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Does drinking soda in childhood lead to osteoporosis as we get older?

Mondays I do my 2 hour live radio show on Doctor Radio – Sirius 114, XM 119. Today we had a great show but one of the topics that really stuck in my mind was the hour on osteoporosis. Osteoporosis is a condition where the bones lose calcium and become weak, prone to breaking (a fracture, as medical people call a bone break). Osteoporosis is often considered a disease of aging. And sure enough, most cases of osteoporosis are diagnosed in older people. But like so many of the common conditions that affect us (including heart disease, stroke, peripheral arterial disease, smoking related lung disease, many cases of diabetes) osteoporosis is a condition that has its origins in childhood. Peak bone density determines, in many cases, if a person will develop osteoporosis later in life. Peak bone density – when the bone has the most amount of calcium and is at its strongest – is achieved by age 28. Yes – TWENTY EIGHT!!!! After that, the bones are losing calcium and are getting – yes – weaker by the year!! So we have only until age 28 to maximize our bone density. I guess for most of you reading this, and for me as well, we are well past this age. So, I hear you ask, what can you do?

SO MUCH!! I am sure many of you have children, grandchildren, nephews or nieces, children of friends etc. etc. Spread the word. Help get the message out there that osteoporosis in later years has everything to do with bone health in youth. Studies show that bone formation for the few years before a child reaches puberty are critical for future bone health, that these few years can literally make it or break it when it comes to the likelihood of developing osteoporosis as an adult. Other studies have clearly shown that bone density increases into the late 20’s and clearly identify these younger years as the most significant time to prevent osteoporosis in the future.

There are some do’s and some dont’s to maximize bone health.

Do get plenty of exercise. Land based (so not swimming) weight bearing exercises are best. A few great studies have identified higher impact jumping exercises such as gymnastics and dancing as leading to greater bone density in young girls and boys than lower impact exercises. Class based jumping jacks are another way to get large groups of kids doing high impact weight bearing exercises, and burning off some of that excess energy that many kids seem to have as they get fidgety during the long school day! Activity and exercise are all relative – to the cough potato, standing can be considered being active. So many of our kids these days spend leisure time in front of the TV, at the computer screen or twiddling thumbs on hand held gaming consoles. So getting the kids away from ‘passive screens’ has to be a goal. After school sports programs, family walks in the park or local neighborhood, or some of the more activity based computer games (there are a whole host of new ones on the market this winter) are better options for leisure time, osteoporosis preventing activity.

Do get enough calcium. This can be a textbook in itself. But to be brief, great sources of calcium for kids include milk, yoghurt, cheese, meats and dark green leafy vegetables. Regarding milk and dairy produce – after the age of 2 years, fat-free products still have all the calcium and protein so essential for optimum bone and muscle growth, but eliminate the saturated fat – better for the heart and waistline into the future. Calcium is not well absorbed from dark green leafy vegetables so while they are rich in calcium, it is often not possible to eat sufficient quantities to get in enough calcium. Many foods are fortified with calcium and these can be a good source. These include juices such as OJ, and breakfast cereals. Finally consider a child multivitamin that contains calcium.

Dont avoid the sun! But do respect the suns power. Believe it or not (but it is true!) the sun plays a crucial role in osteoporosis. The sunlight shinning directly on our skin helps activate vitamin D in our circulation. Only the active form of vitamin D helps our gut absorb calcium. No sun, no active vitamin D, poor absorption of dietary calcium from our gut. For many kids in cold or cloudy climates, or where the sun is hot and powerful and kids are encouraged to slather on sun creams or wear long sleeves to avoid the damaging rays of the sun, higher rates of osteoporosis are noted and can be traced to inadequate sun exposure. But don’t put your kids out to bake in the direct rays of the mid-day sun! 10 minutes of direct sunlight in the early morning and later afternoon will be sufficient to maintain good levels of active vitamin D in your kids.

