The International Medical Group is a multi-disciplinary medical practice that offers professional and personalized care. Dr Bella Beraha, born in Venezuela, joins us from Miami. She is an M.D. in Internal Medicine and runs a successful medically supervised weight loss program from the clinic. The International Medical Group performs a wide range of services from general family medicine and specialist services to Botox, dermal fillers and natural hormone replacement therapy. We always welcome new patients and will assist you in any way that we can to ensure that you get the treatment and care that you need. Stop by our offices or call us with any questions. We look forward to meeting you.

When you think about staying healthy, you probably think about making lifestyle changes to prevent conditions like cancer and heart disease. Keeping your bones healthy to prevent osteoporosis may not be at the top of your wellness list. But it should be.

Osteoporosis is a common problem that causes bones to become abnormally thin, weakened, and easily broken (fractured). There were an estimated nine million osteoporotic fractures worldwide in 2000. Women are at a higher risk for osteoporosis after menopause due to lower levels of estrogen, a female hormone that helps to maintain bone mass.

OSTEOPOROSIS PREVENTION—Some of the most important treatments for preventing osteoporosis include diet, exercise, and not smoking. These recommendations apply to men and women.

Diet — An optimal diet for preventing or treating osteoporosis includes consuming an adequate number of calories as well as optimal amounts of calcium and vitamin D, which are essential in helping to maintain proper bone formation and density.

Calcium intake — Experts recommend that premenopausal women and men consume at least 1000 mg of calcium per day; this includes calcium in foods and beverages plus calcium supplements. Postmenopausal women should consume 1200 mg of calcium per day (total of diet plus supplements). However, you should not take more than 2000 mg calcium per day due to the possibility of side effects.

The main dietary sources of calcium include milk and other dairy products, such as cottage cheese, yogurt, or hard cheese, and green vegetables, such as kale and broccoli. A rough method of estimating dietary calcium intake is to multiply the number of dairy servings consumed each day by 300 mg. One serving is 8 oz of milk or yogurt, 1 oz of hard cheese, or 16 oz of cottage cheese.

Calcium supplements (calcium carbonateor calcium citrate) may be suggested for women who cannot get enough calcium in their diet. Calcium doses greater than 500 mg/day should be taken in divided doses (eg, once in morning and evening).

Vitamin D intake — Experts recommend that men over 70 years and postmenopausal women consume 800 International Units (IU) of vitamin D each day. This dose appears to reduce bone loss and fracture rate in older women and men who have adequate calcium intake (described above). Although the optimal intake has not been clearly established in premenopausal women or in younger men with osteoporosis, 400 to 600 International Units of vitamin D daily is generally suggested.

Milk supplemented with vitamin D is the primary dietary source of dietary vitamin D; it contains approximately 100 IU per cup. Experts recommend vitamin D supplementation for all patients with osteoporosis whose intake of vitamin D is below 400 IU per day. This is the amount found in a daily multivitamin or a calcium/vitamin D supplement.

Protein supplements — Protein supplements may be recommended in some people to ensure sufficient protein intake. This may be particularly important for those who have already had an osteoporotic fracture.

Alcohol, caffeine, and salt intake — Drinking alcohol excessively (more than three drinks a day) can increase the risk of fracture due to an increased risk of falling, poor nutrition, etc, so it should be avoided.

Restricting caffeine or salt has not been proven to prevent bone loss in people who consume an adequate amount of calcium.

Exercise — Weight-bearing exercises can improve bone mass in premenopausal women and help to maintain bone density for women after menopause. Physical activity reduces the risk of hip fracture in older women as a result of increased muscle strength. Most experts recommend exercising for at least 30 minutes three times per week.

The benefits of exercise are quickly lost when a person stops exercising. A regular, weight-bearing exercise regimen that a person enjoys improves the chances that the person will continue it over the long term.

Smoking — Stopping smoking is strongly recommended for bone health because smoking cigarettes is known to speed bone loss. One study suggested that women who smoke one pack per day throughout adulthood have a 5 to 10 percent reduction in bone density by menopause, resulting in an increased risk of fracture.

Falls — Falling significantly increases the risk of osteoporotic fractures in older adults. Taking measures to prevent falls can decrease the risk of fractures. Such measures may include the following:

1      Removing loose items in the home that could lead to tripping, slipping, and falling.

2      Providing adequate lighting in all areas inside and around the home.

3      Avoiding walking on slippery surfaces, such as ice or wet or polished floors.

4      Avoiding walking in unfamiliar areas outside.

5      Reviewing drug regimens to replace medications that may increase the risk of falls.

6      Visiting an ophthalmologist or optometrist regularly to get the optimal eye glasses.

Medications — Prolonged therapy with and/or high doses of certain medications can increase bone loss. The use of these medications should be monitored by a healthcare provider and decreased or discontinued when possible. Such medications include the following:

1      Glucocorticoid medications (eg, prednisone)

2      Heparin, a medication used to prevent and treat abnormal blood clotting (ie, anticoagulant)

3      Vitamin A and certain synthetic retinoids (eg, etretinate)

4      Certain antiepileptic drugs (eg, phenytoin, carbamazepine, primidone, phenobarbital, and valproate)