"But I Hate Milk:" Strong Bones Without The Dairy

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Our bones are at their strongest at age 30, and slowly lose density as we age: this is a natural part of getting older; however, if there was something you could do to prevent a disease, wouldn't you?

This is where a discussion about defending ourselves against osteoporosis starts – the earlier the better.

80 percent of people with osteoporosis are women, so there are certain factors we can't control.

Conversations about healthy, strong bones usually involve milk, but what if you're not a milk-drinker or lactose intolerant?

Certified nurse practitioner Jaclyn Guetzko of Allina Health gives us options.
"But I Hate Milk:" Strong Bones Without The Dairy
Featured Speaker:
Jaclyn Guetzko, DNP -Internal Medicine
Jaclyn Guetzko is an adult-gerontological certified nurse practitioner practicing at Allina Health Bloomington Clinic. Her professional interests include chronic disease management and preventive care. She completed her doctor of nursing practice in 2015.

Learn more about Jaclyn Guetzko
Printable Version

Melanie Cole (Host):  Our bones are at their strongest around age 30 and they slowly lose density as we age. This is a natural part of getting older.  However, if there was something you could do to prevent a disease, wouldn’t you? Conversations about healthy, strong bones usually involve drinking milk but what if you’re not a milk drinker or if you’re lactose intolerant? My guest today is Jaclyn Guetzko. She is a certified nurse practitioner practicing at Allina Health Bloomington Clinic. Welcome to the show, Jacqueline. Let’s talk about osteoporosis and bone density. Explain a little bit about women and what happens to our bones as we age.

Jaclyn Guetzko (Guest):  Women are at increased risk for osteoporosis because we tend to have thinner and smaller bones then men. Also, as we begin to reach menopause and age, estrogen, the hormone that we know protects bones, dramatically decreases as a woman begins to approach and reach menopause.  This is a major contributor to why we lose bone density and why women are more prone to osteoporosis. Those who are at the higher risk are Asian and white women. But, men and women of all ethnicities can get osteoporosis.

Melanie:  Are there some people that are just going to have this problem? Is there a genetic or hereditary component to it or is there something that you can do to prevent it?

Jaclyn:  Prevention is key. You’re never too old or too young to take care of your bones and prevent bone loss. There are a lot of good habits that we can incorporate into our daily life that can help decrease our chances of getting bone loss and osteoporosis. I tell my patients to obtain a diet that is rich in calcium. Get enough calcium and vitamin D as part of a well-balanced diet – rich in fruits, vegetables, protein and low-fat dairy products can help keep our bones healthy. I also like to really impress on patients to engage in a regular exercise program, especially high impact exercises because these are the exercises that help keep the bones strong. These are things like dancing, jogging, hiking or climbing stairs. If you are not somebody who can do high impact exercises, low impact exercises are a good, safe alternative and are also good for bone health. These are things like using an elliptical machine, a stair step machine, or even a treadmill. Other things that we can do to decrease our change of getting osteoporosis are to avoid smoking and limit alcohol intake, which can both lead to bone loss.

Melanie:  Would somebody know if they are suffering this osteopenia (softening) or osteoporosis (bone loss)? Would they know or is this something that you want us to get tested for on a regular basis and have that bone density test?

Jaclyn:  There’s really no signs or symptoms of osteoporosis or osteopenia, which is the early stages of osteoporosis. We don’t recommend screening or bone density scans until you are about 65 years old, because once bones have weakened from osteoporosis you might start seeing symptoms like height loss over time or a stooped posture.  A significant sign of osteoporosis is a bone fracture that would occur much more easily than one would expect given their injuries.

Melanie:  People hear you say calcium and foods rich in calcium and everybody right away thinks about milk. It’s got Vitamin D and calcium, both good for the bones. When we’re thinking about milk, some people can’t. They’re lactose intolerant or they have a milk allergy. So, what do we do if you can’t ingest dairy products?

