Bone Health and Osteoporosis: A Report of the Surgeon General

1. Intro Slide

Bone Health & Osteoporosis

Based on the 2004 Surgeon General’s Report

What It Means To You

2. Your Bone Health is at Risk

• By 2020, half of all Americans over age 50 may have weak bones
• People with weak bones are at higher risk for fractures
• Strong bones are needed for an active life
• Poor bone health is common and costly

You Can Improve Bone Health

3. Poor bone health is common and costly.

• 1.5 million people are hurt each year due to fractures from osteoporosis.
• 500,000 people are hospitalized each year due to osteoporosis.
• 800,000 people make trips to the emergency room due to osteoporosis.
• 2.6 million people make visits to the doctor’s office due to osteoporosis.
• 180,000 people are places in nursing homes due to osteoporosis.

4. Projected Growth in U.S. of Osteoporosis and Low Bone Mass

• In 2002, 43.7 million people in the U.S. had osteoporosis or low bone mass.
• In 2010, 52.4 million people in the U.S are projected to have osteoporosis or low bone mass.
• In 2020, 61.4 million people in the U.S. are projected to have osteoporosis or low bone mass.

To learn more about bone health call toll free 1-866-718-BONE to order a free publication from the Surgeon General or visit www.surgeongeneral.gov.

Source: Bone Health and Osteoporosis: A Report of the Surgeon General.  U.S. Department of Health and Human Services, Office of the Surgeon General, 2004.

4. Projected Prevalence of Osteoporosis and/or Low Bone Mass of the Hip

• In 2002, 21.8 million women 50 years of age or older had low bone mass of the hip and 7.8 million women 50 years of age or older had osteoporosis.
• In 2010, 26 million women 50 years of age or older will have low bone mass of the hip and 9.1 million women 50 years off age or older will have osteoporosis.
• In 2020, 30.4 million women 50 years of age or older will have low bone mass of the hip and 10.5 million women 50 years of age or older will have osteoporosis.
• In 2002, 11.8 million men 50 years of age or older will have low bone mass of the hip and 2.3 million men 50 years of age or older will have osteoporosis.
• In 2010, 14.4 million men 50 years of age or older will have low bone mass of the hip and 2.8 men 50 years of age and older will have osteoporosis. 
• In 2020, 17.1 million men 50 years of age or older will have low bone mass of the hip and 3.3 million men 50 years of age or older will have osteoporosis.
• In 2002, 33.6 million men and women 50 years of age or older had low bone mass of the hip and 10.1 million men and women 50 years of age or older had osteoporosis.
• In 2010, 40.4 million men and women 50 years of age or older will have low bone mass of the hip and 12.0 million men and women 50 years of age or older will have osteoporosis.
• In 2020, 47.5 million men and women 50 years of age or older will have low bone mass of the hip and 13.9 million men and women 50 years of age or older will have osteoporosis.

5. Osteoporosis Affects Women & Men of All Ethnicities

You could be at risk.

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An older African American couple laughing and taking a break from roller-blading in knee pads.

6. Why Are Healthy Bones Important?

Strong bones support us and allow us to move

Bones are a storehouse for vital minerals

Strong bones protect our heart, lungs, brain and other organs

7. What is Low Bone Mass?

Bones lose the minerals, like calcium, that strengthen them

Loss of these minerals causes bones to become weak and break more easily

8. Osteoporosis
The Most Common Bone Disease

Characterized by low bone mass and deterioration of bone structure

Not a natural part of aging

Increased risk for women, post-menopausal, over age 65

All races, sexes, and ages are susceptible

Preventable and treatable!

9. Osteoporosis causes weak bones.

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A picture of normal bone and of bones with osteoporosis (more porous).

10. After your mid-30s, you begin to slowly lose bone mass.  Women lose bone mass faster after menopause, but it happens to men too.

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Active growth of bone mass happens from birth and plateaus around age 30.  A progression of slow bone loss starts at age 30 until age 45.  From age 45 until age 60, there is rapid bone loss.  From age 60 and older, less rapid bone loss occurs.

11. Weak bones cause the spine to collapse.

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Progression of the spine’s collapse as a woman gets older. 

12.  Osteoporosis
When Bones Break

1.5 million Americans suffer fractures due to weak bones

Half of all women over age 50 will have an osteoporosis-related fracture

Medical expenses from osteoporosis-related bone fractures costs $18 billion annually

13.  Osteoporosis
When Bones Break

The most common breaks in weak bones are in the:

Wrist

Spine

Hip

If you break a bone after the age of 50, talk to your health care professional about measuring your bone density

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Woman with picture of her wrist bone, spine and hip bone.

