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Your Bone Health During COVID-19

Take action to make sure you are staying fracture-free and are taking care of your bone health. This pandemic has put enormous pressure on our healthcare systems stretching our resources to the limit and the general recommendation is for people to avoid hospitals and doctor’s offices unless absolutely necessary.

Remember that older adults and people who have certain chronic medical conditions such as diabetes or lung, heart or kidney disease are at higher risk of the more serious complications of COVID-19 illness. We urge you to stay safe by taking the necessary precautions as recommended by government health agencies.

PROTECTING YOUR BONES

WHAT YOU CAN DO

  • Fall Prevention: ensure that your home environment is free of clutter and any obstacles. Take care when walking outdoors.
  • Do not stop any osteoporosis treatment you have been prescribed. Talk to your doctor if you have any concerns.
  • Physical/Social Distancing does not mean self-isolating! Make sure to call and speak to friends or family at least once a day. Video chats are also a great way to stay connected.
  • The Government of Canada has advised you to stay home. Contact your doctor and/or pharmacy if you need a prescription filled or a consultation.
  • Ask for help! There are many ways to get the support you need for getting prescriptions filled and groceries delivered. Most grocers have a delivery service or an online order system where you can go pick up your order. If you do not have the ability to order online, many volunteer groups have popped up. Call your local elected representative and ask for help in locating such services. Also try contacting a neighbour to see if they can drop off supplies at your door or provide information on a service.

Be prepared to manage your bone health and osteoporosis and reduce your risk of breaking a bone during COVID-19.

  • Nutrition: Many pantry staple foods like beans and canned fish contain calcium and protein. Read product labels and also view the list of foods with calcium here. Click here
  • Get the amount of vitamin D you need daily. Click here
  • Stay active! Safely exercise daily by adapting exercises you can do at home. Click here

FROM THE PUBLIC HEALTH AGENCY OF CANADA

It’s important to follow recommendations from the Public Health Agency of Canada (PHAC) to stay safe and well informed.

PHYSICAL/SOCIAL DISTANCING

Together, we can slow the spread of COVID-19 by making a conscious effort to keep a physical distance between each other. Social distancing is proven to be one of the most effective ways to reduce the spread of illness during an outbreak.

This means making changes in your everyday routines to minimize close contact with others, including:

  • avoiding crowded places and non-essential gatherings
  • avoiding common greetings, such as handshakes
  • limiting contact with people at higher risk like older adults and those in poor health
  • keeping a distance of at least 2 arms-length (approximately 2 metres) from others

VULNERABLE POPULATIONS

There is an increased risk of more severe outcomes for Canadians:

  • aged 65 and over
  • with compromised immune systems
  • with underlying medical conditions

Think you may have COVID-19?

Click here to take the Government of Canada’s Self-Assessment

WRITTEN BY

Hassan Vatanparast is a member of Osteoporosis Canada’s Scientific Advisory Council.  He is a Professor with Joint Appointment to the College of Pharmacy and Nutrition and School of Public Health, University of Saskatchewan. He is actively involved in research and health promotion initiatives targeting bone health. Hassan is leading several projects at the local, national, and global levels aimed to improve the nutritional health of the general population, newcomers and indigenous communities.

VITAMIN D IN SUMMER: SUN, FOOD, SUPPLEMENT

Vitamin D is an essential nutrient for proper growth and formation of teeth and bones. We need vitamin D for the absorption of calcium and phosphorus from the foods that we eat. Vitamin D has some other roles in the body, and it is important for our muscles and our immune system. Low levels of vitamin D, known as vitamin D deficiency, has been linked to a wide variety of health issues such as osteoporosis, heart disease, depression, cancer, and multiple sclerosis.

How much Vitamin D do I need?

Osteoporosis Canada recommends healthy adults between 19-50 years of age, including pregnant or breast feeding women, require 400 – 1,000 IU daily. