Osteoporosis is a common disorder that causes a progressive loss in bone density and mass, resulting in bones that become thin, weak, and easily fractured.
It is estimated that more than 1.3 million osteoporosis-associated (or "osteoporotic") fractures occur every year in the United States.
Dr. Rashmi Srinivas, SMG family medicine practitioner, shares the critical role good nutrition plays in preventing osteoporosis.
Selected Podcast
Can You Prevent Osteoporosis with Calcium and Vitamin D?
Featured Speaker:
Rashmi Srinivas, MD
Rashmi Srinivas, MD, specializes in family medicine.Dr. Srinivas is a member of the American Academy of Family Physicians. She is the recipient of the Robert Wood Johnson Medical School Family Medicine Academic Excellence Award and Richard Rapkin Society in Pediatric Medicine Outstanding Leadership Award.Dr. Srinivas participates in various volunteer projects. She has been a project coordinator for Healthy Families for Life, a community outreach initiative to help fight childhood obesity. In addition to volunteering for the American Academy of Family Physicians tobacco-free program, she designed the Literacy Initiative for lifestyle and literacy for Spanish-speaking seniors in New Brunswick. Her volunteer experiences have taught her the important role a community has in caring for patients. It also inspired her to pursue a career in primary care. Dr. Srinivas says, "I wanted a career in medicine because it allows me to transform people's lives. I am devoted to providing personalized, compassionate care for each of my patients."When she is not working with her patients, Dr. Srinivas enjoys classical dance of South India. She has performed and competed in cultural events and state-wide competitions. She also enjoys reading and traveling. Transcription:
Can You Prevent Osteoporosis with Calcium and Vitamin D?
Melanie Cole (Host): Osteoporosis is a common disorder that causes a progressive loss in bone density and mass and that can result in bones that can become weak and thin and easily fractured and it’s estimated that more than 1.3 million osteoporosis associated fractures occur every year in the United States. My guest today is Dr. Rashmi Srinivas. She specializes in Family Medicine at Summit Medical Group. Welcome to the show, Dr. Rashmi Srinivas. Tell us about osteoporosis. What is it and how do we even know if it’s something that we have?
Dr. Rashmi Srinivas (Guest): Thank you so much for having me on this show. Osteoporosis literally means porous bone. It literally means that bone is much more easily fractured and really compromises bone strength. It’s really pediatric onset with geriatric manifestations. The reason I say that is because prevention is key to this disease. Really needs to start at a young age because our peak bone mass is around the age of 30 and after that is a gradual plateau and then a gradual decline of our bone density. The main areas where fractures can occur with osteoporosis are the spine, the hips, forearm. The other sites are also possible. It’s also a silent disease because bone is lost and there may be no signs or symptoms until may be too late. One way to get screened which is very important for osteoporosis is through a bone density testing called the DEXA scan. It’s recommended universally for all women ages 65 and older. But for women who are younger than 65, certainly, with some risk factors as a past history of a hip fracture or family history of osteoporosis, history of smoking, alcohol use, chronic use of steroids, if you have rheumatoid or arthritis or another chronic medical conditions certainly it would be recommended to get screened earlier.
Melanie: We get screened where? Is this something we ask our doctor to do because I see bone density scans being offered up at clinics all over the place and even some health clubs? Where do you advise we get them?
Dr. Srinivas: Yes. I would definitely advise you to go to your primary care physician and usually will tell people I’ll write you script for a bone density scan and then you can go to any local places that offer it. The health clubs are fine, but also usually, a lot of the radiologist departments will offer this. It’s a quick procedure. There’s not much radiation involved. There’s no anesthesia involved and they really look to scan the hip, the spine region and measure your bone density and then that will get them back to the doctor and then the doctor then can communicate with the patient what the results are.
Melanie: Once we find out the results, Dr. Srinivas, we’d like to prevent it. And as you say, it’s something we can start in childhood and work toward as an adult. What do you think are the most important aspects of prevention of this bone mineral loss?
