Choosing the right medication for your osteoporosis

Consider the six types of drugs for osteoporosis.

When it comes time to choose what medicine to take for osteoporosis, you have many options. Over the past 10 years, science has come a long way to assist women to cure bone disease.

First step: Make sure you consume enough calcium and vitamin D, advises Eve Skopelitis, doctor, therapist Ochsner Medical Center in New Orleans. "Vitamin D is a major component in the treatment of osteoporosis. Even if patients taking calcium with vitamin D, may still be a lack of vitamin D. In this case, they may need to take vitamin D, which is a prescription - so it's important.

In fact, even if you begin to undergo treatment for osteoporosis, you just need to continue taking these supplements, said Holly Tucker, Doctor, Director, Center for Women's Health at Cleveland Clinic. "Women, after menopause, you need 1,500 milligrams of calcium each day, plus 1,000 units of vitamin D. Some people need vitamin D, a prescribed [Calcitriol]. Lack of vitamin is a serious problem."

Also important: Do weight exercise, do not smoke or abuse alcohol.

Second step: Talk to your doctor about the survey on the label of bone resorption - a blood test or urine test, says Mary Rupp, doctor, endocrinologist at the health center at the University of Texas at Houston.

Bone resorption is a loss of bone mass - and the test can show whether your medicine for osteoporosis, effective on the effects on bone, she explains. "The first survey shows your original data. Take it before you start taking drugs. Then go after a few months of taking the drug again to see if there are changes." Insurance usually covers the cost of two such surveys during the first year of treatment.

Now let's look at the advantages and disadvantages of the six major types of drugs for osteoporosis.

1: Bisphosphonates: Fosamax, Actonel, Boniva, zoledronic acid (Reclast or Zometa)

Bisphosphonates are the basis for the treatment of osteoporosis today. "They are a fundamental component in the treatment of osteoporosis," says Bobo Tanner, Dr., Director of the Osteoporosis Clinic at the University of Vanderbilt in Nashville, Tennessee. "These drugs give patients a lot of choices."

Fosamax was the first cure for osteoporosis, which was approved by the Office for Quality Control of Food and Drug Administration United States 10 years ago, three years after it was approved and Actonel. Boniva and Reclast been approved recently. "Actonel and Fosamax have good results," - says Tanner, "But the information about Boniva and Reclast we do not have."

How they work: These drugs have shown the ability to increase bone density - and Fosamax and Actonel also reduce the risk of fractures of the spine and hip. Actonel works pretty quickly, reducing the risk of fractures within six months, according to Tanner.

"Boniva is not yet shown results in reducing hip fractures, which are concerned," - she added.

Reclast or Zometa increases bone mineral density and showed the property to reduce hip fractures and spine - reduced risk of susceptibility to fractures of spine persists for more than three years. According to information from the manufacturer, Reclast also reduces the susceptibility to fracture wrists, arms, legs and ribs. Reclast demonstrated the properties to reduce mortality among people who have already been broken, said Tanner.

Options dose: Taking bisphosphonates can be very flexible - depending on whether you want to take medicine for osteoporosis once a day, once a week or once a month - well, you can take the drug by injection, which is done once a year in the office of your physician.

Options:
    Fosamax can be taken once a day or once a week in tablet form.
    Fosamax in liquid form can be taken once a week.
    Actonel can be taken once a day, once a week or once a month.
    Boniva can be taken once a day or once a month in tablet form.
    Intravenous injection of Boniva can be done once a year.
    Reclast or Zometa can be taken once a year in the form of intravenous injection.

With intravenous injection involved a needle that is inserted in your hand and drip - this is what you put in the hospital. And though this may seem extreme in some way of taking the medicine, it does have its advantages. "Intravenous drug goes directly into the bone, completely bypassing the gastrointestinal tract," - said Skopelitis.

The procedure itself takes about 5 minutes in the case of Boniva, and 5 minutes in the case of Reclast - and you're free for a year. "For some patients, this is a very practical option," - says Tanner.

Mode of taking the pills: Medication for osteoporosis in tablet form is not so simple. You do not just have to swallow a pill. You must comply with specific instructions.

    A pill - it's the first thing you should do in the morning - on an empty stomach.
    After the reception you can not sit or lie down.
    You can not eat and drink.
    Wait 30 - 60 minutes, until the body absorbs the medicine.
    After that, you can take other medicines.

The longer it will take before you have something to eat, the greater the chance that a cure for osteoporosis, better digestion by the body. "Your stomach must be empty," - said Skopelitis. "You must be sure that your competitors do not have gastrointestinal medicine." You can take other drugs later - but not before taking drugs for osteoporosis.

