Posts Tagged ‘Nutrition’
Clinical Osteoporosis 2017, NOF and ISCD joint meeting had a different emphasis this year. Fracture Risk, rather than Bone Mineral Density (BMD) is now the key metric. Several speakers emphasizd the importance of VFA in making the diagnosis of Clinical Osteoporosis. This is something I have presented in poster exhibits 2015, 2016 and 2017. I am now mainstream!
“Treat to Target” was the big new message this year. We should set a target of decreased Fracture Risk for each patient and alter treatment until we reach it. This has been routine for years in diabetes, hypertension, cholesterol, etc. This is recognition that Osteoporosis is a chronic disease that we can control, but never cure, just like many others.
Take Control Naturally is the necessary first step, as I have outlined over the last few months. This is often sufficient for prevention and in mild disease.
Advanced Osteoporosis, especially after fragility fractures, or vertebral compression fractures seen on VFA, is usually beyond nutrition and exercise only. This will usually require medications to significantly reduce fracture risk.
The huge change is the recommendation to use an Anabolic medication first, to markedly reduce fracture risk, when BMD is very low or multiple fractures have already occured. Then follow up with an Antiresorptive to maintain a low fracture risk. Traditionally Medicare and other insurances have demanded we try Antiresorptives first to maintain bone as it is, even when multiple fractures have proven the bone to NOT be good enough at curent BMD.
We are entering a new age of Fracture Prevention!!
Jay Ginther, MD
The purpose of good bone health is to prevent fractures. Most fractures happen as a result of a fall. If you do not fall, you decrease your fracture risk. How do you prevent falls?
Regular exercise will strengthen your muscles. Strong muscles are part of the solution. But you also need good balance. Good balance requires exercises to strengthen the muscles required for balance.
Balance exercises have been used for centuries to keep people limber and free from falling, and thereby, free from fractures. They are often taught in group sessions, but can be performed alone on any flat surface.
Tai Chi and Yoga are the best known ancient balance exercises. Daily, or at least 3 times weekly, sessions of 20-30 minutes will gradually improve your balance and prevent falls.
Less interesting, but easier to do anywhere, is simply walking on your toes for several minutes. More challenging is walking on your heels, like a penguin. If you can do that for 2 minutes straight, you have great muscles, strong ankles, and are unlikely to stumble, even on uneven ground.
Take Control Naturally by working on your Balance. Remember that proper nutrition is necessary for strong muscles and bones.
Jay Ginther, MD
Aunt Henrietta enjoys her independent life at 90. Especially when compared to how she was 4 years ago!
I visited her while out east for NOF. She easily walked the 3 blocks to and from church. She led the procession up and down every aisle in the huge Shoprite and the Rite-Aid, while stocking up on provisions for the month. She even strolled more than 1/4 mile across the Delaware River pedestrian bridge.
She lives alone in a 2 story house. I am not happy about the stairs, but she does not fall too often, and has not broken anything in 4 years.
Before Aunt Henrietta started treating her osteoporosis aggressively, she was rightfully terrified to do anything. She was talking about dying in her house. She had broken one wrist, then the other wrist, then her shoulder, in 3 separate falls. Her plight and response has been an inspiration in my efforts for bone health.
She started Adora Chocolates (she loves dark) for Calcium, then added high dose Vitamin D. I harrassed her into eating more protein. But when she fell, she broke. Her Quality of life was in the Dumpster. Time for drastic action!
I talked her into the Anabolic, Forteo. She failthfully gave herself a shot every day for 2 years. Because of her aging kidneys, I followed with Prolia. She has worked hard on proper nutrition. She was determined to regain her Independence. She succeeded.
Aunt Henrietta resurrected her Quality of Life. She is stronger, more active, stubbornly Independent, and Fracture Free! At age 90, that is everything.
Aunt Henrietta beat her osteoporosis! You can too.
Find out what you need to correct with a Complete Bone Health Evaluation.
Take Control to Avoid Fractures and remain Independent.
Jay Ginther, MD
The National Osteoporosis Foundation (NOF) saw major changes at last week’s annual meeting, ISO15. I will present them in detail over the next few blogs.
First, the number of Orthopedic Surgeons has skyrocketed into the most numerous specialty attending the meeting. Orthopods are becoming more involved. This has to be good for preventing second and third fractures.
The major emphasis of the NOF meeting was on Fractures; what they do to their victims, and how we can prevent the suffering they cause.
NOF has joined IOF and NBHA in promoting Fracture Liaison Services (FLS). FLS can be key in identifying persons with fractures, with a high risk of future fractures, and the opportunity to prevent further fractures.
The role of nutrition in building and preserving good bone health received increased attention.
We discussed the places of the various available medications in increasing bone strength and preventing fractures. Changes are coming as we get more options with new and different actions.
NP Katie and I learned a lot. Preventing fractures is becoming easier.
You can take control of your future and prevent fractures.
Jay Ginther, MD