Dr.maninder Ahuja
Chairperson Geriatric gynaecology committe FOGSI
In co-ordination with
Dr.Jaideep Malhotra
&
Chairperson public awareness committee (IMS)
4/7/2015
Dr.MANINDERAHUJA
1
If this is your age
0 to 6 months
7 to 12 months
1 to 3 years
4 to 8 years
9 to 18 years
19 to 50 years
Over 50 years
4/7/2015
Then you need
this much calcium
each day (mg)
210
270
500
800
Growth
1,300
spurt
1,000
1,200-1500 BONE LOSS
Dr.MANINDERAHUJA
2
Some age groups need MORE or LESS than 100% DV for calcium and vitamin
D.
•
Calcium requirements vary by age:
• More is needed as we grow older
• Need is highest during rapid growth of adolescence.
•
100% DV for calcium and Vitamin D are based on 1,000 mg calcium and 400
IU vitamin D.( DV –DAILY VALUES)
4/7/2015
Dr.MANINDERAHUJA
3
600 IU-800IU
600
Daily
vitamin D
needs in
International
Units (IU)
500
400 IU
400
300
200 IU
200
100
0
4/7/2015
up to 50
Age
Dr.MANINDERAHUJA
51-70
over 70
4

FDA uses “Percent Daily Value” (% DV) to
describe amount of calcium needed by
general U.S. population daily

100% DV for calcium
= 1,000 mg

Look for this label:
 “Nutrition Facts” on foods
 “Supplement Facts” on vitamin/mineral
supplements
4/7/2015
Dr.MANINDERAHUJA
5




Broccoli, raw
1 cup = 9% DV

Yogurt-
1 cup (8 oz.) = 30% DV
Collards
1/2 cup = 20% DV

Turnip greens, boiled
1/2 cup = 10% DV
Milk
1 cup = 30% DV

Orange juice and other calciumfortified beverages
Cheese
1½ oz. natural/2 oz. processed = 30% DV

Milk pudding
1/2 cup = 15% DV

Frozen yogurt, vanilla, soft serve
½ cup = 10% DV

Ice cream, vanilla
½ cup = 8% DV

Soy or rice milk, calcium-fortified
1 cup = varies—check label
6 oz. = 20 to 30% DV, varies—check
label
4/7/2015
Dr.MANINDERAHUJA
6
FOOD ITEM
Ca mgs/100gm
%of RDI(25-50 YRS)
Fenugreek
470mg
12%
Cauliflower
140mg
14%
Spinach
60mg
6%
Ladies fingers
90mg
9%
Beetroot
200 mg
20%
Cabbage
80mg
6%
Grapes
30 mg
7%
Dates
70 mg
5%
Orange
50 mg
10%
Raisins
100mg
11%
Banana
10 mg
1%
Papaya
10 mg
1%
4/7/2015
Dr.MANINDERAHUJA
7
FOOD ITEM
Ca mg/100 gm
% of RDI(25-50 YRS)
Ragi
330 mg
32%
Mutton (muscle)
150mg
15%
Crab
1370 mg
137%
Mackerel(bangda)
430mg
43%
Rohu
650 mg
65%
Black gram (urad dal)
200mg
20%
Soya bean
240 mg
24%
Dal
160 mg
16%
Almonds
230 mg
23%
Milk powder skimmed
1270Mg
137%
Milk powder whole
910 mg
91%
4/7/2015
Dr.MANINDERAHUJA
8
• Calcium: The UL(upper limit for 1 year and older
(including pregnant and lactating women)
is 2,500 mg/day. It was not possible to
establish an UL for infants under age 1.
• Vitamin D: No higher than 50 mcg (micrograms)
or 2,000 IU for ages 1 and over; 25 mcg (1,000
IU) for 0 to 12 months
The National Osteoporosis Foundation recommends limiting
Vitamin D to 800 IU/day unless your doctor prescribes it.
4/7/2015
Dr.MANINDERAHUJA
9

An easy way to meet calcium
needs is consuming 3 cups (8
oz.) each day of fat-free or
low-fat* milk or equivalent
milk products in combination
with
a healthy diet.
4/7/2015
equivalents:
• 8 oz. milk
• 1 cup yogurt
• 1-1/2 oz. natural
..or 2 oz. processed
..cheese
Dr.MANINDERAHUJA
10
EXCESSIVE SODIUM


OXALIC ACID
Can increase urinary calcium
excretion
2,300 mg daily



4/7/2015
Dr.MANINDERAHUJA
Oxalic acid in foods such as spinach, chard,
beet greens and chocolate Binds calcium in
those foods
Doesn’t seem to affect calcium in other
foods, including chocolate milk
These greens still good for you; may help
calcium absorption in other ways
11

