Archive for the 'Health Facts on Osteoporosis' Category

Calcium Supplements May Not Be That Safe After All….

April 25, 2011

It has always been my practice to make sure women take their daily calcium supplements to prevent osteoporosis.  It is my contention that by building bone the right way and preventing a fracture is very important health issue.  It is recommended by diffirent medical societies that calcium supplements be given between 1000- 1200 mg per day. 

Now comes a new study showing proofs that calcium supplements may not be that safe after all.  A study published in BMJ in JUly 2010 with a reanalysis done in 2011 showed that calcium supplementation should be reviewed due to inherent harm.




To investigate whether calcium supplements increase the risk of cardiovascular events.


Patient level and trial level meta-analyses.


Medline, Embase, and Cochrane Central Register of Controlled Trials (1966-March 2010), reference lists of meta-analyses of calcium supplements, and two clinical trial registries. Initial searches were carried out in November 2007, with electronic database searches repeated in March 2010.


Eligible studies were randomised, placebo controlled trials of calcium supplements (>or=500 mg/day), with 100 or more participants of mean age more than 40 years and study duration more than one year. The lead authors of eligible trials supplied data. Cardiovascular outcomes were obtained from self reports, hospital admissions, and death certificates.


15 trials were eligible for inclusion, five with patient level data (8151 participants, median follow-up 3.6 years, interquartile range 2.7-4.3 years) and 11 with trial level data (11 921 participants, mean duration 4.0 years). In the five studies contributing patient level data, 143 people allocated to calcium had a myocardial infarction compared with 111 allocated to placebo (hazard ratio 1.31, 95% confidence interval 1.02 to 1.67, P=0.035). Non-significant increases occurred in the incidence of stroke (1.20, 0.96 to 1.50, P=0.11), the composite end point of myocardial infarction, stroke, or sudden death (1.18, 1.00 to 1.39, P=0.057), and death (1.09, 0.96 to 1.23, P=0.18). The meta-analysis of trial level data showed similar results: 296 people had a myocardial infarction (166 allocated to calcium, 130 to placebo), with an increased incidence of myocardial infarction in those allocated to calcium (pooled relative risk 1.27, 95% confidence interval 1.01 to 1.59, P=0.038).


Calcium supplements (without coadministered vitamin D) are associated with an increased risk of myocardial infarction. As calcium supplements are widely used these modest increases in risk of cardiovascular disease might translate into a large burden of disease in the population. A reassessment of the role of calcium supplements in the management of osteoporosis is warranted.


The reanalysis of this study done recently and published in the same journal showed that the risk of MI is actualy MODEST at best around 20% for MI and 30% for stroke BUT… considering the huge number of women doctors have been recommending to take calcium supplements… justify a further close look at this practice as this will have enormous impact on health care risk.

For the past year…I have not been recommending calcium supplements to my patients especially my diabetic hypertensive patients.  I make sure that my dietitian supplements their diet with enough calcium sources from food and milk.  If need be, those patients who cant take enough from food are the ones given the supplements but this number is becoming less each day.

If you are taking calcium supplements on your own , my recommendation is to stop.  If you are taking the supplements as part of your osteoporosis program then talk to your doctor first before stopping.

Walking versus Jogging

October 12, 2009

Walking as an exercise is the simplest form of activity.  I used to walk at least 4x a week.  That has been my form of exercise eversince I decided to emabark on a healthy lifestyle.   BUT I was not really consistent in doing so. There was always a reason for me not to do it this day or the next day. 

But when I started a new regimen of activity after I had a blood sugar of 96 ( with my strong family hist0ry and being the youngest of 9 with a diabetic mother: my risk is pretty high)…and a BMI of 26…I was definitely overweight… I found the differerence between simply brisk walking and running or actually jogging.

I only jog.  Meaning leisurely running 5 km per hour.  I posted my regimen before as the WOG: where I Walk and Jog but for the past several months Ive elevated the activity to all- jogging for 45 min per day. 

 The difference in terms of stamina, ” the feeling good” after the exercise and the “urge” to do it again the next day was something I did not feel whan I was brisk walking.  The sweating was 100 x more and the ” good sense of well being” feeling after the exercise was experienced even more!  I guess the endorphins are really kicking in when you sweat more and do more strenuous activities than just by simply walking without sweating it out!

The added factor to this exercise activity is of coure the maintenance of ones weight.  So far with my diet regimen and my jogging, Ive successfully maintained my weight and BMI of 22.

So guys… which is better?

Try it yourself and you make a choice.  Whatever your choice is …both are great activities to keep you healthy!

Are You Eating What’s Right For Your Bones? … Nutrition and Osteoporosis

July 3, 2007

Bone health is an important part of one’3681618293.jpgs yearly checkup.  The loss of bone mass contributes to early disability and death if the consequences of bone disease take its toll.  Fractures involving the spine and the hip contribute to significant morbidity and mortality that prevention of bone loss is the KEY!

