**RESOLUTIONS - for FEELING YOUR BEST**

Put aside any guilt about holiday overdoing and move ahead with these
basic year-round
[tips](http://www.aicr.org/site/News2?abbr=pub_&page=NewsArticle&id=14207).

-   Spend a few minutes each week to plan meals and keep a stock of
    enjoyable and healthy staples.

-   Schedule a daily minimum of two 15-minute walks or other physical
    activity of moderate intensity.

-   Savor food and eat slowly. What and how we eat matters. Choose more
    fruits and vegetables.

-   Cut back not out. To satisfy a craving, enjoy a modest portion.

> **\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\***

**OSTEOPOROSIS -- the Silent Disease**

![](media/image1.png){width="1.3125in" height="0.6701388888888888in"}

#### Risk Factors for Osteoporosis and Fracture\*^\[2,3\]^ \*Representative list, not comprehensive. (See this [medscape program](http://www.medscape.com/viewprogram/17528_pnt))

+-------------------------------+--------------------------------------+
| **Potentially Modifiable      | **Difficult or Impossible to Modify  |
| Factors**                     | Factors**                            |
+-------------------------------+--------------------------------------+
| Lifestyle Factors             | Physiologic Factors                  |
|                               |                                      |
| -   Excessive intake of       | -   Advanced age                     |
|     caffeine                  |                                      |
|                               | -   Endocrine disorders (e.g.,       |
| -   Excessive intake of salt  |     Cushing\'s, thyroid              |
|                               |     abnormalities, diabetes, adrenal |
| -   Excessive intake of       |     insufficiency,                   |
|     vitamin A                 |     hyperparathyroidism)             |
|                               |                                      |
| -   Alcoholism/high intake (≥ | -   Gastrointestinal disorders       |
|     3 drinks/day)             |     (e.g., malabsorption,            |
|                               |     inflammatory bowel disease,      |
| -   Calcium deficiency        |     celiac disease)                  |
|                               |                                      |
| -   Vitamin D deficiency      | -   Hematologic disorders            |
|                               |     (hemophilia, sickle cell         |
| -   Low                       |     disease, thalassemia, leukemia)  |
|     a                         |                                      |
| ctivity/inactivity/immobility | -   Medical conditions predisposing  |
|                               |     to falls                         |
| -   Smoking (passive or       |                                      |
|     active)                   | -   Prior fracture                   |
|                               |                                      |
| -   Weight ≤ 127, body mass   | Family History                       |
|     index ≤ 22, frailty       |                                      |
|                               | -   Family history of osteoporosis   |
| Medication Use                |     or hip fracture                  |
|                               |                                      |
| -   Aluminum intake (e.g.,    | -   Genetic disorders (e.g., cystic  |
|     antacids)                 |     fibrosis, homocystinuria,        |
|                               |     Gaucher\'s disease,              |
| Physiologic Factors           |     hemochromatosis, Marfan          |
|                               |     syndrome)                        |
| -   Amenorrhea                |                                      |
|                               | Medication Use                       |
| -   Eating disorder           |                                      |
|                               | -   High risk medication use (e.g.,  |
| -   Hormone suppression       |     corticosteroids for ≥ 3 months,  |
|     (e.g., post menopause,    |     heparin, anticonvulsants,        |
|     athletic suppression,     |     chemotherapeutic agents,         |
|     eating disorder,          |     depo-medroxyprogesterone)        |
|     hyperprolactinemia)       |                                      |
|                               |                                      |
| Environmental Factors         |                                      |
|                               |                                      |
| -   Passive smoke exposure    |                                      |
|                               |                                      |
| -   Risks for falls (e.g.,    |                                      |
|     trip hazards, obstacles,  |                                      |
|     ice)                      |                                      |
+-------------------------------+--------------------------------------+

**Vitamin D -- for Musculoskeletal and Heart Health**

Vitamin D deficiency is an emerging cardiovascular risk factor.
According to this
**[article](http://www.webmd.com/heart-disease/news/20081201/too-little-vitamin-d-puts-heart-at-risk?page=2&print=true),**

research has shown that a deficiency is linked to high blood pressure,
obesity, and diabetes and increases the risk of having a heart attack or
stroke. Low levels of vitamin D may predispose one for chronic blood
vessel inflammation and increased resistance to insulin.

Those at risk for vitamin D deficiency are the elderly, darkly pigmented
persons, those with reduced skin exposure, those who smoke or are obese,
and those with kidney or liver disease. Measuring the level of vitamin D
through the blood test, 25-hydroxy vitamin D, may be recommended for
those at high risk. Levels above 30 ng/dL are normal. The current
recommended daily allowance for vitamin D is 200 international units
(IU) per day for those under age 50 years; 400 IU for those between 50
and 70 years; and 600 IU for those over 70 years.

Food sources of vitamin D are salmon, sardines, cod liver oil and
vitamin-D fortified foods. Sunlight exposure at the time when the sun
rays are the strongest results in synthesis of the vitamin by the skin.
(Sunscreen with a sun protection factor of 15 or higher blocks nearly
all of the synthesis.) However, to guard against skin cancer, use
sunscreen for intense sunlight exposure of more than 15 minutes.

![](media/image2.jpeg){width="0.9583333333333334in" height="0.9125in"}

**Healthy Habits and Food for Thought**

-   Quite simply this
    [article](http://www.medscape.com/viewarticle/584181?src=mp&spon=24&uac=101016HK)
    describes how "purpose in life" can affect resilience and mental
    health outcomes following severe trauma.

> **Further notes, about nutrition and food planning, in considering
> resolutions:**

-   One **serving** of meat or fish is about what fits in the palm of a
    hand. One serving of fresh fruit is about the size of a fist. And a
    serving of cooked vegetables, rice, or pasta fits in a cupped hand.

-   Some dietary **fat** -- about 25% to 35% of our daily calories -- is
    needed. The type of fat matters. The healthy or unsaturated fats \--
    found in canola, olive, and safflower oils -- lower LDL \"bad\"
    cholesterol levels and may help raise HDL \"good\" cholesterol;
    monounsaturated fat -- found in nuts -- also lower LDL cholesterol
    and an ounce of nuts a day may lower the risk of heart disease. The
    unhealthy or saturated fats -- found in butter and palm oil -- and
    transfats raise LDL cholesterol. The caveat is the fact that all
    fats have calories; eat them in due moderation.

-   A bowl of oatmeal or whole-grain cereal has benefits that last all
    day. The fiber and complex carbohydrates in **whole grains** (also
    found in brown rice, quinoa, popcorn, whole wheat pasta, and beans)
    also reduce LDL cholesterol and can be an important part of a weight
    loss strategy.

-   Consider these
    [tips](http://www.realage.com/StayingYoung/Nutrient_Quiz.aspx) and
    ingredients of "**foods to fight aging.**" Turmeric, found in Indian
    curries, may boost memory and protect against Alzheimer's disease.
    Quercetin, found in onions, apples, blackberries, garlic, tomatoes,
    asparagus, and cranberries, is a powerful antioxidant that
    strengthens the immune system and sharpens mentation. Folate, a B
    vitamin, and phytochemicals, found in leafy greens, may assist in
    hearing high-frequency sounds.

> No one food alone will establish better health, but a basket of them
> will.