SUZANNE

Suzanne a 48 year old lady is our most recent client today, and she tells us she is experiencing menopause. After carefully examining her diet with her, we find out that her daily intake of calcium is only about 600 mg/day from the foods that she eats.  Suzanne does not take vitamins either.  The best recourse to take with Suzanne is to provide education in order to help her understand why she is going through her menopause so soon, and based on the given information.  Calcium is needed for our heart, muscles and nerves to function properly and for blood to clot. Inadequate calcium significantly contributes to the development of osteoporosis. Many published studies show that low calcium intake throughout life is associated with low bone mass and high fracture rates. National nutrition surveys have shown that many women and young girls consume less than half the amount of calcium recommended to grow and maintain healthy bones.  However, calcium alone cannot prevent osteoporosis and is not a substitute for medication that may be needed to curb excessive bone loss. Menopause is characterized by the loss of estrogen production by the ovaries. This may occur by natural means or by the surgical removal of both ovaries. This loss of estrogens accelerates bone loss for a period ranging from 5 to 8 years. The reason I use menopause in this explanation, is to make the client aware of the consequences this disease can have on her later in life. There in terms of bone remodeling the lack of estrogen enhances the ability of osteoclasts to absorb bone. Since the osteoblasts (the cells which produce bone) are not encouraged to lay down more bone, the osteoclasts win and more bone is lost than is produced.  Taking only 600 mg/ a day is not nearly enough, Suzanne should be getting 1000mg a day for her age.  Suzanne should also be exercising regularly.  She must be sure to eat a well-balanced diet a day also.  If she is a smoker then Suzanne should quit and consider all the other fact that come with smoking, it can make osteoporosis worse.  Susanne may want to talk to her doctor about HRT (Hormone Replacement Therapy) or other medicines to prevent or treat osteoporosis.  It’s usually best to try to get calcium from food. Nonfat and low-fat dairy products are good sources of calcium. Other sources of calcium include dried beans, sardines and broccoli.  If she is not getting enough calcium from the food she is eating, Suzanne’s doctor may suggest taking a calcium pill. Take it at meal time or with a sip of milk. Vitamin D and lactose (the natural sugar in milk) will help her body absorb the calcium.  The main four essential multivitamin supplements that women require are Calcium, Vitamin D, Magnesium and Vitamin K in order to ensure good bone health.  The best way to get all the nutrients you need is to eat a sensible balanced diet with lots of fruit, vegetables, beans, yogurt, bread and potatoes, together with smaller amounts of  very lean meat, lower-fat cheese and oily fish (esp. sardines). In addition, have at least half a pint of low-fat milk per day. Lastly, cut down on red meat, chocolate, caffeine, nicotine and alcohol, as all these things tend to weaken our bones and increase the risk of getting Osteoporosis. The goal of educating others about their health is a very important factor in prevention.  It does not matter how much medicine some patients receive, there is always a need for the patient education.  As a health educator; it is my responsibility to see that Suzanne is properly instructed as to what she must do to prevent osteoporosis and why.    

References:

 

Cashman, K. (2007, Nov.). Diet, nutrition, and bone health. The Journal of Nutrition, 137(11S), 2507S.  Retrieved from Proquest at

Doyle, L., & Cashman, K.D. (2004, May). The DASH Diet May Have Beneficial Effects on Bone Health. Nutrition Reviews, 62(5), 215-221.

Harkness, L. (2004, Jan/Feb). Soy and Bone: Where Do We Stand? Orthopaedic Nursing, 23(1), 12-18.

Lanham-New, S. (2008, Jan.).  The Balance of Bone Health: Tipping the scales in favor of potassium-rich, bicarbonate-rich foods, The Journal of Nutrition, 138(1), 172S. 

Rafferty, K., & Heaney, R. (2008, Jan.).  Nutrient effects on the calcium economy: emphasizing the potassium controversy. The Journal of Nutrition, 138(1), 166S.

Tylavsky, F., Spence, L., & Harkness, L. (2008, Jan.). The importance of calcium, potassium, and acid-base homeostasis in bone health and osteoporosis prevention. The Journal