A parent is worried about a teen-aged daughter who has decided that she is a Vegan. She has decided that she will be more healthy if she avoids all animal products. But she has not yet added the plant products necessary for those who avoid meat and dairy. A healthy diet is more about what is included than what is avoided.
Protein, Calcium, and B vitamins are among the essential nutrients that need to be replaced. We need to look to people who have had centuries to discover what foods are necessary when meat is rare or absent. Tofu, lentils, garbanzos, and beans of many varieties head the list. All grains , including rice, should be eaten brown and whole.
We said goodbye to my father-in-law these past weeks. He was 90 and alert to the end. Hospice is wonderful for both patient and family. Don had the time to say goodbye to everyone over the last months and died with his family in attendance for the final hours.
The final events became a family gathering of his 14 grandchildren, many with spouses, and 11 great grandchildren, with # 12 due this week. The next generations became the focus, as it should be.
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.