Tag: osteoporosis

The Importance of Vitamin D

The Importance of Vitamin D

vitamin-dVitamin D has been a vitamin which has gained utmost importance in research as well as in day to day life. Vitamin D is also known as “sunshine vitamin” as sunlight helps to synthesize this hormone. There was a time when mother used to tell me that they would not waste sunshine and they spent a lot of time outdoors. But now we have moved on to indoor video games, play stations,work in air conditioned offices and also work out in indoor gyms. We also can blame the pollution and lack of outdoor places to exercise. This deficiency is now seen in all age groups while previously it was limited to post menopausal women only

There was a time when mother used to tell me that they would not waste sunshine and they spent a lot of time outdoors.

Causes for Vitamin D deficiency

  • Less or no exposure to sunlight
  • Poor intake of vitamin D rich food
  • Excessive use of sunscreen
  • Following fad diets with zero oil intake
  • Minimal exposure of skin to sunlight such as wearing full sleeves, covering oneself in totality.
  • Staying indoors all the time in airconditioned offices; offices executives, software engineers, night duty workers
  • Darker skin
  • Chronic illness where one is bedridden

Consequences of Vitamin D deficiency

  • Poor bone health with conditions such as osteopenia and osteoporosis
  • Increased risks of fractures in post menopausal women
  • Poor teeth health
  • Poor calcium absorption due lack of the precursor ie. sunlight
  • Weight gain; Studies have shown calcium and vitamin D deficiency can cause weight gain.
  • Depression
  • Poor insulin secretion, hence can be prone to develop diabetes
  • Poor immunity
  • Increased cancer risk
  • Increased risk of Alzhiemers and Rheumatoid arthritis
  • Increased blood pressure and many more

How can you prevent Vitamin D deficiency

Our requirements are about 600-1000 IU/day. Now before you get up and run to the nearest pharmacy to pick up supplements, firstly add Vitamin D to your diet with naturally as well as fortified food sources.

  • Sources are Milk and all other milk products, Oily fish such as salmon, sardines and tuna are naturally rich in D. Other foods are fortified with Vitamin D such as orange juice, soy milk, butter substitutes, oils and some yogurts and cereals, egg yolk, organ meats etc
  • Spend atleast 15-20 minutes in the sunlight without sunscreen. preferable opt to stay out before 9 am and after 3 pm to avoid UV radiation which can damage skin. I meet my Vitamin D requirements by swimming in the morning.
  • Supplement only under a physicians guidance as there can be chances of hypervitaminosis and toxicity.

Feeling cranky? Get outdoors and this will definitely lift your mood and get a good dose of this feel good vitamin and make your immunity stronger, healthier bones and a stronger you.

Prevent Osteoporosis and Age Beautifully

Prevent Osteoporosis and Age Beautifully

By Maye Musk, MSc(Dietetics), MSc(Nutritional Sciences), RD(Registered Dietitian)

About the writer….
Maye Musk is a New York City based registered dietitian, Ford model and 61-year-old grandmother of 7. She has had practices in San Francisco, Toronto and Johannesburg.

She is my role model who has taken the field of dietetics and nutrition to newer dimensions.

Thanks Maye for this wonderful article…To know more about Maye Musk, visit her site www.mayemusk.com

Thank you,

To look good and feel young, we need to have a lot of energy and stay healthy. Focusing on good eating and activity habits to prevent ageing diseases like osteoporosis, will keep us walking upright and aging beautifully.


Osteoporosis is a silent bone disease that leads to loss of bone mass and is widely prevalent in India. Fractures are a common cause of morbidity and mortality in adult Indian men and women.

Hip fractures occur at a relatively earlier age in Indian males and females, compared to western counterparts; and a higher male-to-female ratio suggests that Indian males are at a higher risk for hip fractures. This may be because men seeking hospital attention is greater than that for women.

Up to 50 million Indians may be affected. Low vitamin D level and low calcium intake seem to be the major contributing factor to poor bone health and osteoporosis in India.