Such a strict regime of taking is very important, says Tanner, as the body can absorb quite a bit of medication. The body absorbs only about 1% of the drug - "so, make sure you get the most out of each dose," - she said.

Selecting: When deciding on the admission of bisphosphonates, you should ask themselves eight questions:

1.     How often do you want to take medicine for osteoporosis?
2.     Do not forget if you take the medicine?
3.     Will you follow a strict regime of taking the pills in the morning?
4.     Do you take other medicines on a regular basis?
5.     Do you have any problems with the digestive tract?
6.     Do you have difficulty swallowing?
7.     Would you like to take medicine once a year?
8.      Does your insurance cover the cost of such drugs for osteoporosis?

Bisphosphonates tablets are not recommended for people who have problems with the gastrointestinal tract, such as gastritis or ulcers - as well as people who have serious problems with the esophagus, such as stenosis. "We want to be sure that the patient will be able to learn medicine," - says Tanner. "If they suffer from other diseases, then it is better to consider a variant with an intravenous technique."

Also, for patients who are not subject to concessional pharmaceutical plan - under the terms of health insurance or government programs to provide free medical care to the elderly - intravenous administration of Reclast and Boniva are the best option, says Tanner. "Since it happens in the doctor's office, the cost will be covered." However, you must comply with the terms of their own insured retention and surcharges.

Generic Fosamax: If you have no problem with taking the drug in tablet form, Fosamax is now possible to buy cheaper, generic form. This is a great option if there are financial problems, says Tanner. "Some people can not afford to spend more than $ 4 a month." However, we must know that the generic drug must meet 80% of the original drug, it is not 100% identical to, she says. "For a drug that worked so hard absorbed by our body, I think it's risky."

Possible side effects: These drugs for osteoporosis can lead to stomach upset, cause heartburn for a day or two. "Actonel, it seems, leads to fewer side effects in the gastrointestinal tract," says Rupp.

Some patients complain of pain in muscles and joints during the course of treatment for osteoporosis, but there are some serious problems. "It's not a reason not to take medicine," - says Tanner.

However, side effects are the main reason why people refuse to continue taking drugs for osteoporosis, according to Rupp. In this case study may help to label bone resorption. "It can show the effectiveness of drugs, whether it affects the disease. Some people just need to see this again. It's a positive thing to continue taking the medicine."

Since Reclast in the treatment of osteoporosis is introduced every year, some people are nervous because of side effects - whether they occur throughout the year, says Tanner. "About 20% have flu-like illness, during the first few days after drug administration. In very rare cases, a pain in the bones, which may continue for some time. But this happens in less than 1% of cases. This is a rarity" . Treatment of ibuprofen (eg Advil, Mortin) or acetaminophen (eg Tylenol) helps in the manifestation of these symptoms.

Existing Risks: Anxiety can cause arrhythmia (abnormal heartbeat rhythm). A major study has shown that some patients who were treated with zoledronic acid (Reclast or Zometa), heart rate deviated from the norm more than those who received placebo. Follow-up studies did not give such results. Office of the Food and Drug Administration has advised the U.S. not to stop the patients taking bisphosphonates - but to report on the manifestation of side effects and symptoms to their doctors.

There is also a small risk of osteonecrosis of the jawbone, which can cause pain, swelling, the vulnerability of the bone, local infection and a broken jaw. However, osteonecrosis is rare and occurs in few patients who have undergone chemotherapy or radiation therapy, and for a long time took bisphosphonates, says Tanner. "It happens very rarely," - she said. "The benefit of preventing bone fractures than the risk of osteonecrosis of the jaw bone."

Tucker agrees: "The risk of developing osteonecrosis of the jaw bone is too exaggerated. Horizon Trial Group examined the effects of Reclast 8,000 postmenopausal women and found no increased risk of osteonecrosis of the jaw bone."

2: Evista: Prevention of breast cancer and osteoporosis

Women with osteopenia [low bone density, but not osteoporosis] - or those who have problems with the digestive tract and they can not take bisphosphonates - can choose the drug Evista. Evista - is a selective estrogen receptor modulator (SMRE), which is used to treat breast cancer. The drug is approved by the Office of the Food and Drug Administration United States for use in the treatment and prevention of osteoporosis.

The drug binds to estrogen receptors in the body and has a similar effect of estrogen - including the prevention of bone loss.

Evista helps prevent vertebral fractures but not hip, according to Tucker. "Evista is not as effective as hormone therapy or bisphosphonates for the skeleton. But the Office for Quality Control of Food and Drug Administration United States encouraged the drug for the treatment of osteoporosis, as well as to reduce the risk of breast cancer. So, for women there are additional benefits of Evista ".

Possible side effects: Rarely, but there is a risk of deep vein thrombosis.

