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"Lastly, loss of bone strength can also make older people more susceptible to hip fractures, which is one of the leading causes of death for older people. Adequate levels of calcium might explain why Nicoyans are avoiding risks that kill other populations. "But (there was always a "but" with the ever-cautious Gianni) before we can say for sure that Nicoya's water is part of the explanation of its longevity, we must do more tests." SAFETY NETS One night toward the end of the expedition, it was my turn to stand up after dinner and present a report to the team." - Dan Buettner, The Blue Zones: Lessons for Living Longer From the People Who've Lived the Longest (Get the book.)

"More women every year die from hip fractures — a vulnerability of osteoporosis — than from breast cancer. Women reach peak bone mass at around thirty, and after that they lose about 1 percent a year until menopause, when the pace doubles. The result is that by age sixty, about 30 percent of a woman's bone mass has disappeared. Unless, that is, she takes calcium and vitamin D (which comes free with ten minutes of morning sun a day) and does some form of exercise or strength training to stress the bones. Walking doesn't quite do the job—save that for later in life." - John J. Ratey, MD, Spark: The Revolutionary New Science of Exercise and the Brain (Get the book.)

"There is evidence that the frail individuals most likely to suffer osteoporotic hip fractures are likely to be malnourished generally (Hanger et al. 1999), including calcium (Ensrud et al. 2000) and vitamin D (LeBoff et al. 1999) deficient, but these tend to be debilitated, institutionalized elderly. There are randomized controlled trials, over a decade old now, suggesting that supplementation with vitamin D and calcium has demonstrable benefit in terms of hip fracture risk (M. C. Chapuy et al. 1992), not just improving osteopenia." - Nortin M. Hadler MD, Worried Sick: A Prescription for Health in an Overtreated America (Get the book.)

"The study randomized women between the ages of 70 and 79 to receive Actonel (the brand name of risedronate, a cousin of Fosamax) or a placebo for three years. hip fractures were significantly reduced only in the women who already had a spine fracture when the study began (40 percent of the women in the study). One hundred such women would have to take Actonel for about one year to prevent one hip fracture. For the other 60 percent of women in the study without a preexisting spine fracture, Actonel did not significantly reduce the risk of hip fracture." - John Abramson, Overdosed America: The Broken Promise of American Medicine (P.S.) (Get the book.) "How can it be that drugs approved for the prevention and treatment of osteoporosis succeed in increasing bone density but have such limited impact on reducing hip fractures? The answer can only inspire awe at Mother Nature's elegance. There are two types of bone. Eighty percent of the body's bone is made up of the hard and dense outer layer called cortical bone." - John Abramson, Overdosed America: The Broken Promise of American Medicine (P.S.) (Get the book.) "So how can older women reduce their risk of hip fractures? As we've just seen, there are no magic pills. But there are ways to significantly strengthen bones and reduce the risk of fracture at any age. Proper exercise and good nutrition are important through all stages of life to build and maintain strong bones. Reaching young adulthood with bones strengthened by routine exercise and a diet with adequate calcium makes future problems far less likely." - John Abramson, Overdosed America: The Broken Promise of American Medicine (P.S.) (Get the book.) "And for women over 70—even those with severe osteoporosis—Fosamax's cousin, Actonel, significantly reduces the risk of hip fractures only in women who have already had spine fractures. Meanwhile, how many women taking these drugs are aware of the research showing the significant benefits of exercise in preventing fractures and, more important, improving overall health and longevity? Those are 10 of the 15 best-selling drugs for seniors." - John Abramson, Overdosed America: The Broken Promise of American Medicine (P.S.) (Get the book.)

"A deficiency leads to weak bones and hip fractures. Moreover, a series of recent studies has pointed to poor vitamin K status as a significant risk factor for severe coronary artery calcification. The dilemma we face is that Coumadin is a vitamin K antagonist, and when vitamin K levels fall, the propensity for arterial damage increases. Obviously, we don't want this to happen to our patients. Thus, we are concerned about the long-term use of Coumadin, especially since doctors usually tell patients to take the medication for the rest of their lives." - Stephen Sinatra, M.D. and James C., M.D. Roberts, Reverse Heart Disease Now: Stop Deadly Cardiovascular Plaque Before It's Too Late (Get the book.)