Baked beans
1 cup = 14% DV

Salmon, canned, with edible bones
3 oz. = 18% DV


Sardines, canned, in oil, with edible
bones
3 oz. = 32% DV

Soybeans, cooked
1 cup = 26%

Tofu, firm, with calcium
½ cup = 20% DV; check label
4/7/2015
Cereal, calcium- fortified
Serving size and amount
of calcium varies—check
label
Dr.MANINDERAHUJA
12




Vitamin D is manufactured in your
skin following direct exposure to sun.
Amount varies with time of day,season,
latitude and skin pigmentation.
10–15 minutes exposure of hands,
arms and face 2–3 times/week may be
sufficient (depending on skin
sensitivity).
Clothing, sunscreen, window glass and
pollution reduce amount produced
4/7/2015
Main dietary sources of vitamin D are:
• Fortified milk
(400 IU per quart)
• Some fortified cereals
• Cold saltwater fish
(Example: salmon, halibut, herring,
tuna, oysters and shrimp)
• Some calcium and vitamin/mineral
supplements
Dr.MANINDERAHUJA
13

There may be additional substances in foods that
affect the body’s absorption and use of their
calcium. So try to obtain Ca requirement from
food.

A balanced diet that promotes a healthy weight
may provide additional benefits to protect against
osteoporosis.
At one time body can absorb 500 mg so take
throught day.

4/7/2015
Dr.MANINDERAHUJA
14





Start with small portions of
foods such as milk and
gradually increase serving size
Eat dairy foods in
combination with a meal or
solid foods.
Try dairy foods other than
milk:
Many hard cheeses (cheddar,
Swiss, Parmesan) have less
lactose than milk
Yogurt made with live, active
bacteria
4/7/2015



It may be easier to digest
lactose that is pre-digested
or broken down to its simple
sugar components
(glucose and galactose):
Lactose-hydrolyzed milk and
dairy products
Commercial lactase
preparations
Dr.MANINDERAHUJA
15
IF YOU DON’T LIKE MILK? TAKE ALTERNATIVES
Add milk to coffee
Make oatmeal and
cream-type soups with
milk instead of water
Add powdered milk to food
(1 tablespoon = 50 mg calcium)
4/7/2015
Dr.MANINDERAHUJA
16
Serve milk-based desserts
(puddings, frozen yogurt,
custard, ice cream,kheer).
Limit
fat and sugar.
Make instant
hot cocoa
with milk,
not water.
4/7/2015
Try chocolate milk.
• 8-oz. has only 2 - 7 mg
caffeine.
• Average glass provides
only 60 more calories
than unflavored milk.
Dr.MANINDERAHUJA
17




For support of back and
hip
Would reduce pain
Less chances of fracture
if used properly
Not used during night
time
4/7/2015
Dr.MANINDERAHUJA
18

Aerobic like walking,
yoga, taichi, dancing for
heart endurance and
weight management ,
balance, range of
movement and toning up
of muscles
4/7/2015

Weight bearing and
strength building for
prevention of weak
muscles and weak bones
Dr.MANINDERAHUJA
19
Cobra Pose –
 Lie on your belly. Place your
hands besides your chest or
shoulders. Inhale as you lift
your head and shoulders,
pressing your hips into the
floor and tightening your
buttock muscles. Using your
hands as support, arch your
back up, to a comfortable
stretch. Keep your shoulders
relaxed back and down
without overstretching your
lower back. Only come as
4/7/2015high up as is comfortable.
Dr.MANINDERAHUJA

20


Half Wheel Pose –
On your back, grab your ankles and
draw your heels to the buttocks,
with the heels about 18 inches
apart. Tighten your buttock
muscles, raise your entire torso up
off the ground, slowly as if
massaging each part of your back,
and arch your spine, as if pressing
your navel point to the sky. Hold
this position for up to 3 minutes,
or move the body in
synchronization with your breath,
inhaling as you stretch up and
exhaling as you relax your back
down. This exercise helps to
strengthen your lower back, and
relieve tension in the ovaries.
4/7/2015
Dr.MANINDERAHUJA
21


Knees to Chest for Lower Back
Relaxation –
Lying on your back, gently draw
your knees to your chest and hold
them there with your hands. Relax
your head, neck and shoulders.
Relax your breath. You can gently
rock side to side as well. This
posture provides a gentle stretch for
your lower back and massages your
ovaries and reproductive organs.
This is a rejuvenating exercise.
Relax in this posture to help you
tune into your body and let go of
tension.
4/7/2015
Dr.MANINDERAHUJA
22
SEATED ROW FOR BACK
KEEP YOUR BACK ST.DON’T BEND
FORWARD
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LUNGES FOR THIGH
Dr.MANINDERAHUJA
23
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Dr.MANINDERAHUJA
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Dr.MANINDERAHUJA
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