5 SD below Severe osteoporosis and fragility fracture > 2.5 SD below BMD = bone mineral density; SD = standard deviation
Beck and Shoemaker (2000) state that "calcium consumption alone is not considered adequate protection against osteoporosis" however calcium does play "an important role in the prevention and management of postmenopausal osteoporosis. " Optimal calcium intake as stated by the National Institutes of Health are those stated for the age and intake as follows:
Hormone Status Age in Years Recommended Daily Calcium Intake (mg)
Premenopausal 11-24 1,400
Premenopausal 25-50 1,000
Premenopausal, pregnant
or lactating 25-50 1,400
Postmenopausal, taking
Estrogen 65 1,500
Calcium intake effectiveness is dependent upon the proper levels of calcium being absorbed by the human body. Vitamin D must be present in the body in sufficient levels in order for the body to absorb calcium. Sunlight results in the synthesis of vitamin D in the body however, even after exposure to sunlight, as the age of the individual increases the body's ability to synthesize vitamin D decreases. Beck and Shoemaker (2000) state that the adequate daily intake of vitamin D for the different ages of the individual are as follows:
Age Daily Vitamin D Intake
Age 50-200 IU (5 micrograms)
Age 51-70-400 IU (10 micrograms)
71+ 600 IU (15 micrograms)
Also important to combat osteoporosis is estrogen replacement therapy (ERT) and as well bisphosphonates including: (1) alendronate sodium; (2) etidronate disodium; (3) pamidronate disodium; and (4) risedronate sodium, also decrease bone resorbption. Of these, alendronate is stated to show the "greatest efficacy in increasing BMD and preventing fractures and is the only FDA-approved bisphosphate for osteoporosis." (Beck and Shoemaker, 2000) Prevention dose is stated at...
Women experience more rapid bone loss in the early years after menopause, which places them at earlier risk for fractures. An important risk factor in men is hypogonadism. Men and perimenopausal women with osteoporosis more commonly experience secondary osteoporosis than do postmenopausal women." (Hellekson, 2002) Hellekson additionally states: "The bone mass attained early in life is perhaps the most important determinant of lifelong skeletal health. Individuals with the highest peak bone mass after adolescence have the greatest protective advantage. Nutrition, exercise, gonadal steroids, and growth hormone and body composition all play a role in bone density. Building good eating habits early in life is important. In particular, getting enough calcium and vitamin D is crucial. Exercise, particularly resistance-based and high-impact exercise, is also beneficial because it helps increase bone density. In addition, sex steroids (estrogen, testosterone, growth hormone, and insulin-like growth factor I) secreted during puberty substantially increase BMD and peak bone mass." (2002) Conclusions related to osteoporosis stated by the National Institutes of Health include the following: (1) Osteoporosis occurs in all populations at all ages; (2) Adequate calcium and vitamin D intake are crucial to develop optimal peak bone mass and to preserve bone mass throughout life; (3) Gonadal steroids are important determinants of peak and lifetime bone mass in men, women, and children; (4) Regular exercise contributes to development of high
