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14 Risk factors Do little or no physical activity Are a smoker Have a high alcohol intake Have low body weight Have low calcium intake Low vitamin D levels Frequently fall Have had long-term drug treatment with corticosteroids (such as prednisone)

15 Reducing your risk Maintain could calcium and vitamin D levelsWeight-bearing, high impact and strengthening exercise such as yoga Check the medications that may cause bone loss Stop smoking and drinking less alcohol A bone density test if appropriate

16 Bone mineral density scan DEXAdual energy x-ray absorptiometry

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18 Calcium Deposited as crystals in the bone giving hardnessEssential in the normal functioning of nerves and muscles Bones act as a storage bank for calcium Dietary intake is low, calcium is withdrawn from the bones .

19 Calcium metabolism Ingested calcium → blood → boneLow calcium blood ← bone (vitamin D and parathyroid hormone)

20 recommended calcium intake1000 mg per day 1300 mg per day, postmenopausal women and men over 70

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22 Recommended vitamin D intake5-15 micrograms per day (depending on age)

23 Recommended Sun exposureSydney 10 PM to 2 PM Summer, 6 to 8 min Winter, 26 to 28 min

24 Food sources of vitamin DFatty fish Liver Eggs Fortified, margarine and low-fat milk

25 Food source Serve size Calcium (mg) Regular milk 1 cup (250ml) 285 Skim milk 310 Natural yogurt 1 tub (200g) 340 Low fat yogurt 420 Cheddar cheese 40g cube  Low fat cottage cheese 100g  80 Non – dairy White bread 1 slice  15 Cooked spinach 1 cup (340g) 170 Cooked broccoli 1 cup (100g)  30 Canned salmon (+ bones) ½ cup 230 Canned sardines (+ bones) 50g 190 Almonds 15 almonds  50 Tofu 100g block *

26 Calcium inhibitors Very High Protein diet Salt Caffeine Phosphorus

27 Drug treatment Fosamax Protos

28 General principles Weight-bearing practicesNonweight bearing practices High impact movements

29 Avoid forward bends, especially with resistance

30 Yoga postures to avoid Shoulder stand Rolling along the spine Plough pose Sit up poses

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32 Modifying forward bends and twisting posesBend from the hips Keep the head up and the spine straight Only bring the head forward once the body is supported on the hands or the elbows

33 Categories of asanas for osteoporosisMuscle strengthening Balance training Posture and mobility High impact

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