3: Forteo: "Builder" of bone
If you have a severe degree of osteoporosis, you may want to take a drug called Forteo. Forteo - a hormone pair of the thyroid gland, which increases bone density and bone strength, in order to avoid fractures. Forteo stimulates kosteformiruyuschie cells called osteoblasts to form bone tissue. This is a cure for osteoporosis, a significant effect on bone density in the spine, reducing fractures and 90%.

Forteo is taken daily for a period of time, and administered by injection. This medication is usually prescribed for osteoporosis for people with severe osteoporosis, or those who had been one or more fractures. You can enter injections themselves at home or with someone.

"Forteo" builds "the bone, while the other drugs, just to protect from fractures" - explains Skopelitis. "Women with severe osteoporosis refuse other drugs and start taking Forteo, which is much stronger."

Possible side effects: Some people complain of dizziness or weakness, rapid heart rate when administered in the form of injection drugs, or nausea, vomiting, constipation, and muscle weakness.

4: Denosumab: In the pipeline
As well as Forteo, a medication for osteoporosis, "builds" of the bone. Tests showed three phases of a reduced level of vertebral fractures and hip. The drug activates osteoblasts kosteformiruyuschie different from Forteo way. This is a new drug for osteoporosis administered as injections, but these injections should be done several times a year. The drug will be available from 2009, according to Rupp.

"Preliminary information on denosumabe we like" - says Tanner. "It may be useful for people who can not tolerate or who do not help other medications."

5: Calcitonin: For a comprehensive treatment
Calcitonin is the first drug for osteoporosis, which was approved in 1984 - and still take it sometimes. This hormone is produced from salmon calcitonin, which helps slow down bone loss, increases bone density and relieves pain. In the process of impact it binds osteoclasts, cells that break down bone, and this prevents loss of bone mass. The major advantage of calcitonin is that it reduces the risk of vertebral fractures.

Calcitonin is often used as an additional medication for osteoporosis or if people can not tolerate bisphosphonates. You can enter in the form of injections.

Possible side effects: diarrhea. Redness of the face or hands, increased urination, loss of appetite.

6: The Hormone Estrogen: Prevention of tides and prevention of osteoporosis

Women who want to get rid of the tides - and prevent osteoporosis - may choose hormone replacement therapy (HRT). However, there are serious risks of heart disease, stroke and of blood clots in the lungs. Also, there is an increased risk of breast cancer, as well as, possibly, other cancers.

These risks disappear once women stop taking HRT, according to new research. But doctors prescribe the smallest possible dose of HRT for the shortest possible period of time, women who delivered tidal restlessness. The benefits of HRT are kosteformirovaniya plus - as it is known that it preserves bone mass and prevent fractures.

Tanner does not support the use of HRT for osteoporosis. "HRT has been quite criticized by the Office for Quality Control of Food and Drug Administration United States - and is classified only for short-term use," - says Tanner. "Another aspect is the fact that HRT has no lasting effect. As soon as you stop taking it, your skeleton menopause, unlike bisphosphonates, which provide long-term effect for several months if not years, after you stop them to take. " Fosamax is in the bones are not over 10 years, he adds.

But Tucker said that "too much hormone is ignored." She is the author of the book, Women's Health: Your body, your hormones, your choice. "It can reduce the susceptibility to all types of fractures in women. If you're 50, you are a woman and you are threatened by osteoporosis, you have hot flashes and other menopause symptoms, think about hormone therapy. If you are under 60 years of age, the benefits outweigh risks."

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Osteoporosis and diet: Recipes for the strengthening of the skeleton

Foods that are useful for bone tissue can be also delicious! Try to prepare meals, fortified with calcium and vitamin D, today.

If you have been diagnosed with osteoporosis, you need a diet that will consistently provide you with enough kosteformiruyuschih nutrients. The following delicious recipes high in calcium and vitamin D, which is the basis of the diet to strengthen the skeleton, as well as many other important nutrients for bone health, including protein.

Bonus: Poached salmon is particularly rich in polyunsaturated fatty acids omega-3, which are very useful for the bones and heart, and contains almost a daily dose of vitamin D for most adults aged 19 to 50 years, and the savory pie, casserole with ham, broccoli and cheese contains more calcium than milk 200 ml.