14.  Osteoporosis
When Bones Break

Hip fractures are the most devastating

One in five elderly people die within a year of the fracture

One in four become disabled

One in five must move to a nursing home within a year

Many become isolated and depressed

15.  Prevention and Treatment
For All…

Live a Healthy Lifestyle

Eat foods rich in calcium and vitamin D

Follow recommended daily amounts

Be physically active every day

Include activities to improve strength and balance

Maintain a healthy body weight

Don’t smoke

Limit alcohol intake

16.  Prevention and Treatment
For All…

Discuss significant risks with a health care professional

Medications

Family history

Recent falls or broken bones

17.   Tips for keeping bones strong

Calcium is found in foods like milk, leafy green vegetables, and soybeans.  Enjoy snacks of yogurt and cheese to increase your calcium.  You can also take calcium supplements or eat food specially fortified with calcium.

Your body needs vitamin D to absorb calcium.  Make sure you get enough vitamin D from your diet, sunshine, or supplements.

Even simple activities like walking and stair climbing will strengthen your bones.  Get at least 30 minutes of physical activities a day, even if it’s only 10 minutes at a time.  (Children should get at least 60 minutes a day.)

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Woman jogging on the beach with dumbbells.  Milk, yogurt, calcium supplements and leafy green vegetables pictured as well.

18.  Your body needs calcium.

If you are age 0 to 6 months, you need 210 mg of calcium each day.

If you are age 6 to 12 months, you need 270 mg of calcium each day.

If you are age 1 to 3 years, you need 500 mg of calcium each day.

If you are age 4 to 8 years, you need 800 mg of calcium each day.

If you are age 9 to 18 years, you need 1,300 mg of calcium each day.

If you are age 18 to 50 years, you need 1,000 mg of calcium each day.

If you are over age 50, you need 1,200 mg of calcium each day.

(A cup of milk or fortified orange juice has about 300 mg of calcium.)

19.  Calcium Calculator

Help your bones.  Choose foods that are high in calcium.  Here are some examples.

Babies and toddlers ages 0 to 3 need two to five points. 

Children ages 4 to 8 need 8 points. 

Teens need 13 points. 

Adults under 50 need 10 point. 

Adults over 50 need 12 points.

One packet of fortified oatmeal has 350 mg of calcium and 3 points.

Three ounces of sardines canned in oil with edible bones has 324 mg of calcium and 3 points.

One and half ounces of shredded cheddar cheese has 306 mg of calcium and 3 points

One cup of nonfat milk has 302 mg of calcium and 3 points.

One cup of milkshake has 300 mg of calcium and 3 points.

One cup of plain low-fat yogurt has 300 mg of calcium and 3 points.

One cup of cooked soybeans has 261 mg of calcium and 3 points.

One half cup of firm tofu with calcium has 204 mg calcium and 2 points.

Six ounces of calcium fortified orange juice has 200-260 mg of calcium and 2 to 3 points.

Three ounces of canned salmon with edible bones has 181 mg of calcium and 2 points.

One half cup of instant pudding made with 2% milk has 153 mg of calcium and 2 points.

One cup of baked beans has 142 mg of calcium and 1 point.

One cup of cottage cheese with 1% milk fat has 138 mg of calcium and 1 point.

One cup of spaghetti or lasagna has 125 mg of calcium and 1 point.

One half cup of vanilla, soft serve frozen yogurt has 100 to 1000 mg of calcium and 1 to 10 points.

One cup of ready-to-eat cereal fortified with calcium has 100 mg of calcium and 1 point.

One slice of cheese pizza has 100 mg of calcium and 1 point.

Two fortified waffles has 100 mg of calcium and 1 point.

One half cup of boiled turnip greens has 99 mg of calcium and 1 point.

One cup of raw broccoli has 90 mg of calcium and 1 point.

One half cup of vanilla ice cream has 85 mg of calcium and 1 point.

One cup of calcium fortified soy or rice milk has 80 to 500 mg of calcium and 1 to 5 points.

Call toll free 1-866-718-BONE to order a free publication from the Surgeon General about bone health. For more information visit www.surgeongeneral.gov.

Citation

U.S. Department of Health and Human Services. Bone Health and Osteoporosis: A Report of the Surgeon General. U.S. Department of Health and Human Services, Office of the Surgeon General, 2004.

20.  You need more vitamin D as you get older.

Until age 50, you need 200 IU of vitamin D.  Between age 51 to 70, you need 400 IU of vitamin D.  Over age 70, you need 600 IU of vitamin D.

One cup of vitamin D fortified milk or juice provides 50 IU.  Multivitamins typically provide 400 IU of vitamin D.

21.  Food labels, like this skim milk label, tell you how much calcium and vitamin D you get per serving.

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Picture of a nutrition label for skim milk.

22.  Osteoporosis
Falls Break Bones

You can prevent most falls

Improve your balance, coordination, and strength through weight-bearing physical activity such as dancing or Tai Chi

Review medicines with a health care professional (some medicines may cause drowsiness or dizziness)

Have your vision checked

Make your home safer

23.  Protect Your Bones

Ways to Make Your Home Safer

1. Have handrails and plenty of light in all stairways.
2. Wear shoes that give good support and have non-slip soles.
3. Don’t use stepstools.  Keep items you need within easy reach.
4. Maintain a clear path to the bathroom.
5. Remove all small rugs.  They can make you trip.
6. Make sure your walkways are wide enough.
7. Remove things that you may trip over from stairs and places where you walk.
8. Move phone and electrical cords away from walkways and open areas.
9. Make sure that all areas are well lit.  Use bright light bulbs.
10. Be aware that some medications, including over-the-counter medicines, can make you dizzy or sleepy.
11. Get your vision checked.
12. Use non-slip mats in the bathtub or shower.  Have grab bars put in next to your toilet and in the bathtub or shower.