"Although most studies do not show a positive effect of calcium in reducing fracture risk, in the Women's Health Initiative (WHI) trial, hip fractures were significantly reduced in older women on the calcium supplement program.65 Calcium supplementation has also been shown to decrease bone loss in postmenopausal women.66 The effects of calcium supplementation have been greatest in women whose baseline calcium intake was low, in older women, and in women with osteoporosis." - Tori Hudson, N.D., Women's Encyclopedia of Natural Medicine: Alternative Therapies and Integrative Medicine for Total Health and Wellness (Get the book.) "The rates of hip fractures were reduced by 77 percent, other non-vertebral fractures by 81 percent, and vertebral fractures by 60 percent.110 Most of the studies in this meta-analysis were of postmenopausal women, but some of the studies included patients who had diseases that are associated with higher risk of osteoporosis, including patients with primary biliary cirrhosis and some on glucocorticoids." - Tori Hudson, N.D., Women's Encyclopedia of Natural Medicine: Alternative Therapies and Integrative Medicine for Total Health and Wellness (Get the book.)

"The WHI study results included evidence of an increase in the risk for breast cancer and heart disease, yet reduced the risk of hip fractures and colorectal cancer. One reason for the results in the WHI trial is the use of synthetic progestogens rather than natural progesterone. LOW TESTOSTERONE IS COMMON IN DIABETIC MEN A study in the November 2004 issue of the Journal of Clinical Endocrinology and Metabolism revealed that one out of three diabetic men have low testosterone levels." - Steven V. Joyal, What Your Doctor May Not Tell You About Diabetes: An Innovative Program to Prevent, Treat, and Beat This Controllable Disease (Get the book.)

"A recent review of research looking at vitamin D treatment for osteoporosis published in the Journal of the American Medical Association showed an average 26 percent reduction in hip fractures and a 23 percent reduction in all nonspine fractures. This magnitude of protection exceeds the benefits seen with some medications currently approved by the FDA for the prevention and treatment of osteoporosis. These benefits were seen only in studies using 800 IU per day or more of vitamin D. Studies that looked at lower doses showed no decrease in fracture rates." - James Dowd and Diane Stafford, The Vitamin D Cure (Get the book.)

"Women with a family history of osteoporosis, and especially hip fractures, are at the highest risk of developing the condition. Eighty to ninety percent of the determination of the development of osteoporosis is a family history of osteoporosis. • Fracture risk can be determined from a medical history, physical exam, laboratory testing, and a DXA bone density test. or have eating disorders are susceptible to insufficient intake of vitamins and minerals and therefore may have insufficient bone mass." - Tori Hudson, N.D., Women's Encyclopedia of Natural Medicine: Alternative Therapies and Integrative Medicine for Total Health and Wellness (Get the book.)

"While their rate of hip fractures is lower than in the US, the Japanese have twice the rate of vertebral fractures. The difference in hip fractures is probably due to a difference in anatomy, which makes the hip less likely to break on impact. Other evidence suggests that isoflavones do promote bone strength. The US Department of Agriculture (USDA) and the National Institutes of Health (NIH) are currently allotting significant resources—approximately $10 million—for studies to determine whether isoflavones play a role in bone health. •Breast cancer." - Bottom Line Health, Bottom Line's Health Breakthroughs 2007 (Get the book.)

"Nicoyan water has the country's highest calcium content, perhaps explaining the lower rates of heart disease, as well as stronger bones and fewer hip fractures. Keep a focus on family. Nicoyan centenarians tend to live with their families, and children or grandchildren provide support and sense of purpose and belonging. Eat a light dinner. Eating fewer calories appears to be one of the surest ways to add years to your life. Nicoyans eat a light dinner early in the evening. Maintain social networks. Nicoyan centenarians get frequent visits from neighbors." - Dan Buettner, The Blue Zones: Lessons for Living Longer From the People Who've Lived the Longest (Get the book.)

"Although heart disease, cancer, stroke, and diabetes are the leading causes of death for Americans over age sixty-five, many of them live in fear of falling and breaking their brittle bones. hip fractures are particularly devastating because they require months to rehabilitate, and losing mobility in such a pivotal, weight-bearing joint can dramatically reduce a person's activity level. About 20 percent of older adults who break a hip die within a year." - John J. Ratey, MD, Spark: The Revolutionary New Science of Exercise and the Brain (Get the book.)