Poached Salmon

    3 tablespoons margarine in a plastic box
    1 peeled and chopped yellow onion, medium size
    Peeled and chopped 2 cloves garlic
    3 diced unpeeled red potatoes
    2 cups 2% of skim milk
    1170 g of a tin of salmon without skin and bones, drained, or 170g cooked salmon
    1 tablespoon of dried herbs
    Salt and freshly ground black pepper, to taste



    Melt margarine in a medium size saucepan over medium heat.
    Add the onion and fry it until almost transparent state, add the garlic and, stirring constantly, cook until tender.
    Add to the pan with milk and potatoes.
    Close the lid and boil over medium heat, stirring every few minutes until the potatoes will not be ready, about 15-20 minutes.
    Add the salmon, fresh herbs and stir. Serve warm. The remains can be stored in the refrigerator.

4 servings (about 3/4 cup each).

Serving: 348 calories, 18 grams protein, 35 grams carbohydrates, 3 grams fiber protein, 15 grams fat, 3 grams saturated fat, 0 grams of hydrogenated fat, 40 milligrams cholesterol, 213 milligrams sodium, 169 International Units of vitamin D; 155 milligrams of calcium.

Pie with broccoli, ham and Cheddar cheese

    2 tablespoons margarine in a plastic box
    1 peeled and chopped yellow onion, medium size
    1 package (340 mL) 2% of skimmed UHT milk
    2 large eggs
    2 protein of the large eggs
    1/4 cup flour
    1/4 teaspoon freshly ground black pepper
    1 cup (100 g) chopped 50% - of low-fat cheddar cheese
    1 cup finely chopped ham finished (about 3 large slices of ham)
    January 10-ounce package frozen chopped broccoli, thawed, or 2 cups cooked



    Preheat oven to 350 degrees. Cover the 10 "form spray for vegetables.
    Melt the margarine over medium heat in a pan of medium size. Add the onion and fry it until almost transparent state.
    In a bowl, whisk together the average size of the milk, egg whites, flour and pepper. Set aside for a while.
    Spread half the cheese in the form of (1/2 cup), and ham. On top coat onions and broccoli.
    Fill in the form of a mixture of milk and eggs. Spread the remaining cheese.
    Bake 35 - 40 minutes, or until a knife inserted in the middle of the center will not be dry. Before serving, refrigerate on a wire rack for 10 minutes.

6 servings.

Serving: 217 calories, 16 grams protein, 16 grams carbohydrates, 2 fiber protein, 10 grams fat, 4 grams of saturated fat, 0 grams of hydrogenated fat, 96 milligrams cholesterol, 473 milligrams sodium, 53 international units of vitamin D; 323 milligrams of calcium.

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Exercise for Osteoporosis

The best way to strengthen bones and prevent osteoporosis is to perform regular exercise. Even if you already have osteoporosis, exercise can help you maintain bone mass that you have.

The reasons for exercising with osteoporosis

Why do health experts recommend exercise for osteoporosis? When you exercise, you are building not only train the muscles and your endurance, you also are building and maintain the thickness of your bones. You may have heard that health professionals call it "the density and bone mass."

Three types of exercise for osteoporosis:

    Power Load
    The resistance
    Flexibility

All three types of exercise for osteoporosis are necessary for the formation of healthy bones.

Exercises on the power load for osteoporosis

Weight load means that your legs are all of the weight of your body. Some examples of weight-bearing exercises for osteoporosis:

    Walking
    Hiking
    Dancing
    Climbing the ladder

Sports such as cycling and swimming are very good for the heart and lungs. However, they are not weight-bearing exercises for osteoporosis, because your weight is not transferred to his feet, and bike or water.

If you are going to walk three to five miles, it will contribute to a healthy skeleton. Many experts recommend that everyone do at least half an hour a day for five days a week, strength training at a moderate pace to enhance overall health. Even better, for about forty minutes five - hour.

Exercises with resistance in osteoporosis

Resistance means that you are working to overcome the weight of another object. Exercises to help the resistance in osteoporosis, because they strengthen the muscles and shape the dice. Studies have shown that resistance exercises improve bone density and reduce the risk of fractures.

Exercises to resist osteoporosis include:

    Free weights and exercise equipment at home or at the gym
    Exercise resistance elastic tube that can be performed with different force
    Exercise in the water - any movement in the water causes your muscles to work harder.

For best results, follow the exercises in the resistance of two or three times a week. Gradually add weight or repetitions of exercises. Engage all your muscles - including the arms, chest, shoulders, legs, abdomen and back. Make sure you do not perform resistance exercise, utilizing the same muscle group two days in a row. Allow time for each muscle group to recover and relax.

Physical exercises for flexibility in osteoporosis

Stretching exercises are another important group exercise for osteoporosis. Joint flexibility helps prevent injuries.

Examples of flexibility exercises for osteoporosis include:

    Regular stretching
    Tai Chi
    Yoga

Safe performance of physical exercises for osteoporosis
Many people are concerned about safety during exercise in the elderly. You should also take care of it, if you have osteoporosis or osteopenia. Perhaps you have never been physically active. Whatever your problem, you can always choose one of the safest sports.