Clients come to see me with osteopenia, mild bone loss, out of fear of osteoporosis, a crippling disease resulting in a stooped back and bones that break easily. Besides the cost of this disease, losing independence and lowering quality of life is a concern.

–       Bones are built up to maximum strength until age 30

–       A bone feels like a rock but it isn’t, it’s living tissue. The body is continuously making new bone and replacing old bone. We need to give the body a constant supply of bone-building calcium to prevent bone loss.

–       There is high prevalence of vitamin D deficiency in the Indian population despite the availability of abundant sunshine. This includes urban and semi-urban Indians, postmenopausal women, pregnant women, school children and newborns. Studies have shown that the majority of urban office workers and hospital staff have moderate to severe vitamin D deficiency.

–       In a US study, the fracture rate in women with low bone density was nearly double that of women with normal bones, and four times higher in women with osteoporosis.

–       In the USA, the incidence of osteoporosis is higher with women (25 – 30%) than with men (12 – 15%). Higher consumption of fruits, vegetables and cereals was associated with greater femoral bone mineral density in men in a study of 907 adults aged 69-93 years old.


–       Family history: Genetics play a role as body types run in families.

–     Frame: small and thin. Indians have low bone mineral density as compared to western Caucasians, which could be attributed to differences in skeletal size.

–       Age: older people are at higher risk for fractures.

–       Race: Caucasian of northern European descent and Asians are at higher risk.

–       Menopause: After menopause, estrogen falls to the point where women can’t absorb enough calcium to replace the bone they naturally lose. A little plumpness after menopause increases estrogen levels and is good for her bones. Just a few extra pounds….

–       Poor diet: Low calcium intake: This is the main mineral that builds up bone density. Other nutrient deficiencies increase the risk for osteoporosis such as vitamin D, magnesium, manganese, Vitamin K and boron.

–       Anorexia: leads to low estrogen production and increased bone loss.

–       High protein intake: High-protein foods tend to be high in phosphorus, a mineral that depletes calcium out of the bone. The more phosphorus you consume, the more calcium you need to maintain your bone mineral density.

–       Soda: these beverages contain phosphorus. Also, soda replaces milk.

–       Vegans (people who eat no animal products at all): As calcium in milk and dairy products is better absorbed than calcium found in vegetables or supplements, strict vegetarian diets containing no milk may increase risk.

–       Certain vegetable compounds: The oxalates in spinach and sweet potatoes and phytates in legumes and grains decrease the absorption of calcium. These foods should be included in the diet as they contain some calcium which counteracts these compounds.

–       Salt: a high salt intake increases loss of calcium in the urine.

–       Coffee: More than two cups a day can decrease bone density in older women. Be sure to add milk or drink a café latte.

–       Alcohol: maximum one serving a day.

–       Excess Vitamin A supplementation.

–       Smoking depletes minerals from bone and decreases bone-preserving estrogen in blood.

–       Sedentary lifestyle.

–       Drugs can rob the bones of calcium. These include: cortisone, prednisone, thyroid hormones, anticonvulsants and aluminum-based antacids.


You cannot change your sex, race, build and age, but you can change your eating habits and activity.

Healthy lifestyle (diet, exercise and sunlight exposure) can have a major positive impact on the bone metabolism and bone health of Indians. These public health measures are recommended for the population at large as they are efficacious, safe and cost-effective.

Eat Well

Plan daily intake of calcium-rich foods. See a registered dietitian for a healthy meal plan.

– Milk (including skim milk and 1% milk) is the best. Milk contains lactose and is enriched with vitamin D; both nutrients help with the absorption of calcium. Many people who have trouble digesting lactose can drink one or two servings of milk with solid food and not have problems. A recent study showed that women over 65 reduced bone loss by 12 to 25% over 2 years if they received adequate calcium intake.

