Archive for August, 2012
I recently saw a patient who has not improved her Bone Mineral Density despite 2 years of Forteo followed by 3 years of Reclast. The good news is that she stopped having Fragility Fractures. But she is very disappointed that her BMD has not improved.
Her problem is obvious. She is willing to take high-powered osteoporosis medications. She is not willing to take Calcium either in her diet or in supplements.
WRONG!!!! 85% of women who suffer Fragility Fractures have “Osteopenia”. Close to 90% of men. How can this be? ”Osteopenia” is NOT a Diagnosis. Unfortunately, most people do not understand that “Osteopenia” is not a Diagnosis.
Fracture Risk is not just DXA t-score or Bone Mineral Density (BMD). ”Osteopenia” is a BMD t-score of minus 1.1 through minus 2.4. Increased Fracture Risk (the NIH definition of Osteoporosis) starts at minus 2.5 at age 60, but Increased Fracture Risk starts at minus 1.3 at age 80. And that is only if there are no other Risk Factors, such as previous fracture, parent with a hip fracture, smoking, inhalers, etc.
Sodium intake of less than 2500 mg daily helps preserve your bone health, decrease fracture risk, and prevent osteoporosis. It also helps prevent high blood pressure, heart attack, and stroke. Many Americans consume a diet with 5000 mg of sodium or more daily.
Fast food can be a killer unless you pay attention. McD Angus, Bacon & Cheese with a Chocolate Shake is 2450 mg of sodium. There are smarter choices if you look. McD Hamburger with Wildberry Smoothy is only 535 mg. Southwestern salad without chicken plus a Fruit+Yogurt Parfait is 220 mg.
Prepared foods, such as canned soup, can have 800 mg or more sodium per serving. But I can make great french onion soup from fresh using Herb-Ox Sodium Free Bouillon and Hy-Vee Swiss Cheese (50 mg sodium/oz). Helluva Good Cheddar has only 25 mg/oz.
More Salt in your diet can result in more Calcium loss from your bones. This also explains the association of Osteoporosis with Calcium containing Kidney Stones. Calcium containing kidney stones are more likely the unintended consequence of too much sodium in the diet rather than too much calcium.
Most of us get far more than the recommended 1500 to 2500 mg of sodium daily. My BP issues require that I try to stay under 1500 mg. To do that, I have to avoid “flavor enhanced” (with injected salt water) meats, deli foods, prepared and canned foods, most chips and crackers, most salsas and condiments, many cheeses, and most “fast food”. We do a lot of made from fresh in our home.