Heres an important Fact Sheet from the University of Nebraska that I want to share because this involves common concepts in bone health involving common foods that we eat:


While dietary calcium and vitamin D are important in helping prevent or treat osteoporosis, the following dietary concerns also come into play.

1.Fiber. Excessive fiber can interfere with calcium absorption. Dr. Miriam Nelson (author, Strong Women, Strong Bones) advises that the fiber occurring in food is probably not a problem. But, if you’re sprinkling extra fiber on food, such as bran on cereal, that might affect calcium absorption.

2.Caffeine. Excessive caffeine can increase urinary excretion of calcium. A 6 oz. cup of coffee has about 100 milligrams caffeine — the actual amount would depend on brewing time, etc. Tea, soft drinks and various medications also can contain caffeine. There are about 40 milligrams of caffeine in 6 oz. of regular brewed tea; green tea may contain less caffeine. Some soft drinks are comparable to tea in caffeine content.

3.Excessive sodium. Excessive sodium can increase urinary calcium excretion. Go easy on the salt shaker; taste before you salt. Limit the number of high salt foods. The Food and Nutrition Board recommends sodium be limited to 2,400 mg daily.

4.Alcohol. Consuming more than seven alcoholic drinks per week is associated with an increased risk of low bone density and of falls and fractures. Obviously, you shouldn’t drink seven drinks all in the same day.

5.Oxalic acid. This acid, present in certain foods, such as spinach, chard and beet greens, binds up the calcium in these foods. However, it doesn’t seem to affect the calcium in foods served with them. These greens are still good for you and may actually help improve calcium status in other ways. Also, though chocolate is a source of oxalic acid, it doesn’t seem to tie up the calcium in milk if you drink chocolate milk.

6.Soft drinks. When soft drinks replace milk as a beverage, individuals are drastically reducing the calcium content of their diets.


Nutrition will always remain a part of once daily life whether for health and to prevent disease… be it for diabetes, obesity,hypertension or osteoporosis.

Eat Right, Be Light and Live Longer!

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The Seattle Experience: The Depression Factor

April 19, 2007

1ebfscd.jpgJust came back from a fruitful and educational meeting in Seattle where I attended the Annual Convention of the American Association of Clinical Endocrinologists.  I was therefore off my usual schedule in updating my blog.  Attending the AACE meeting also afforded me the chance to say hello to my mentors at Mayo especially this year where more than 8 of the plenary speakers and workshop facilitators were my former mentors at the Mayo Clinic. 

I also make it a point to also explore the place in between serious learning to learn more about the people and the culture  especially Seattle where we heard most from the movie Sleepless in Seattle.

It is indeed true that it rains 70% of the time in this part of the world.  It was almost always cloudy and that there was only 1 day out of 7 that I saw the sun!  In fact the newscaster was saying …” this is your chance to get out and enjoy because were not sure when the sun will come out again”.

The place reminds me of an important and yet unrecognized aspect in treating hospitalized patients. When I see patients in the hospital and if I know that  they will be there for quite sometime, I usually request them a room with a window.  For me light therapy is as important as my medications. It is not easy to be hospitalized and be worried about the illness.  Therefore being able to enjoy and see the light from the sun can be a bonus to early recovery.  This is already known in the world of depression especially during winter wherelight therapy in fact has been shown to be as effective as antipsychotic medications in the treatment of depression.  And experience wise… it almost always works.

The Seattle Experience therefore brought back memories of my days in Rochester Minnesota where winter is at its worst and therefore light is at its minimum.  Beautiful places but nothing beats the SUN in Cebu!

So if you have the chance… enjoy our year round sunlight.  Its one beautiful bonus that we have which we seem to take for granted.  The sun gives us the perk we need to stay alert,and  the Vitamin D we need to help our bones and muscles strong.  Unfortunately…as is true to everything we own… be it a person or a thing…we only start missing the value of a thing or a person when they’re gone!

The Seattle experience made me take a second look at Cebu and value each day that we have the sun! Enjoy the benefits of it … be it for fun or for health!

Beat Depression…Enjoy the SUN! 

Fracture: Another Reason To Be Careful With Aging…

April 3, 2007

2296240349.jpgThis weekend I attended a well organized meeting and a certification course in Osteoporosis in Singapore.  So I thought of sharing with you some new information about this condition.

Why do we worry about fractures due to osteoporosis? 

Osteoporosis is a state where your bones are thin because of poor calcium intake, an effect of menopause and aging resulting in a decrease bone strength that can lead to increase risk to fracture at low trauma.

Those at risk to this state includes: thin built, postmenopausal, a family history of osteoporosis ( look at your mom- check if she is hunched back already) especially above the age of 60 plus a previous history of fracture…  If you have any of the above, then be careful and be aware because complications arising from this disease can be prevented.

The National Osteoporosis Foundation has the following facts:

  • The rate of hip fractures is two to three times higher in women than men

  • The one year mortality following a hip fracture is nearly twice as high  for men as for womenIt is estimated that 10-20% die within 6 months after a hip fracture!

  • A woman’s risk of hip fracture is equal to her combined risk of breast, uterine and ovarian cancer.

  • An average of 24 percent of hip fracture patients aged 50 and over die in the year following their fracture.

  • One in five of those who were ambulatory before their hip fracture requires long-term care afterward.

  • At six months after a hip fracture, only 15 percent of hip fracture patients can walk across a room unaided.

  • 1 in 5 will end up in nursing homes for chronic care!

BUT remember… not just hip fractures, but also the more prevalent vertebral fractures are also linked with an increased risk of death… a progressine increase in excess mortality in the next 5 years.  And a previous fracture predicts ones risk to further fractures.  Therefore addressing a fracture as a disease rather than as a consequence of aging is of paramount importance to prevent complications and death!

We are so aware of the risk to die due to breast cancer but take note: ones lifetime risk to die with an osteoporotic fracture is similar to that of having a breast cancer

The GOOD NEWS is: we have ways to help! The meeting emphasized the availability now of drugs that not only help prevent further bone loss due to aging but to those with spinal deformities already and have lost height… we now have the availability of durgs to prevent further bone loss but more importantly we now have a product called Teriperatide that also can BUILD bone!

Maintain Your Bone Health For Long Life!

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Do You Have Muscle Aches? Maybe it’s the Vitamin D?

August 1, 2006

3998566497.jpg One of the intriguing topics in our conference was the idea that majority of us are actually Vitamin D deficient.  Vitamin D is predominantly made in our skin via exposure to the sun.  But come to think of it…I wake up and work before the sun gets up…stay in my office till afternoon… then drive home straight to my house.  How much sun exposure do I get?

Dr Holick who is the author of the UV Advantage was our plenary lecturer and his lecture really made an impact that patients complaining of muscle aches and bone pain and osteoporosis may all be suffering from Vitamin D Deficiency.  In fact there is a link between the rising incidence of breast cancer, prostate cancer and colon cancer to Vitamin D Deficiency!!!! His study revealed facts that almost always we don’t think of Vitamin D at all. A dose of 400 IU in our multivitamin may not be enough…if you’re taking only one tablet daily.

The best way to check if your muscle aches are due to Vitamin D deficiency is to get a 25 (OH) Vitamin D level.  If its below 30 mg/dl then take a Vitamin D supplement at most 1000 IU per day.  Food sources can only give us as much as 100 IU/day from salmon, juices and dairy products. 

PLUS… try to expose your arms and legs at least 15 minutes per day most days of the week to avoid Vitamin D Deficiency… another reason to enjoy the sun…

So my advise is… before you put on your sunblock, enjoy the benefits of the sun for 15 minutes then apply your sun block lotion to avoid increasing your risk for skin cancer.

Muscle Aches?… Enjoy the SUN!

Osteoporosis: The Silent Killer

August 1, 2006

637275227.jpg Osteoporosis is a silent killer.  Due to thinning of the bones, one’s bones become porous enough that even mild bending to do vacuuming chores or coughing can cause a fracture.  Studies have shown that once you get an osteoporotic fracture especially of the hip, your life span is decreased since you end suffering from complications arising from being bed-ridden.

Everyone can be at risk for osteoporosis.  A family history of fracture is significant.  Other risk factors which are preventable include smoking, sedentary lifestyle, intake of medications like thyroid hormones, steroids or diuretics… all can increase one’s likelihood to suffer from this disease.

Low intake of calcium during childhood also predicts one’s chances of developing this disease.  Very prevalent among women ( due to loss of estrogen with menopause), it is advised that intake of 1000 to 1500 mg of elemental calcium is recommended during the premenopausal state.

It is advised that enough calcium in the diet can help. Some Rich sources of calcium includes: milk, yogourt, cheese, brocolli, sardines, oats and soy products as tofu.

Important health tips to prevent osteoporosis:

1.weight bearing exercise like jogging or walking but not swimming

2.proper intake of calcium in the diet

3.avoidance of smoking since it affects absorption of calcium and reduce estrogen effect on the bone

4.limit caffeine : 2-3 cups of coffee is okay as long as you have enough calcium in the diet

5.limit or avoid alcohol. Consuming 2 alcoholic drinks a day can decrease bone formation

If you’re past 45 or menopausal, have yourself screened… if your past 70, age related bone loss is prevalent…

Be Warned…Take Care of Your Bones!