APPENDIX B

OSTEOPOROSIS: RISK ASSESSMENT AND RECOMMENDATIONS

CHOOSE THE ITEM IN each category that best describes you, and fill in the point value for that item in the space to the right. In categories marked with an asterisk (*), you may choose more than one item.

 

Frame Size	Points
Small bones or petite	10
Medium frame, very lean	5
Medium frame, average or heavy build	0
Large frame, very lean	5
Large frame, heavy build	0
Score	———
Ethnic Background
Caucasian	10
Asian	10
Other	0
Score	———

 

Activity Level

How often do you walk briskly, jog, engage in aerobics or sports, or perform hard physical labor, for at least 30 continuous minutes?

 

Seldom	30
1–2 times per week	20
3–4 times per week	5
5 or more times per week	0
Score	———
Smoking
Smoke 10 or more cigarettes a day	20
Smoke fewer than 10 cigarettes a day	10
Quit smoking	5
Never smoked	0
Score	———
Personal Health Factors*
Family history of osteoporosis	20
Long-term corticosteroid use	20
Long-term anticonvulsant use	20
Drink more than 3 glasses of alcohol each week	20
Drink more than 1 cup of coffee per day	10
Seldom get outside in the sunlight	10
Score	———
For women only
Had ovaries removed	10
Premature menopause	10
Had no children	10
Score	———
Dietary Factors
Consume more than 4 ounces of meat daily	20
Consume soft drinks regularly	20
Consume the equivalent of 3–5 servings of vegetables each day	-10
Consume at least 1 cup of green leafy vegetables each day	-10
Take 1,000 mg of supplemental calcium and 800 IU of vitamin D	-10
Consume a vegetarian diet	10
Score	———
Total Score	———

 

INTERPRETATION

If your score is greater than 50, you are at significant risk of osteoporosis. However, you can reduce your score significantly by taking steps to reduce or eliminate risk factors. Start an exercise program; quit smoking; do not consume alcohol, coffee, or soft drinks (these leach calcium from the bones); take a good calcium and vitamin D supplement; and consume a diet low in protein and high in vegetables. These changes could take as many as 150 points off your total score.

If you are a woman, hormone replacement therapy may be appropriate for you, especially if you experienced an early menopause, had your ovaries surgically removed, or never had children. Both estrogen and progesterone have been shown to protect against bone loss. In women with established bone loss, these hormones may actually increase bone mass.

In my opinion, for women who are at risk of osteoporosis or who have already experienced significant bone loss, the benefits of natural hormone therapy outweigh the risks. But women at high risk of breast cancer or women with a disease aggravated by estrogen, such as active liver diseases or certain cardiovascular diseases, are an exception.

SUPPLEMENT RECOMMENDATIONS

• Foundation supplements
  • High-potency multiple vitamin and mineral: follow dosage recommendations on Backmatter.
  • Greens drink: one serving daily.
  • Fish oils: 1,000 mg of EPA and DHA daily.
• Calcium: 1,200 to 1,500 mg daily.
• Vitamin D: 1,000 to 2,000 IU daily.
• Magnesium: 250 to 400 mg daily.
• Boron: 3 to 5 mg daily.
• Soy isoflavones: 90 mg daily.