– Cheese, fortified cottage cheese and yogurt are also good sources of calcium. Low fat options contain the same amount of calcium as high fat types.

– Canned salmon and sardines with bones.

– Calcium fortified orange juice

– Collards, turnip greens, rhubarb, broccoli, kale, oranges, almonds contain calcium.

– Vitamin D: in fortified milk, eggs, salmon and sardines with bones, cheese, fortified margarine and fortified breakfast cereals.

– Sun: although it’s best to keep out of the sun, a little can supply the essential vitamin D. Expose sun to hands, face and arms three times a week for 5 – 15 minutes before sunscreen is applied. That should be adequate as 80 – 90% of vitamin D comes from exposure to sunlight.

– Magnesium: seeds, soybeans, wheat germ, seafood.

– Manganese: nuts, avocados, oatmeal.

– Vitamin K: spinach, broccoli, green cabbage, tomatoes.

-Boron: applesauce, peaches, pears, cherries.

– Omega 3 fats: salmon, sardines, walnuts. Saturated fats can influence bone density negatively

– Soy protein and its isoflavones, genistein and daidzein: soy-type foods three times a week: edamame, soy burgers, miso soup, calcium-fortified tofu.

– Lower salt, soda, caffeine and alcohol intake.

Activity (important for bone strength)

–       Walk or exercise every day for a 30 – 60 minutes.

–       Swimming strengthens muscles and gives a good stretch.

–       Stretching exercises to move joints.

–       Weight-bearing exercises have been proven to prevent bone loss.


As a public health measure, it is important to encourage children to drink

milk and play in the sun. This will ensure adequate calcium intake, vitamin D synthesis, and exercise. These three are the crucial elements in determining peak bone mass. There is thus an urgent need for greater public awareness in this regard. The peak bone mass of the population can be increased significantly by appropriate and timely intervention in children.


See your dietitian before buying a supplement. A diet rich in bone-producing nutrients is your best choice.

Do I take supplements?

I’m Caucasian, 61 years old and grandmother of 7, and am not on estrogen replacement therapy.

I don’t take any calcium supplements because I love dairy foods: milk in my breakfast cereal and yogurt and cottage cheese during the day. I eat well most of the time, am active nearly every day, have never smoked, and have a moderate intake of caffeine and alcohol. My mother (95) started with osteoporosis three years ago so I plan to stay on track.


Your doctor will advise you on drugs after measuring bone mineral density, particularly in postmenopausal women who have had fractures or a family history of osteoporosis.

For the middle aged and elderly, early detection and treatment of osteoporosis with available agents can significantly reduce the risk of fractures and associated morbidity and mortality.

In India, and elsewhere, pharmacological interventions are expensive and should therefore be targeted to only those at high risk of fractures.


We need to eat well and be active. See a Registered Dietitian for your healthy,  personalized meal and activity plan.


[1] Natl Med J India. 1996 Nov-Dec;9(6):268-74.Links Osteoporosis in India–the nutritional hypothesis. A. Gupta

[2] Indian J Med Res 127, March 2008, pp 263-268. Osteoporosis in Indians. N. Malhotra & A. Mithal

[3] Bone mineral density and dietary patterns in older adults: the Framingham Osteoporosis Study. Am J Clin Nutr 2002;76(1):245-252

Cheese and its health benefits

Cheese and its health benefits

cheeseCheese is the most misunderstood food around, mainly because of its fat content. Eating cheese has its own benefits.