Jaclyn:  Yes. Milk products and low-fat dairy are great choices but if you don’t like milk or you avoid lactose products, there are other good food choices. Foods that are a great source of Vitamin D are things like fish, especially canned sardines or salmon with bones are high in calcium. Fatty fish, like salmon or tuna, is a great source of Vitamin D. Other good choices to get adequate calcium and Vitamin D are things like fruits and vegetables. Specifically, dark green vegetables like your kale, your broccolis, Chinese cabbage, mustard greens or turnips are good sources of calcium. Some foods are often fortified with calcium and Vitamin D. These are foods that have calcium and Vitamin D added to them. You can see this often times on the box when you are looking at foods at the grocery store. Certain brands of juices, brands of breakfast foods, soy milk, rice milk, snacks or bread sometimes are fortified with both calcium and Vitamin D.

Melanie:  How do you know if you’re getting enough Vitamin D and/or calcium? Do you recommend supplementation? Vitamin D supplements or Cal-tabs or one of the calcium supplements?

Jaclyn:  Our bodies need Vitamin D in order to absorb calcium. So, they do go hand in hand. I do recommend calcium supplements to those that think that their food sources are deficient or they’re not getting enough calcium in their diet. Women aged 50 and younger should be getting about 1000 milligrams of calcium per day and about 400-800 International Units of Vitamin D. Those 51 and older should be getting about 1200 milligrams of calcium per day and 800-1000 International Units of Vitamin D per day. This is your total daily calcium and Vitamin D. You can get this from food sources or you can get it from supplements. It is important to get into the habit of reading food labels to check the nutrition facts for the daily values of calcium and Vitamin D. It’s usually listed as a percentage on the side of the box. If a nutrition label states that it has 25% of the daily value of calcium, this means that you are getting 250 milligrams of calcium. This is a good way to count how much calcium you’re getting and if you’re noticing a shortage at the end of your days, go ahead and supplement. But, there is no benefit to taking additional calcium and there is also a small chance of developing kidney stones if you’re taking too much calcium. In terms of Vitamin D, it can be pretty hard to get Vitamin D from our food sources alone. We can get Vitamin D from the sunlight in terms of UVD rays, but if you live in an area like where I live in Minnesota, where sun exposure is very small, especially in the wintertime, it can be hard to get Vitamin D, or it can be almost absent. And also we tell all of our patients to us SPF 30 or higher and this blocks the UVD rays making it almost to get Vitamin D from the sun. Same as calcium, you want to check the food labels to make sure you’re getting enough Vitamin D in your total daily servings, but many people do need to take a Vitamin D supplement to get enough Vitamin D for bone health. Before taking a supplement, if you’re already taking a multivitamin, go ahead and check and see the content of the Vitamin D, especially since vitamin supplements are already in a multivitamin.

Melanie:  So, in just the last few minutes, Jaclyn, speak about prevention regarding osteoporosis and really what the listeners can do starting today to help them build strong, healthy bones.

Jaclyn:  This is one of my favorite things to talk about. Prevention is key in building strong and healthy bones. In addition to getting adequate Vitamin D and calcium, I really push for patients to get regular exercise. My best advice is to really stay physically active because this can help you build strong bones and slow your bone loss and it also keeps us healthy. Exercising can benefit our bones no matter when we begin and if you initiate a regular exercise program when you’re young and continue to exercise throughout your life, you’ll really gain the most bone health benefits. I recommend combining strength training with weight bearing exercises, like your walking, your jogging, your dancing. Strength training through weights in our upper body can help strengthen bones in the upper extremities and upper spine. The weight bearing exercises like our walking and jogging can help improve the bone health in our lower extremities, hips and lower spine.

Melanie:  Thank you so much. It’s absolutely great information. You’re listening to The WELLcast with Allina Health. For more information you can go to AllinaHealth.org. That’s AllinaHealth.org. This is Melanie Cole. Thanks so much for listening.