To ensure safety in the sport for osteoporosis, remember the following:
    Consult your doctor before starting any exercise program. This is especially important if you know that you have bone loss due to osteoporosis.
    Strength training should not be performed with a heavy load. Jogging and jumping can damage the spine. Intense exercise can lead to fractures of weakened bones. If you already have bone loss, then weight exercises without heavy load, such as walking, dancing, aerobics at a moderate pace and the average intensity of cultivation, or prefer a garden or vegetable garden.
    If you already have osteoporosis are sick, be careful with exercises that involve bending and turning at the waist. This movement may put you at risk for fracture. The exercises, which include pan and tilt at the waist, may be squatting, bending to the toes and on the rowing machine exercises. Golf, tennis, bowling and some yoga postures also include pan and tilt at the waist. Consult your doctor before you select one of these types of sports.

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Treatment For Osteoporosis

Most of the drug therapy is working to reduce bone resorbsi. The fact shows that there diresorbsi bone but not replaced, and the figure reached 5 to 10% of bone mass. By reducing resorbsi bone, bone density can be achieved up to about 5 to 10% during the period of two to three years. However, none of the drug therapy that can restore bone mass to normal. Postmenopausal women who experience bone loss at high speed is recommended to receive hormone replacement therapy (HRT), exercise, and calcium supplements.

Drugs to treat osteoporosis.

In general, the goal of treatment for patients with osteoporosis should be like the following actions:

Eliminate or reduce complaints, mainly pain and illness.
Improve the quality of life by trying to give answers to problems, functional and practical problems.
Prevent further fractures by preventing falls or possible injury.
Prevent and reverse the loss of bone.

Therefore, it should cover the treatment of osteoporosis include:

Information and education on the patient
Adequate supervision or control of pain or illness
Assessment of functional and practical advice or suggestions.
Physiotherapy advice or recommendations and ways to exercise.
Prevention of falls or injury.
And efforts at prevention of bone loss.

Drugs or supplements are recommended for patients with osteoporosis

 

A. Bisphosphonates

This compound is well tolerated and showed no significant side effects. Absorption through the digestive tract and is exacerbated by poor calcium and caffeine. These preparations should be swallowed up in an empty stomach with a glass of water, then the patient should remain in an upright position for 30 minutes. Due to the low side effects, bisphosphonates are important in the prevention of osteoporosis of any kind. The main side effect is irritation of the digestive tract. Alendronate is a second-generation bisphosphonates. This drug is a pretty tough antiresoptif, with a dose of 10 mg / day can prevent postmenopausal bone loss and increase bone density in the spine.

Another type of bisphosphonate risedronate at a dose of 5 mg / day may be used to treat and prevent osteoporosis. Bisphosphonates may also be used in male patients and patients taking corticosteroid drugs.

B. Hormonal treatment (hormone replacement therapy)

Hormone replacement therapy using estrogen in postmenopausal women, effectively reduces bone turnover and slow loss of bone mass. Its use is also associated with a decreased risk of fractures, especially hip bone. Because the efficacy of estrogen the main thing is to prevent loss of bone mass, so the earlier the treatment the more structure and bone mass that can be maintained.
Benefits of estrogen persisted during the treatment run. Once treatment is stopped, the back bone loss takes place with the original speed.

C. Raloxifene

Included in the class SERM (Selective Estrogen Receptor Modulator). Dose of 60 mg / day can prevent and treat postmenopausal osteoporosis.
Raloxifene increase bone mass and reduce the risk of vertebral fractures, as well as reducing the risk of breast cancer due to decreased estrogen. In addition to its effects on bone, raloxifene effects on lipid profile, thereby reducing the risk of heart attack and stroke. This medicine may be taken at any time, when the stomach is empty or after meals, and is independent of body position.

D. Calcitonin

The hormone calcitonin was found in 1961, produced by the thyroid gland cells, serves to reduce the level of calcium in the blood and deposit it into the bone. Calcitonin is useful in osteoporosis with high bone turnover and is useful for preventing osteoporosis due to steroid or osteoporosis in men. And the drug is safe and has the effect of an analgesic (pain relieving)

E. Calcium

Provision of calcium should be adjusted for age. To maintain bone health, calcium per day is as follows.
Age                   Element Calcium
1-10 years            800-1000 mg
11-25 years              1200 mg
25-49 years              1000 mg
> 50 years                1500 mg

Elem calcium content in each of the calcium salt form comprising:
A. Calcium carbonate  400 mg / 1 gram
2. Calcium citrate        211 mg / 1 gram
3. Calcium Lactate      380 mg / 1 gram
4. Calcium gluconate    90 mg / 1 gram
Enough calcium in the diet is essential for growth and maintenance of normal bone. Inadequate intake of calcium reduces peak bone mass and accelerated bone loss associated with age.