So here is the answer to the teaser up above. YES – kids drinking sodas increases their risk of developing osteoporosis when they grow up. Many carbonated colas and sodas contain large amounts of phosphoric acid and while phosphate is a bone chemical, too much causes loss of calcium from bone and its elimination from the body, and so leads to osteoporosis. Caffeine may also play a role in calcium loss. Given that our kids are drinking more and more of these drinks (just look at the vending machines in so many schools!!), and sodas and colas appear to be displacing other more beneficial childhood drink staples – like MILK – as this next generation of kids grows up, (and hopefully with the benefit of modern preventive medicine live longer and longer) we are set to see an epidemic of osteoporosis!

So the bottom line is: Protect your kids from osteoporosis. Have them exercise, drink skim / fat free milk, get sufficient sunlight and avoid the carbonated drinks. Strong bones are made in young kids by good habits. Start now!!

Living well – keeping your heart healthy

Recently a young woman came to my office for consultation. 47 years old, married and 3 children, she had perfected the art of multi-tasking. Taking care of her kids and co-ordiating her husband, managing the household, working a part-time job as well as finding time to keep up her friendships with her girlfriends. She came to see me because she had just been told she has heart disease. With a history of high blood pressure, overweight by 35lbs and a ‘social’ smoker – 5 – 10 cigarettes a few times a week when out with her friends, she new that heart problems were not an impossibility but really never thought that it would present so early in her life. “I have been checking my breasts for lumps and have mammograms when my Doctor says I need to, but we never talked about heart disease”

Truth is, heart disease is the number ONE killer of women, not breast cancer. And that my patient had early menopause and was not on a regular exercise program, she had other risk factors for heart disease that she did not initially tell me about, or realize herself. She did not realize that age of onset of her periods, age of menopause, or lack of dedicated aerobic physical activity increased her risk for heart disease. In fact, she thought she was exercising because “I try and walk everywhere, I am not a couch potato!” Although walking, and any activity for that matter, is good, exercise to help and protect the heart is very specific, and most activities just don’t cut it as heart exercise.

This patients story, sadly, is one of many that I hear every day. Despite all the information that is ‘out there’ on websites and magazines, so many people remain confused about what they should be doing, and are too confident that what they are doing is the right thing for their heart health. Many times people come to see me after a cardiac event, already with a diagnosis of heart disease. Occasionally we are all elated when a patient who is overweight, or smokes, or has just been diagnosed with diabetes (these are all risk factors for heart disease) comes to see me and we work together to try and correct the condition BEFORE heart disease strikes. My task is to unscramble all the information and habits that have become part of the lifestyle of my patients, and rebuild, restructure and reshape health habits to keep my patients, and their hearts healthy.

Living a heart healthy life is not difficult. Getting there is another matter all together. Transitioning from complex lifestyles where people are prone to develop heart disease is not that easy – the statistics show us that!! No doubt, to change your life around to focus on your heart health will take some time and effort on your part. To understand that lives are complex and so many things can complicate our ability to make changes is essential. And to know that this transition does not have to be made on your own is crucial to your success. Over the past 11 years I have cared for literally thousands of people also wanting to make this transition. Some I have met recovering from heart surgery in the ICU at NYU Langone Medical Center in Manhattan, where I work running the cardiac and pulmonary rehabilitation and wellness program. Others have heard about the work I do and see me for consultation in my office. But all have the same desire – to live well, to live long and productive, happy lives, and to keep their hearts healthy.

By reading this blog, you are taking your first step to your heart health. As you follow my posts, I will guide you to optimize your heart healthy lifestyle. More than that, I will give you my angle on many health issues, including many common health issues such as stroke, arthritis, osteoporosis, nutrition etc. You can catch me every Monday, 6-8am EST on Sirius Satellite Radio channel 114, XM 119 – Doctor Radio, when I host a live call in show covering many of these health topics. This week I will be discussing the recall of Darvocet – a strong pain medication, interviewing a Special ops soldier injured in Afghanistan about his rehabilitation after losing his legs, and covering the latest breaking news in management of osteoporosis.

Great to have you on-board! And “cheers” to living well!

The medical information provided is of a general nature and cannot substitute for the advice of a medical professional. Consult with your physician.