Dr. Srinivas: A couple of things. Adequate intake of calcium and vitamin D arekey things. Really, I’ll just discuss briefly. Calcium is essential for a lot of different things including the heart and muscles and nerves but also very important in bones, to strengthen bones. Inadequate calcium intake definitely contributes to development of osteoporosis so it’s very important that we get enough of this mineral. It’s mainly absorbed through the small intestine so ways to get it and sources definitely are dairy -- different food sources. Dairy is one biggy, dark fish, green vegetables. Deserts really come -- and a lot of the different products are now fortified with calcium so it’s important that we get enough of it and it really varies by age group how much it’srecommended that you get. Vitamin D is another vitamin that there’s a lot of research ongoing about this vitamin but the body needs vitamin D to absorb calcium. So if you’re not getting the vitamin D, you can't even absorb the calcium that you’re intaking and that leads to obviously weaker bones and then it goes to fracture as we discussed earlier. And ways to get vitamin D are through the skin, through the sunlight, UV light, just about 10 to 15 minutes out in the sun more in the midday. You can get vitamin D that way. It can convert to an active form in the body as well as through diet. A lot of the fresh water fish. Again a lot of the dairy products are now fortified with vitamin D so those are important ways.And supplements, obviously. If you are deficient in vitamin D, something that can be measured in the blood and certainly, supplements are important. Again, the recommendations of how much you need to get varies by age.
Melanie: When do we need or know that we need to supplement? If we’re not getting calcium, should we be eating tums? If we’re not getting our vitamin D, when do we know that we need to supplement these things with -- people are wearing sunscreen now so they’re not getting as much vitamin D just naturally from the sun. When do we know that we need to supplement?
Dr. Srinivas: Certainly, if you know that you’re deficient, that’s one thing but if you don't know, certainly your primary care doctor can test you through the blood, the calcium level as well as vitamin D level. And certainly, looking into your diet. If you’re not having a balanced diet as green vegetables, fish, dairy, these are ways to see. Okay, you may calcium deficient, certainly, if you are a thin female with the right Asianethnicity, you’re more predisposed. So sometimes to check to know if you are calcium and vitamin D deficient is important that way in turn medications can also inhibit calcium and vitamin D absorption certainly in like proton pump inhibitors. If you’ve been chronically on those medications, you can. And certainly, smoking definitely predisposes you to this as well as alcohol apparently inhibits calcium absorption. More than moderate use of alcohol intake can predispose you to a deficiency so that may be a clue to testing for it. And certainly, certain chronic medical conditions like Coeliac disease, they’re in malabsorption state because calcium and vitamin D are mainly absorbed through the small intestines so certainly, those diseases or a surgery that you’ve had to take out the small bowel may be a clue to get your calcium and vitamin D tested and then for some maybe it requires supplementation.
Melanie: What role does weight-bearing exercise and activity play in prevention of osteoporosis?
Dr. Srinivas: Thank you so much for bringing that up. Weight-bearing exercises are so important because really, when you are exercising, the muscles are contracting and that pulls on the bones and that strengthens the bone. But really something that will -- whether it’s lightweight or walking, hiking, jogging, climbing stairs, playing tennis, these are all just various ways to get weight-bearing exercises. And it’s so important from early stages to the prevention of osteoporosis because again, it strengthens the bones and again, helps to prevent fracture.
Melanie: So it’s really important that our children even start because as children, if we give them that weight-bearing activity and jumping and playing then it can lead into a healthier bone healthy adult, true?
Dr. Srinivas: Absolutely. I mean, I can’t reinforce that enough that kids who are hopefully going in school, being active in the gym and also at home, that also gets their parents involved and it could be a whole family activity which I absolutely encourage because again, prevention is key in this disease process.
Melanie: Dr. Srinivas, in just the last minute or so, give your best advice for osteoporosis and the prevention of it as we grow into adults.