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Foods Menu For Osteoporosis

Not difficult to meet calcium needs of the daily diet. Since recent times, for example, the recommendation to drink milk is often touted to prevent bone loss. is not entirely true. Population of the country with the consumption of milk and milk products highest in the world like the United States would indicate a high risk of osteoporosis. There, one in three women aged 50 years and had a broken bone or fracture due to osteoporosis, while Asian women in Hong Kong who do not consume too much milk the risk of osteoporosis is only 1:6.

One of the determining is the food. Asian women food menu is loaded with green vegetables, nuts, and soy products are rich in phytoestrogens (natural estrogens) are needed to facilitate the absorption of calcium.

At the time of eating, in addition to considering the intake of calcium, we must also consider how much calcium is wasted because of the wrong diet. Menu with a high animal protein (beef, chicken, goat) will increase the removal of calcium from the body. Without attention to this, you are like a driver who kept stepping on the gas pedal with his right foot, while the right foot on the brakes again.
Eat plenty of foods containing high calcium. Besides milk and various dairy products (choose low fat), as well as green vegetables, soy products, sardines, dried fruits, cereal (oatmeal), and nuts.

Osteoporosis Menu

The following menus are examples of menus that can be relied on to ward off osteoporosis early for those of you who have not experienced it and inhibit the rate of osteoporosis for those who have experienced it.

Menu For Breakfast

French Toast with cheese

Cheese and soy milk in this menu contains high levels of calcium for bone health. While tomatoes contain vitamin C, E, and beta carotene which are antioxidants and protects the heart.

Ingredients:
6 pieces of fresh bread
150 ml of soy milk
1 egg
6 pieces of cheese
2 tomatoes, cut into thin

How to make
Cut the edge of the bread. Whisk milk and eggs. Dip bread into it until both sides wet
Heat ½ tablespoon butter / margarine in a nonstick skillet. Flatten. Fry the bread until golden brown. Turn over and fry other side until golden brown
Put a piece of cheese on the bread, wet-milk cheese with egg batter. Revert to just melt the cheese. Lift.
Finish frying all the bread. Serve immediately with tomato slices.

Lunch menu

Broccoli Garlic Sauce

Calcium content in broccoli is high. So is canned sardines (with bones). While the active ingredient in garlic can be relied upon to protect the body from infection.

Ingredients:
200 g broccoli, cut lengthwise, cut into pieces
2 red bell pepper, cut crosswise
2sdm cooking oil
4 cloves garlic, finely chopped
½ tsp sesame oil
1 tablespoon soy sauce
2 tablespoons oyster sauce
75ml broth
¼ teaspoon pepper
Canned sardines

How to make:
Boil water to a boil, dip the broccoli for 2 minutes, remove and drain.
Sauce: heat the olive oil / cooking oil. Saute the garlic until fragrant flavorful. Put all other ingredients. Pick up after boiling.
Presentation: grammar broccoli on a serving plate. Pour the sauce over it. More complete if served with canned sardines

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Home and Environmental Modifications for People with Osteoporosis

attach a rod of iron near the tub and toilet

To avoid the possibility of your Fall and suffered broken bones, you should modify your home

Floor
Get rid of the cables are expected to jam the foot. Set the rug so that you will not stumble, by way of leveling the surface of the carpet nor shall until the end of the carpet folded.

Bathroom
Attach a handle made ​​of metal near a bathtub or toilet, to help balance the body

Lighting

The dim lighting is less suitable for people with osteoporosis

Make sure the room, stairs, and entrances well lit or. It is necessary to help you see clearly part of the room / stairs / doors or objects that are scattered on the floor which is expected to be stepped on and shake the balance of the body.

Kitchen
Keep the floor around the sink is always dry. If you need to install anti-slip floor.

Try to keep the floor near the sink is always dry

Stairs
Ralling pairs. If using carpet, keep the edges are not folded to avoid tripping feet.

Clothing
We recommend wearing loose clothing and straight. If wearing grooming, avoid sharp edges.

Shoes
Avoid high heels. Choose rugged soles so you do not easily slip. Should not choose a shoe lace. In addition to hard wear, also eases your foot caught

 Other

In addition to the foregoing, there are still some issues that need your attention again.

1. Eye Health

Sight plays an important role to reduce the risk of accidents

Wear reading glasses to match. Meanwhile, to maintain eye health, you are encouraged to consume foods that contain vitamin A. Always look at the state of your eyes, if there are abnormalities such as cataracts that require surgery or other progressive eye disorder which needs to be detected.

2. Use of Drugs

The right to use drugs, you need to understand their effect. Tranquilizers, for example, will cause drowsiness which could jeopardize the balance of the body so you can easily fall. Hypertension drugs, causing impaired balance, especially on changes in body position from lying to sitting or standing. Therefore, if you consume it, change the position should be done gradually, or ask for help from others. Antihistamine drug, contained in drugs for the flu or allergy. It also can cause drowsiness or dizziness, thereby disrupting the balance of the body.

3. Understanding Fractures (Broken Bones)

The most vulnerable are the hip, spine, and wrist bones.

4. Understand the daily security

No heavy lifting
Do not bend at the waist
Do not stand on a stool or chair to reach something on a higher place
Using a footstool when changing position from sitting to standing.

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Rehabilitation Exercises For Osteoporosis

If you already have bone loss, do the following exercises:

A. Lying on stomach

• Bend both arms beside the body with palms facing down.
• Raise your upper body slowly while resting on your elbows (keep elbows in order to remain flat on the floor). The view still leads to the floor. That is, do not look ahead or neck lift. Breathe out as you lift the weight. Inhale when the body fell onto the floor.
• Perform 10-12 reps.

B. Stand up straight.

• Hold onto the back of a chair or wall. Squeeze your legs. Raise your right leg to the side.
• Return to starting position. Perform 10 to 12 repetitions. Do it with your left foot with the same number of repetitions.
• Rest 30-60 seconds between the two sets of exercises.

C. Sit upright in a chair, do not bend.

• Stacks on the right foot left foot. Put your right arm over the right thigh by holding dumbbel 0.5 to 1.5 kg (1-2 pound)
• Place the back of the wrist above the knee. Lower the weight as far as can be done, then lift weights toward your chest.
• Repeat 8 times. Do it with your other hand. Rest 30-60 seconds between the two sets of exercises.

D. Sit with your back straight, not bent.

• Hold the dumbbell weighing 0.5 to 1.5 kg (1-2 pound) according to ability. Let your arms relaxed at your sides.
• Raise both arms to shoulder height with elbows slightly bent. Breathe out as you lift the weight, inhale when both hands down.
• Repeat 10-12 times. Rest 30-60 seconds between the two sets of exercises

E. Sit up straight, not leaning or bending.

• Hold the stick, place it behind the shoulder. Rotate your upper body to the right oblique. Return to starting position. Repeat in the opposite direction. Do not twist the body excessively.
• Repeat 10-12 times each direction. Rest 30-60 seconds between the two sets of exercises.

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Avoid Injury When Exercise Osteoporosis

To avoid injury and to form the body's endurance and strength, training for people with osteoporosis should be done gradually. In other words, the type of exercise performed at an early stage should not be as heavy exercise should be done later. Do not practice with the increase in stages that are too fast, because it can give rise to injury. Training program consists of a balance between aerobic exercise with a load, such as walking, abdominal muscle isotonic strength training, and extension exercises backbone.

Sit-Up Exercises to train the abdominal muscles

If you ever had a broken bone and still feel pain, you should start with back muscle strengthening exercises while sitting in a chair. When the pain has disappeared, add strengthening exercises abdominals and back muscles. Walking exercise program should also be added later.


If you are not experiencing pain, you can start with a walking exercise program, exercise for the back extension, abdominal muscle strengthening exercises as well. Exercises for muscle strength with the added burden exercise program afterwards. It should be remembered, the addition of exercise should not cause pain, and before you are able to exercise the maximum amount for the extension back in the chair and back extension exercises by lifting the back foot. If the pain comes back or increased during the course of the exercise program, you must immediately stop the exercise and consult a physician

What are the Steps to consider when training?

1. Protect the vulnerable areas.

Vulnerable areas such as the hip, spine, and wrist, serious attention is necessary to avoid bone loss. Because these areas prone to fractures (broken bones) due to osteoporosis, and fractures of the hip and lumbar spine can lead to several diseases, even death. Results showed, to prevent the occurrence of fractures should be the target of the exercise is prone areas are prone to fracture.

As mentioned in the previous section, after experiencing menopause (in women), 4% of bone each year suffered 'damage', while bone formation is only about 2%. In other words, the amount of damages greater than the number of bone formation. That is what lead to osteoporosis, the thinning of the bones which later became porous.

Bone loss that sometimes lead to spontaneous fractures. To assist in the formation and the balance (in addition to improving muscle strength), you can do weight training. This exercise can simultaneously reduce the likelihood of falls and collisions because of a fall.

2. Try to keep your back straight.

To back, back exercise is the key. For the beginner, start with stretching exercises to train the floor or bend the waist. Other back protector is the back extensor muscles (the muscles that straighten the limbs to contract). Be very effective when the tools are available back extension machine; special machine to straighten your back. You can also do a harder workout, the squat, to increase muscle mass by way of imposition of the spine and hip.

3. Note the wrist.

using a stationary exercise can help strengthen the wrist

Fractures (broken bones) in the wrist are very common. wrist need to be trained by bending the wrist (wrist curl), who performed two or three sets interspersed with lots of rest (long break between 30 to 60 seconds). Each set of no more than 10 to 12 reps. Rest is very important in a lot of motion exercises held, such as holding a stationary bicycle handlebars. Holds in the long term can increase blood pressure.

4. Notice the hips.

Hip can be trained to perform squats, which can be done with the machine for the exercises of flexion (bending) and hip extension (straightening the body), adduction fiber (close to the body) and hip extension (moving the leg away from body)

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Osteoporosis Exercises

Many people with osteoporosis do not dare to do the exercises. In fact, exercise is very important in helping to overcome problems experienced by people with osteoporosis. Exercise can help strengthen muscles and bones and improving balance of the body, thereby reducing the risk of fractures due to falls.

However, not all types of exercises can be done by people with osteoporosis. Improper exercise can  increase the risk of injury in patients with osteoporosis, such as the rapid movements and stomping (such as running and jumping) or bending movements (such as sit ups, golf, tennis, and bowling). Here are some types of exercises are recommended for many patients with osteoporosis to maintain bone health. However, do not forget to consult your doctor before doing exercise to determine the most appropriate type of exercise for your bone health.

Weight-Bearing Exercise 

This training includes aerobic exercise against gravity with the bone as a support body weight, for example walking. The benefits gained from this exercise will be effective if done regularly, at least 15 to 20 minutes for 3 to 4 times per week. If you are just starting this exercise, do it with a light intensity progressively increased. When walking was painful and difficult for you, try doing exercises using an exercise bike.
 

Resistance Training

This workout includes exercises using weights or strength-training machines. If you want to start this exercise, do it with a light intensity increased gradually and slowly. To reduce the risk of injury, do the exercises slowly (lifting and lowering loads slowly) and do the movement correctly. Do not add to the burden of more than 10% every week because of an increase in excess weight can increase the risk of injury. Preferably, do this exercise once every 3 days to provide an opportunity for the body to rest.

However, before starting weight training, there are some things that need to be considered by people with trauma or osteoporosis to prevent fractures.

Weight Training Tips for People with Osteoporosis:

     There is a good idea before starting the exercise, consult your doctor first, to measure the degree of damage to your bones as well as the history of other diseases.

1.  Do exercises 2 or 3 times a week with one day of rest in each session.
2.  Lift the load slowly, and do not use muscle power other than muscle that is focused to be trained.
3.  Tighten your abdominal muscles to protect your spine while weight training.
4.  Consult your coach when it is appropriate for you to do additional training load and how much weight can you add.
5.  If your spine section has been detected osteoporosis, then you should never lift more than 20 pounds weight with your arms and do not rotate your body opposite to the direction of your training load.

Your bones may not be getting the benefits of exercise on the instant, but by doing light to moderate weight training on top, you will get benefits for your bone density and health. But again, always consult with your physician to determine the proper exercise your condition.

Flexibility Exercise

    These exercises include stretching exercises or stretching. This exercise serves to increase the flexibility of the joints so as to prevent muscle injury and help improve posture. Stretching exercises should be done at the end of the training session (after the muscles to warm up) slowly, quietly, and accompanied by deep breathing. Avoid types of stretching exercises that can give excessive pressure to the spine, such as bending, because it can increase the risk of fractures.

Now, to obtain optimum results for your bone health, combine exercise with treatments and setting a healthy diet

Exercise that should not be done by people with osteoporosis

Do not exercise too much pressure on the spine

1. Exercises or activities that are at risk of collision and loading on the spine. Such activity would increase the risk of fractures of the spine, because the weak vertebra unable to resist the imposition. Avoid exercise in the form of a jump, with a heavy impact aerobics (high impact aerobics), and jogging.

2. Exercise or physical activity that requires you to bend forward from the waist, with back arched
(spinal flexion). This movement increases the danger of damage to the vertebrae. You are also prohibited from doing sit-ups, reach your toes, exercise with a rowing machine.

3. Exercise or physical activity that makes you easy to fall. Never exercise with a trampoline, or step aerobics. Do not practice on a slippery floor or use any harsh or flat-soled shoes.

4. Exercise or physical activity that requires you to move the legs to the side or cross-body with weights. Such practice will result in you prone to hip fractures due to bone under conditions of strong (weak)

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