How to Keep Your Hip Healthy by Don Chambers

[Pat Walter]

                                How to Keep Your New Hip Healthy by Don Chambers

Note: Posted by Patricia Walter for Don Chambers

With my hip surgery less than 6 weeks away I have begun researching things I can do to prepare myself. I want to have the best chances for success. The possibility of femoral neck fracture is something I want to avoid. It is also very important that the bone structure remains as healthy as possible, for as long as possible, no matter what implant device you have.

There are several top priorities to keeping your new hip healthy. Exercise should be at the top of the list. When a person’s limb is immobilized in a cast or lies down for a period of time the weight bearing bones become relieved of their burden. This is called “skeletal unloading,” and results in bone deterioration. An exercise as simple as walking will prevent this type of bone loss. Exercise stimulates bone formation, so walk, walk, and walk some more!

Bone Loss

Lurking in the darkness is yet another type of bone loss deterioration that occurs naturally as we age and is often overlooked.  Maximum bone density is achieved between the ages of 15 and 25. Then, especially during menopause, women can lose 20 percent or more of their bone mass. Men also lose bone mass but at a slower rate. When bone density becomes too low you can develop conditions such as osteoporosis.

Is Bone Loss due to Aging Preventable?  

For years the common wisdom was to simply increase your calcium intake. Some people take a calcium supplement, yet most people do not take anything! Most rely on their daily diet, which is not sufficient on its own in preventing bone loss. Even more surprising are new studies that show that supplementing with calcium alone does NOT stop the bone loss.  Calcium absorption is the key to preventing bone loss, and you have to supply your body with the proper tools to do so.

Vitamin D for Calcium Absorption

According to Dr. Michael F. Holick, Director of the Vitamin D Skin and Bone Research Laboratory at Boston University, “If you don't have adequate vitamin D you cannot efficiently absorb calcium," he said. "Vitamin D also helps maintain bone health by keeping bone cells active."

Holick also notes, “The fracture-vitamin D link has been observed for 15 years, the good news is it’s consistent, the higher your vitamin D status, the lower the risk of your developing a hip fracture.”

Low levels of vitamin D can boost older women’s risk for hip fracture by more than 70 percent, according to a study at the University of Pittsburgh.

Vitamin D3 …The Critical Link

Technically not a “vitamin," vitamin D is in a class by itself. Its metabolic product, calcitroil, is actually a secosteroid hormone that targets over 2000 genes (about 10% of the human genome) in the human body. It has a great effect on overall health.

Dr. James Dowd, who has more than 20 years of related research explains, “It is important to understand that activity levels, diet, and exposure to the sun have dramatically changed over the years. Many people mistakenly think they get enough vitamin D from casual sun exposure or diet. This is not true. People in today’s urban society rarely get enough sun exposure to fill their vitamin D requirement.”

Odds Are, You Are Vitamin D Deficient

According to a recent report from the Center for Disease Control and prevention (CDC )  55% of Caucasian men, 65% of Caucasian women,  75% of Latinos, and 90% of African Americans are vitamin D deficient.

How Much Vitamin D3 Is the Right Amount?

Dr. John Jacob Cannell, Executive Director of the nonprofit Vitamin D Council says:

If well adults and adolescents regularly avoid sunlight exposure, research indicates a necessity to supplement with at least 5,000 international units (IU) of vitamin D daily. To obtain this amount from milk one would need to consume 50 glasses. With a multivitamin more than 10 tablets would be necessary. Neither is advisable.

The skin produces approximately 10,000 IU vitamin D in response to 20â€"30 minutes of summer sun exposure.  That is 50 times more than the US government's recommendation of 200 IU per day!

How Can I Tell If I’m Vitamin D Deficient?

Take the test to find out.

“Women need to know their vitamin D status," Dr. Cannell says. “They need to ask their doctor for the right test,” known as the 25 hydroxy D test. “Women should strive to keep your vitamin D levels above 125 nanomoles per liter, year round. To do that, they are going to require supplements…Most people are not getting enough of the nutrient. In fact, most people are vitamin D deficient.”