"A hypothesis: The causes of hip fractures. J. Gerontol. 44, M107-M111. 6. Schwartz, A. V., Capezuti, E., and Grisso, J. A. (2001). In "Osteoporosis" (R. Marcus, D. Feldman, and J. Kelsey, Eds.), 2nd ed., pp. 795-807. Academic Press, San Diego, CA. 7. Lee, C. A., and Einhorn, T. A. (2001). The bone organ system, form and function. In "Osteoporosis" (R. Marcus, D. Feldman, and J. Kelsey, Eds.), 2nd ed., pp. 3-20. Academic Press, San Diego, CA. 8. Brown, E. M. (1994). Homeostatic mechanisms regulating extracellular and intracellular calcium metabolism. In "The Parathyroids" (J. P." - Ann M. Coulston and Carol J. Boushey, Nutrition in the Prevention and Treatment of Disease (Get the book.) "The potential health implications are grave and include vertebral fractures, kyphosis, hip fractures, and Colles' fracture of the lower radius in the arm [14]. These problems can begin in childhood, when radiographs may reveal delayed bone age, rickets, or osteomalacia, which left untreated may lead to osteoporosis. It is believed that early interventional therapy with a gluten-free diet may prevent progression and may even reverse bone loss [15]." - Ann M. Coulston and Carol J. Boushey, Nutrition in the Prevention and Treatment of Disease (Get the book.) "Vitamin D3 and calcium to prevent hip fractures in the elderly women. N. Engl. J. Med. 327, 1637-1642. 25. NIH Consensus Conference. (1994). Optimal calcium intake. JAMA 272, 1942-1948. 26. Food and Nutrition Board, Institute of Medicine. (1997). "Dietary Reference Intakes for Calcium, Magnesium, Phosphorus, Vitamin D, and Fluoride." National Academies Press, Washington, DC. 27. "Recommended Dietary Allowances," 10th ed. (1989). National Academies Press, Washington, DC 28. Matkovic, V., and Heaney, R. P. (2002). Calcium balance during human growth. Evidence for threshold behavior. Am. J." - Ann M. Coulston and Carol J. Boushey, Nutrition in the Prevention and Treatment of Disease (Get the book.) "Bone density at various sites for prediction of hip fractures. The Study of Osteoporotic Fractures Research Group. Lancet 341(8837), 72-75. 59. Johnell, O., Kanis, J. A., Oden, A., Johansson, H., De Laet, C, Delmas, P., Eisman, J. A., Fujiwara, S., Kroger, H., Mellstrom, D., Meunier, P. J., Melton, L. J. 3rd, O'Neill, T., Pols, H., Reeve, J., Silman, A., and Tenenhouse, A. (2005). Predictive value of BMD for hip and other fractures. /. Bone Miner. Res. 20, 1185-1194. 60. Faulkner, K. G. (2003). Improving femoral bone density measurements. J. Clin. Densitom. 6, 353-358. 61. Kanis, J. A." - Ann M. Coulston and Carol J. Boushey, Nutrition in the Prevention and Treatment of Disease (Get the book.)

"Well, they had 29 percent fewer hip fractures than those who'd not followed precise instructions. There could be a calcium-vitamin D cancer connection. Keep in mind that short-term studies are simply not long enough to see definitive effects on cancer incidence. Cancer is a disease that typically develops over 10 to 20 years. From this trial, though, certain interesting results were noted. The women who started the study with low blood levels of vitamin D developed colorectal cancer twice as often as those with the highest levels." - Elaine Magee, Food Synergy: Unleash Hundreds of Powerful Healing Food Combinations to Fight Disease and Live Well (Get the book.)