Dr. Srinivas: I would just say again that we got to start young and healthy because you may not have any signs and symptoms of osteoporosis till it may be too late when you get a fracture and you’re hospitalized. We really need to try to prevent that and the best way to do that is to definitely get enough calcium and vitamin D, whether it’s diet or whether in a sunlight or vitamin D sources or supplementation is very important and then definitely exercise. Exercise as much as possible. It’s definitely recommended for kids most days of the week stay active and for adults, at least to get one 15 minutes or so per week of exercise. And definitely go get checked if you think you are deficient in calcium and vitamin D at your primary care doctor’s office and get screened for this if you are a woman aged 65 or older or if you have risk factors, younger at that point. I definitely encourage to be proactive in your health to prevent osteoporosis.
Melanie: Thank you so much. You’re listening to SMG Radio and for more information, you can go to summitmedicalgroup.com, that’s summitmedicalgroup.com. This is Melanie Cole. Thanks so much for listening and have a great day.
Can You Prevent Osteoporosis with Calcium and Vitamin D?
Melanie Cole (Host): Osteoporosis is a common disorder that causes a progressive loss in bone density and mass and that can result in bones that can become weak and thin and easily fractured and it’s estimated that more than 1.3 million osteoporosis associated fractures occur every year in the United States. My guest today is Dr. Rashmi Srinivas. She specializes in Family Medicine at Summit Medical Group. Welcome to the show, Dr. Rashmi Srinivas. Tell us about osteoporosis. What is it and how do we even know if it’s something that we have?
Dr. Rashmi Srinivas (Guest): Thank you so much for having me on this show. Osteoporosis literally means porous bone. It literally means that bone is much more easily fractured and really compromises bone strength. It’s really pediatric onset with geriatric manifestations. The reason I say that is because prevention is key to this disease. Really needs to start at a young age because our peak bone mass is around the age of 30 and after that is a gradual plateau and then a gradual decline of our bone density. The main areas where fractures can occur with osteoporosis are the spine, the hips, forearm. The other sites are also possible. It’s also a silent disease because bone is lost and there may be no signs or symptoms until may be too late. One way to get screened which is very important for osteoporosis is through a bone density testing called the DEXA scan. It’s recommended universally for all women ages 65 and older. But for women who are younger than 65, certainly, with some risk factors as a past history of a hip fracture or family history of osteoporosis, history of smoking, alcohol use, chronic use of steroids, if you have rheumatoid or arthritis or another chronic medical conditions certainly it would be recommended to get screened earlier.
Melanie: We get screened where? Is this something we ask our doctor to do because I see bone density scans being offered up at clinics all over the place and even some health clubs? Where do you advise we get them?
Dr. Srinivas: Yes. I would definitely advise you to go to your primary care physician and usually will tell people I’ll write you script for a bone density scan and then you can go to any local places that offer it. The health clubs are fine, but also usually, a lot of the radiologist departments will offer this. It’s a quick procedure. There’s not much radiation involved. There’s no anesthesia involved and they really look to scan the hip, the spine region and measure your bone density and then that will get them back to the doctor and then the doctor then can communicate with the patient what the results are.
Melanie: Once we find out the results, Dr. Srinivas, we’d like to prevent it. And as you say, it’s something we can start in childhood and work toward as an adult. What do you think are the most important aspects of prevention of this bone mineral loss?
Dr. Srinivas: A couple of things. Adequate intake of calcium and vitamin D arekey things. Really, I’ll just discuss briefly. Calcium is essential for a lot of different things including the heart and muscles and nerves but also very important in bones, to strengthen bones. Inadequate calcium intake definitely contributes to development of osteoporosis so it’s very important that we get enough of this mineral. It’s mainly absorbed through the small intestine so ways to get it and sources definitely are dairy -- different food sources. Dairy is one biggy, dark fish, green vegetables. Deserts really come -- and a lot of the different products are now fortified with calcium so it’s important that we get enough of it and it really varies by age group how much it’srecommended that you get. Vitamin D is another vitamin that there’s a lot of research ongoing about this vitamin but the body needs vitamin D to absorb calcium. So if you’re not getting the vitamin D, you can't even absorb the calcium that you’re intaking and that leads to obviously weaker bones and then it goes to fracture as we discussed earlier. And ways to get vitamin D are through the skin, through the sunlight, UV light, just about 10 to 15 minutes out in the sun more in the midday. You can get vitamin D that way. It can convert to an active form in the body as well as through diet. A lot of the fresh water fish. Again a lot of the dairy products are now fortified with vitamin D so those are important ways.And supplements, obviously. If you are deficient in vitamin D, something that can be measured in the blood and certainly, supplements are important. Again, the recommendations of how much you need to get varies by age.
