Mary P. Clarke, Bone bank deposits and withdrawals: leader's guide, Kansas State University, August 1998

Clarke, Mary P., 1928-

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Bone BankDeposits andWithdrawalsLEADER’S GUIDEKansas State University Agricultural Experiment Station and Cooperative Extension ServiceYou may have learned abouthigh blood pressure, some -times called the “silent killer”because most people who haveit do not feel sick. This is usuallytrue for osteoporosis as well. Unlessthe spinal vertebra compress andpinch nerves or the person suffers afracture, osteoporosis is a silent dis-ease and can go undetected for manyyears. Yet, such bone disease cancause considerable pain and expense,curtail quality of life, and result inloss of independence.Lesson Goal:Program participants will learn howdiet, exercise and other measures canprevent and treat this chronic, crip-pling disease—osteoporosis.LESSON OBJECTIVESAt the conclusion of the lesson, par-ticipants will be able to:• Recognize reasons why so manyolder adults have osteoporosis andbreak bones.• Tell a friend at least three impor-tant ways a person can protectbones from osteoporosis.• Name three nutrients needed tobuild strong bones.• Name at least two food compo-nents that encourage bone loss.• Increase calcium and vitamin D in-take to recommended levels.PLANNING THE LESSONThere are more ideas here than can be presented in 20 to 30 minutes.Think about your group, their interests and their abilities to protect bonebanks from excessive withdrawals so they don’t end up breaking bones.Review the fact sheet MF-2347 Bone Bank Deposits and Withdrawals. Notemain titles and subtitles such as “Bone Robbers” and “What You Can Do.”Think through how you are going to present the information, involve theparticipants in learning, and enable them to fulfill the lesson objectives.Plan a community service activity.The remainder of this guide has suggestions for activities. Sources of addi-tional materials are at the end, followed by a brief evaluation tool. The fol-lowing quiz can be used as your lesson outline.Activity #1 Boning Up on What You KnowHave participants respond to the questions below by marking them true orfalse. Hand out copies of the questions, or read them aloud and ask partici-pants to write down their answers. Give everyone who answers all cor-rectly a calcium supplement, such as 1 cup of nonfat dry milk in a smallbag to make 3 cups of milk, or Tums antacid. (This amount of milk isnearly enough to meet the calcium RDA for adults younger than 50 yearsold.) This activity can help fulfill the first two objectives. Discuss each an-swer, and note that the three most important ways a person can prevent ortreat osteoporosis are diet, exercise and drugs. See fact sheet. All answersare true except 1, 6, and 9.True or false:___1. Nutrients, such as calcium, are deposited in bones while a personis young and stay there until they are gradually released duringold age.___2. Both men and women can suffer osteoporosis.___3. Some people are more at risk for developing osteoporosis thanothers because of their inherited genes.___4. A key hormone for protecting bones from osteoporosis is estro-gen, but testosterone also helps protect men.___5. Young women can develop osteoporosis because of excessive dieting.___6. Good exercises for protecting bones are swimming and bicycling.___7. Cigarette smoking increases bone loss.___8. Calcium needs vitamin D to be absorbed and used in the body.___9. Most young adults get enough calcium in their diets.__10. Women should have their first bone scan about age 50.Activity #2 Nutrients and Your Bone Bank: Deposits and WithdrawalsThis activity will inform participants that what they eat throughout theirlives has a direct bearing on bone strength and their risk for osteoporosis.Study the section of the fact sheet that discusses the different kinds of nu-trients needed to build strong bones. In your body, other dietary compo-nents, the Bone-Building Inhibitors, can inhibit or partly prevent calciumOutdated Publication, for historical use. CAUTION: Recommendations in this publication may be obsolete.Publications from Kansas State University are available on the World Wide Web at: http://www.oznet.ksu.eduContents of this publication may be freely reproduced for educational purposes. All other rights reserved. In each case, credit Mary P. Clarke, Ph.D., “Bone Bank Deposits and Withdrawals,” Kansas State