in foods is not concentrated as they are in supplements, so they are absorbed into the bloodstream more slowly and gradually. Therefore, it is beneficial to get calcium more naturally from foods. While milk and cheese products contain calcium, so do other foods that contain less toxins and certainly less saturated fats. For example, almond milk supplies more calcium per 8 oz. glass than cow’s milk. Below is a list that compares (from higher to lower) the approximate calcium content of some foods to that of milk and a slice of cheddar cheese.
bear on that injured extremity, usually for many weeks until their bone heals. Within a few weeks of non-weightbearing, the patient’s x-rays can show findings of disuse osteoporosis . Disuse osteoporosis has the x-ray appearance of “washed out” or faded looking bone. (This finding is also seen on x-rays of paraplegic and quadriplegic patients who cannot weight bear permanently.) When the fracture heals, and the patient is allowed to resume normal weight-bearing activities, the bone begins to reincorporate calcium and minerals. The bone then naturally strengthens, and the x-rays eventually show resolution of disuse osteoporosis. NASA physicians caring for the astronauts in the early era of spaceflight missions had diagnosed disuse osteoporosis. Even astronauts, this elite group of physically fit human beings, were found to be susceptible to disuse osteoporosis when they returned to earth from zero-gravity space. The problem was time-dependent, meaning that the longer the time spent in zero-gravity, the worse the disuse osteoporosis condition became. NASA scientists have since learned how to avoid, or at least modify this condition. In more recent space missions, you may have noticed video feeds of astronauts from the ISS (International Space Station). The videos show footage of them floating in the ISS compartments rather than sitting. These astronauts might be seen pushing off the walls, mimicking push- ups, or performing other acrobat-like activities such as “floating” somersaults. This looks like fun, but NASA scientists had learned from experience about the importance of movement and activity for bone health, even when gravity is “out of the picture.” Our earthbound routine of daily activities (such as walking, climbing stairs, or carrying and lifting objects) are usually sufficient to fend off disuse osteoporosis. These daily activities of using and moving our arms and legs against gravity often supply enough bone resistance forces to avoid disuse osteoporosis. The important point about activity recommendations is to be consistently active. That means that is best to try to be active frequently during the day, and every day. But staying active does not mean one has to do the weight-lifting equivalent of curling 100 lb. barbells or running a marathon. It simply means that choosing activity over being sedentary is important. Observational, retrospective, and prospective randomized trials have demonstrated this in a number of studies. These studies have shown the beneficial effects of exercise on bone accumulation during growth, with particular benefit from maintaining activity and exercise throughout life. Prevention of osteoporosis with activity is critically important, since hip fractures are a frequent occurrence in postmenopausal osteoporotic patients. Based on decades of research, a sad statistic is that approximately one out of three patients who suffer a hip fracture will die within the first year of that injury. This post-hip fracture mortality statistic has not changed over the past few decades despite advances in life-saving medical treatments and use of state-of-the-art surgical bone fixation devices. --- Dr. Tedd Weisman is a partner at OrthopedicHealth, a division of Connecticut Orthopaedic Specialists, and Chairman of the Department of Orthopedic Surgery at Milford Hospital, in Milford, CT. Excerpted from Dr. Weisman’s forthcoming book, Have You Got Milk? Not For Bone Health * WESTONMAGAZINEGROUP.COM 189
FOOD AND CALCIUM CONTENT Watercress 1,000 mg/serving Tofu 500 mg/cup Almond milk 370 mg/glass Almonds 350 mg/cup OJ (calcium fortified) 300 mg/8 oz. glass Soybeans 300 mg/cup Cow’s milk 300mg/8 oz. glass Cheddar cheese 200 mg/1 oz. slice
Disuse Osteoporosis is a term which teaches us the importance of exercise as a natural way to prevent and treat osteoporosis. Disuse osteoporosis occurs when there is insufficient weightbearing stress on bone. In other words, bones lose mineralization and bone density if not stressed by exercise and weightbearing activities. This is the “use it or lose it” phenomenon. Disuse osteoporosis occurs when the body, in its physiologic wisdom, gets a message that the bones are not being normally stressed by activity. Our body determines that if bone doesn’t weight bear, then calcium and minerals should be removed from bone so they can be used elsewhere in the body for other important functions. As a common example of disuse osteoporosis, we can look no further than to see what happens when a patient suffers an ankle fracture. The patient is instructed by the orthopedist not to weight
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