"In the elderly, 25% of hip fractures lead to a permanent loss of independent function. No wonder many seniors, especially frail ones, live in mortal fear of fractures that may send them to oft-dreaded nursing homes for the rest of their few remaining days (although my neighbor lived out her long life at home). Bone Density Bone density, that is, the thickness of your bones, is determined by a bone-mineral density (BMD) test." - J. Douglas Bremner, Before You Take that Pill: Why the Drug Industry May Be Bad for Your Health (Get the book.) "The only studies that showed that calcium and vitamin D prevented hip fractures involved French women who had osteoporosis and were living in nursing homes.9 However, it is unclear whether these women had calcium and/or vitamin D deficiency due to their nursing-home diet or lack of sunlight from their environment. Other studies of individuals outside nursing homes found no beneficial effects from vitamin D and calcium supplementation in terms of hip-fracture prevention." - J. Douglas Bremner, Before You Take that Pill: Why the Drug Industry May Be Bad for Your Health (Get the book.) "The only studies that showed that calcium and vitamin D prevented hip fractures involved French women who had osteoporosis and were living in nursing homes.17 However, these women may have had a calcium and/or vitamin D deficiency due to diet or lack of sunlight as a result of their environment. Other studies of individuals outside nursing homes found that vitamin D and calcium supplementation had no beneficial effects in terms of hip-fracture prevention." - J. Douglas Bremner, Before You Take that Pill: Why the Drug Industry May Be Bad for Your Health (Get the book.) "It is clear from the studies that the people who get hip fractures are those who become frail and inactive and thus more likely to fall. In fact, osteoporotic fractures of the hip are inversely related to exercise. Furthermore, although bone thinning contributes to the risk of fracture, the risk is primarily related to a loss of balance, which often results in falls. Exercise helps elders maintain their balance. In fact, there is no difference in bone density between those with and without fractures. The best exercise for increasing bone mass is strength training." - J. Douglas Bremner, Before You Take that Pill: Why the Drug Industry May Be Bad for Your Health (Get the book.)

"A 2004 report in Nutrition Reviews speculated that long-term consumption of diets high in vitamin A stimulates bone resorption and inhibits bone formation, and may contribute to osteoporosis and hip fractures. This report caused many patients to discontinue supplementation with vitamin A. These concerns turned out to be unfounded. In a very large 2004 cohort study published in Osteoporosis International, 34,703 postmenopausal women were followed prospectively to determine if their supplemental vitamin A and dietary intakes were associated with increased hip fractures or all fractures." - Abram Hoffer, PhD, MD, FRCP(C) and Dr. Jonathan Prousjy, DPHE, DSC, ND, FRSH, Naturopathic Nutrition: A Guide to Nutrient-rich Food & Nutritional Supplements for Optimum Health (Get the book.) "A 20% reduction in hip fractures in United States would prevent about 45,000 hip fractures and save about $1.5 billion dollars in health costs. Dr A.R. Gaby and Dr J.V. Wright, in their book Nutrients and Bone Health, describe the following compounds that can be used in treating osteoporosis: 1. Estrogens and calcium. These are only partially helpful. Estrogen in the context of hormone replacement therapy has been shown to have too many risks (e.g., stroke, blood clots, breast cancer) and is becoming a less than desirable option for post-menopausal women. 2. A naturopathic diet." - Abram Hoffer, PhD, MD, FRCP(C) and Dr. Jonathan Prousjy, DPHE, DSC, ND, FRSH, Naturopathic Nutrition: A Guide to Nutrient-rich Food & Nutritional Supplements for Optimum Health (Get the book.)

"So, when women choose not to take estrogen after menopause, they are more likely to lose trabecular bone and therefore may be at higher risk for vertebral and hip fractures. Cortical bone loss occurs with calcium and vitamin D abnormalities such as vitamin D deficiency and leads to an increased risk of extremity fractures. An extreme form of this is rickets, which presents with bowing of the femurs that results from small microfractures of those bones." - Tori Hudson, N.D., Women's Encyclopedia of Natural Medicine: Alternative Therapies and Integrative Medicine for Total Health and Wellness (Get the book.)

"Wennberg's group looked at rates of heart attacks, strokes, hip fractures, cancer, and bleeding in the stomach in order to measure whether level of illness could account for how much care people got. There were differences, but they were slight. The elderly in Birmingham, Alabama, for instance, were less healthy on average than those living in Palm Springs, California, largely because the residents of Birmingham were poorer. But rates of illness had little to do with rates of medical care in Palm Springs and Birmingham, or with how much Medicare spent." - Shannon Brownlee, Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer (Get the book.)

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