Melanie: When do we need or know that we need to supplement? If we’re not getting calcium, should we be eating tums? If we’re not getting our vitamin D, when do we know that we need to supplement these things with -- people are wearing sunscreen now so they’re not getting as much vitamin D just naturally from the sun. When do we know that we need to supplement?
Dr. Srinivas: Certainly, if you know that you’re deficient, that’s one thing but if you don't know, certainly your primary care doctor can test you through the blood, the calcium level as well as vitamin D level. And certainly, looking into your diet. If you’re not having a balanced diet as green vegetables, fish, dairy, these are ways to see. Okay, you may calcium deficient, certainly, if you are a thin female with the right Asianethnicity, you’re more predisposed. So sometimes to check to know if you are calcium and vitamin D deficient is important that way in turn medications can also inhibit calcium and vitamin D absorption certainly in like proton pump inhibitors. If you’ve been chronically on those medications, you can. And certainly, smoking definitely predisposes you to this as well as alcohol apparently inhibits calcium absorption. More than moderate use of alcohol intake can predispose you to a deficiency so that may be a clue to testing for it. And certainly, certain chronic medical conditions like Coeliac disease, they’re in malabsorption state because calcium and vitamin D are mainly absorbed through the small intestines so certainly, those diseases or a surgery that you’ve had to take out the small bowel may be a clue to get your calcium and vitamin D tested and then for some maybe it requires supplementation.
Melanie: What role does weight-bearing exercise and activity play in prevention of osteoporosis?
Dr. Srinivas: Thank you so much for bringing that up. Weight-bearing exercises are so important because really, when you are exercising, the muscles are contracting and that pulls on the bones and that strengthens the bone. But really something that will -- whether it’s lightweight or walking, hiking, jogging, climbing stairs, playing tennis, these are all just various ways to get weight-bearing exercises. And it’s so important from early stages to the prevention of osteoporosis because again, it strengthens the bones and again, helps to prevent fracture.
Melanie: So it’s really important that our children even start because as children, if we give them that weight-bearing activity and jumping and playing then it can lead into a healthier bone healthy adult, true?
Dr. Srinivas: Absolutely. I mean, I can’t reinforce that enough that kids who are hopefully going in school, being active in the gym and also at home, that also gets their parents involved and it could be a whole family activity which I absolutely encourage because again, prevention is key in this disease process.
Melanie: Dr. Srinivas, in just the last minute or so, give your best advice for osteoporosis and the prevention of it as we grow into adults.
Dr. Srinivas: I would just say again that we got to start young and healthy because you may not have any signs and symptoms of osteoporosis till it may be too late when you get a fracture and you’re hospitalized. We really need to try to prevent that and the best way to do that is to definitely get enough calcium and vitamin D, whether it’s diet or whether in a sunlight or vitamin D sources or supplementation is very important and then definitely exercise. Exercise as much as possible. It’s definitely recommended for kids most days of the week stay active and for adults, at least to get one 15 minutes or so per week of exercise. And definitely go get checked if you think you are deficient in calcium and vitamin D at your primary care doctor’s office and get screened for this if you are a woman aged 65 or older or if you have risk factors, younger at that point. I definitely encourage to be proactive in your health to prevent osteoporosis.
Melanie: Thank you so much. You’re listening to SMG Radio and for more information, you can go to summitmedicalgroup.com, that’s summitmedicalgroup.com. This is Melanie Cole. Thanks so much for listening and have a great day.