  • It has high quality protein and is high in calcium as well as phosphorous, zinc, Vitamin A, Riboflavin and vitamin B12.
  • As it is rich in calcium, it prevents dental decay as it is low in sugar ie milk sugar lactose compared to other milk products. So cheese can protect your teeth by fighting cavities. The proteins present too help to prevent plaque preventing dental caries.
  • Bone health is very important for all ages especially in children. Cheese helps in maintaining the strength and density of bones. If the diet in poor in calcium, then calcium from the bones is required for maintaining normal blood calcium levels. Hence you need to have an optimum intake of calcium for healthy bones.
  • Many stay away from cheese because of its fat content, but actually cheese helps to prevent weight gain. Firstly it is nutritionally rich, hence will help in fat burning. Calcium in cheese helps in fat burning process.If you are exercising daily, then you need not worry about the fat content. Remember you do need some fat and you are getting it from natural sources. But you can still opt for low fat cheeses if you have a high body fat content.
  • It is rich in Vitamin B12 which most of the vegetarians are deficient in and helps to prevent pernicious anemia. The B12 content increases on fermentation and to make cheese, you need ten times its equivalent of milk, hence you can see why it is nutritionally dense when compared to other milk products.
  • It prevents osteoporosis. Hence if diets are rich in calcium from the younger ages, most of the bone diseases can be kept at bay. Hence eating cheese is very beneficial.
  • Cheese helps in preventing cancers of the colon and breast.
  • Cheese is a boon for lactose intolerant. If you opt for aged or hard cheese, it has very low levels of lactose. Hence it can provide calcium and minerals in high amounts to those who suffer from lactose tolerance.
  • The zinc content in cheese prevents acne. So you dont need to avoid milk products as they infact help to reduce acne.
  • Being nutritionally dense, it helps in the absorption of various nutrients.

Now how do you eat cheese? Cheese can be had as a snack at any time during the day. You can pick up cheese singles or cubes. These can be stored with out refrigeration for some time. Hence you can carry it around in your pocket or bag. Toddlers can be given cheese as a snack.

For children, cheese can be placed over bread, wheat roti etc.

The harmful forms of cheese come when they are added in burgers and pizzas. These foods are heated at high temperatures, hence can result in chemical changes in the fat content of cheese. Plus these food have white bread, fat coming from deep fried patties or chicken or meat chunks on pizza which is very harmful.

Pasta too have a lot of cheese on it plus they are drizzled with a lot of oil be it olive or any oil.

These food are already high in calories and hence we blame poor cheese for the high calorie content. Cheese coming from cheese popcorn, chips or cheeslings are not the kind of cheese we need.

Lets not get cheesy about cheese. There are a lot of low fat options available in the market to choose from. So, Say cheeeesee!!!!

Exercise daily for stronger bones

Exercise daily for stronger bones

female_liftin_dumbells.topIt is impossible to lose weight if a low calorie diet is not combined with exercise. As we know, exercise burns off extra calories and fat, improves the metabolism and there’s more to it. Exercising regularly can improve your bone density. Constant dieting can make you lose calcium from bones. It is always advisable to take advise from a dietitian as they will provide you healthy diets with adequate calcium and other minerals.

It has been constantly observed that when a low calorie diet is followed by many of my clients, they cut out milk products worrying about fat content. Hence there is a decrease in calcium intake and hence a decrease in bone density. This increases the risk for osteoporosis.

Hence combine a low calorie diet with exercise. Weight training is very important as it can induce new bone production. Weight bearing exercise such as jogging on the treadmill, walking too can help. So keep walking consistently to prevent bone loss.

Do not make excuses to skip exercise. Now you know why!!!!

Osteoporosis and Lactose intolerance

Osteoporosis and Lactose intolerance

Lactose intolerants are those who cannot digest milk sugar lactose from dairy products. So the calcium requirements are not fulfilled hence they are at higher risks of developing osteoporosis. On several surveys it has been noted that there are thinner bones visible in the scan of those who are lactose intolerant than those who are not.

Many of the lactose intolerant people have higher levels of Parathyroid hormone which can leach out calcium from the bones which are already thinner. This hormone helps to maintain the calcium balance in the bones and in the blood. Excess of this hormone weakens the bones and increasing the susceptibility to fractures.

Hence patients  with lactose intolerance should increase their calcium intake and also that of Vitamin D to prevent bone loss.

Include calcium rich food or calcium fortified food in every meal for healthy bones and for a stronger you.