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House with labels on all potentially harmful locations marked.

24.  Protect your bones at every age.

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A family, including children and grandparents, taking a walk.

25.  Prevention and Treatment
You are never too old or too young to improve your bone health

Adults

At least 30 minutes of moderate physical activity a day

Strength and balance training

Protect from falls

Eye exam to check for visual impairments

Bone density test with a fracture after age 50, and for everyone with risk factors

Bone density test for all women over age 65

Extra calcium and vitamin D over age 50

Medication, if indicated, to prevent
bone loss or build new bone

26.  Prevention and Treatment
You are never too old or too young to improve your bone health

Children & Teens

Teens are at greater risk for poor bone health because of rapidly growing bones and poor diet

At least one hour of physical activity a day

Increase calcium during teens

Babies

-    Bone health begins before birth

27.  All women over 65 should have a bone density test.

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A woman doctor giving a woman patient a bone density test.

28.  Are You at Risk for Weak Bones?

Check Any of These that Apply to You

I’m older than 65

I’ve broken a bone after age 50

My close relative has osteoporosis or has broken a bone

My health is “fair” or “poor”

I smoke

I am underweight for my height

29.  Are You at Risk for Weak Bones?

Check Any of These that Apply to You

I started menopause before age 45

I’ve never gotten enough calcium

I have more than two drinks of alcohol several times a week

I have poor vision, even with glasses

I sometimes fall

I’m not physically active

30.  Are You at Risk for Weak Bones?

Check Any of These that Apply to You

I have one of the these medical conditions:

Hyperthyroidism

Chronic lung disease

Cancer

Inflammatory bowel disease

Chronic hepatic or renal disease

Vitamin D deficiency

Cushing’s disease

Multiple sclerosis

Rheumatoid arthritis

31.  Are You at Risk for Weak Bones?

Check Any of These that Apply to You

I take one of these medications:

Oral glucocorticoids (steroids)

Cancer treatments (radiation, chemotherapy)

Thyroid medicine

Antiepileptic medications

Gonadal hormone suppression

      Immunosuppressive agents

32.  Other Harmful Conditions

Rickets and osteomalacia

Kidney disease

Paget’s disease of bone

Genetic abnormalities

Endocrine disorders

33.  Everyone has a Role to Play in Improving Bone Health

This report is a starting point for national action.

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Cover of Surgeon General’s Report and a photo of the Surgeon General holding a copy of the What It Means To You booklet.

34.  The Surgeon General’s
Call for National Action

Encourages individuals and communities to join together to promote bone health by:

Increasing awareness

Promoting lifestyle changes

Defining and implementing prevention and treatment options for people of all ages

35.  How Can You Help?Educate Others

Tell your family and friends about the importance of bone health

Know your own risks

Improve your bone health habits and those of your family

36.  How Can You Help?
Educate Community Groups

Send an article to organizations’ newsletters

Send an email to a listserv

Discuss bone health at a meeting

Encourage other groups to collaborate

Offer to speak at meetings

Form a “Healthy Bones” coalition and develop
a plan to educate community members about bone health

37.  How Can You Help?
Educate Health Care Professionals and Health Insurers

Host a speaking tour

Send a bone health letter to health care facilities, professionals, and insurers

Disseminate fact sheets and the bone health checklist

Encourage bone health screening and treatment in facilities, including extended care facilities

Host a seminar

38.  How Can You Help?Engage the Media

Hold a news conference and “pitch” it to the local media

Write an op-ed

Submit a letter to the editor

39.  How Can You Help?Target Parents and Schools

Plan a health fair

Work with school parent-faculty associations

Provide information to school leaders

Encourage school nurses to be involved

40.  How Can You Help?Work with Businesses

Focus on customers and employees

Provide information to include in bills or shopping bags, or for printing in store circulars

Encourage community and coalition involvement

Encourage participation in or host a health fair with bone health screening, bone density tests, and prevention and treatment tips

41.  For More Information

Call toll free 1-866-718-BONE (2663) or visit www.surgeongeneral.gov to order:

“The 2004 Surgeon General’s Report on Bone Health and Osteoporosis: What It Means to You”

“Bone Health and Osteoporosis: A Surgeon General’s Report” – Full Report and Executive Summary

Posters

42.  For More Information

National Institutes of Health Osteoporosis and Related Bone Diseases ~ National Resource Center (NIHORBD~NRC)
Phone: 202-223-0344
www.osteo.org

43. 

Let’s Work Together to Get America Bone Healthy!

44.  Identical intro slide

Bone Health & Osteoporosis

Based on the 2004 Surgeon General’s Report

What It Means To You