How to Get Enough Vitamin D3

There are 3 ways for adults to ensure adequate levels of vitamin D:

•   Regularly receive midday sun exposure in the late spring, summer, and early fall, exposing as much of the skin as possible.
•   Regularly use a sun bed (avoiding sunburn) during the colder months.
•   Take 5,000 IU per day for three months, and then obtain a 25-hydroxy vitamin D test. Adjust your dosage so that blood levels are between 50â€"80 ng/mL.

Any health food store, pharmacy, or even Wal-Mart has 2000 IU capsules for about $9.00 for 200 pills. But the best source, by far, is exposing your skin to the sunlight.

Dr. Holick states:
Photosynthesis of vitamin D has been occurring on earth for more than 750 million years. Some of the earliest life forms that were exposed to sunlight for their energy requirement were also photosynthesizing vitamin D. Both children and adults have in the past depended on adequate sun exposure to satisfy their vitamin D requirement. It is well documented that at the turn of the last century upwards of 80% of children in the industrialized, polluted cities of northern Europe and northeastern United States suffered from the devastating consequences of vitamin D deficiency rickets. The skin has a large capacity to make vitamin D. An analysis of data has demonstrated that neither children nor adults are receiving an adequate amount of vitamin D from their diet or from supplements.

The Advantage of Sunlight over a Pill

When vitamin D is made in the skin from sunlight it enters the dermal capillary bed, and essentially 100% is bound to the vitamin D binding protein. When vitamin D is ingested in pill form, it is processed by the liver. As a result, no more than 60% of the vitamin D that is ingested is bound to the vitamin D binding protein, whereas the other 40% is mostly bound to lipoproteins. Thus, the vitamin D that is made in the skin is more effective than when ingested from the diet or from a supplement.

An added benefit is sun exposure is free, unlike a vitamin D supplement.

Controversy about Sun Exposure

Dr. Holick explains:
90-95% of most people’s vitamin D requirement comes from casual exposure to sunlight. Why is there such a controversy about sensible sun exposure as a recommendation to satisfy our vitamin D requirement? The sun has been demonized, and as a result, most of the world’s population has been brain washed into thinking that any exposure to sunlight is bad medicine. This is unfortunate since there is essentially no substantiated scientific evidence to suggest that moderate sun exposure either significantly increases risks of squamous and basal cell carcinomas, and more importantly, the most deadly form of skin cancer melanoma. There is no question that excessive exposure to sunlight and sun burning experiences significantly increase risk of both basal and squamous cell carcinoma. However, these cancers are often easily detected, and if detected early, are easily treated and often cured. Melanoma on the other hand, is a very aggressive and deadly form of skin cancer. However, most melanomas occur on the least sun exposed areas, and a recent meta-analysis of 35 studies suggests that occupational exposure to sunlight decreases risk of developing melanoma.

Back to Calcium

It is possible your calcium intake is already adequate, but is not being processed because of a lack of Vitamin D. Now that you know how to get plenty of Vitamin D, the calcium should be absorbed properly into your system.  According to the Office of Dietary Supplements, 1,200 mg of calcium per day is the recommended amount for people over 50. Unlike Vitamin D, many foods are naturally rich in calcium. Conclusion

To have healthy bones requires an important balance of nutrients. As we age the requirement of Calcium increases. The key point of this article to make people aware that vitamin D3 is extremely important in how your body processes that calcium. I truly hope that those of you who have been blessed with a new hip replacement take the effort to go one more step and have their Hydroxy D test and make sure you are giving that new hip the best chance for survival.


References:

John Jacob Cannell, M.D., Executive Director, Vitamin D Council, Atascadero, Calif.

Dr. Michael F. Holick, Director of the Vitamin D Skin and Bone Research Laboratory at Boston University. Dec. 5, 2008

Dr. James Dowd

[B.I.L.L.]

Thanks for posting that Pat.  Good reading.
I'm a poolman so I should have the walking and sunlight exposure part covered.