University, August 1998.Kansas State University Agricultural Experiment Station and Cooperative Extension ServiceMF-2346 AUGUST 1998It is the policy of Kansas State University Agricultural Experiment Station and Cooperative Extension Service that all persons shall have equal opportunity and access to its educational programs, services, activities, and materialswithout regard to race, color, religion, national origin, sex, age or disability. Kansas State University is an equal opportunity organization. Issued in furtherance of Cooperative Extension Work, Acts of May 8 and June 30, 1914, asamended. Kansas State University, County Extension Councils, Extension Districts, and United States Department of Agriculture Cooperating, Marc A. Johnson, Director.File code: NUTRITION NPabsorption or increase calcium loss. The inhibitors aremainly excessive amounts of sodium and salt and pro-tein. Weaker inhibitors are alcohol, caffeine andphytate or oxalate, if present in high amounts. Seefact sheet.Bring a sample of 20 or so foods, and ask participantsto try to group them into two categories. Examples ofBone-Builders: milk with vitamin D, cheese, yogurt,tofu, kale or Swiss chard, canned sardines, calcium-fortified orange juice; 100% whole-grain bread.Examples of Bone-Inhibitors (sodium, protein, ox-alate and phytate): cured meat; canned soup; 8ounces or larger serving of meat, fish or poultry; manyfrozen entrees; wheat bran; canned spinach; three ormore servings of alcoholic beverages.Some foods—such as spinach and cooked, drybeans—can belong in both groups because they con-tain both Builders and Inhibitors. Moderation is thekey. In a meal with plenty of variety, the amount ofan inhibitor is minimized. If you are uncertain aboutthe composition of a food, ask your FACS agent tohelp you decide if a food is high in sodium or salt,protein or calcium. Note that almost no foods besidesmilk and fortified cereals have vitamin D added.Activity #3 Calcium ComparisonsPrepare a display of the amount of calcium in differ-ent common servings of foods. Purchase a bag of min-iature marshmallows. Using a chart that provides thenumber of milligrams (mg) of calcium in a serving offood, place one marshmallow for each 10 mg of cal-cium in a transparent plastic bag. For example, the300 mg calcium in a cup of milk equals 30 marsh-mallows. Have participants match the number ofmarshmallows with the names of the dozen or sofoods.Activity #4 Bone WithdrawalsUsing white flour, illustrate how much calcium canbe lost from bones over time. Measure out the sug-gested number of cups of flour and seal in a plasticbag.Label bag #1: Young adult woman’s (35 years) cal-cium in skeleton. Medium to small well-nourishedframe (8 cups of flour = 1000 g calcium)Label bag #2: Woman, 10 years after menopause (61/2 cups of flour; 20% loss = 1 1/2 c)Label bag #3: Woman, 85 years with osteoporosis (43/4 cups of flour; 40% loss = 3 1/4 c)Activity #5 Tasting Calcium-rich RecipesPrepare some recipes for taste-testing that contain atleast 150 to 200 mg calcium in each serving. YourFACS agent has some recipes you can try, or you canuse your own. Be adventuresome. Try a recipe, suchas spaghetti sauce, made with calcium-coagulatedtofu or an “orange julius” drink containing dry milk.SOURCES OF ADDITIONAL INFORMATIONYour county extension FACS agent.  She may be able to borrow osteoporosis resources produced by Texas Agri-cultural Extension Service, The Texas A&M University System, College Station, TX.Midland Dairy Council, 10901 Lowell, Suite 135, Overland Park, KS 66210.  Phone: 913-345-2225 or FAX 913-345-0790. Check to see if you are in their service area. If you are not, ask your county FACS agent for assistancein securing sample copies from your state nutrition specialist for gerontology.National Osteoporosis Foundation is at 1150 17th Street, NW, #500, Washington, DC 20036-4603.BONE BANK DEPOSITS AND WITHDRAWALS LEADER’S GUIDEEVALUATION• At the end of the meeting, pass out the post-test, the same questions as in Activity 1. Have participantsmark their answers, then compare them with their first answers. Give prizes to all who increased theirscores.• Ask each participant to write down one way in which they plan to increase their calcium and vitaminD intakes. Ask for a report at the next meeting.Outdated Publication, for historical use. CAUTION: Recommendations in this publication may be obsolete.

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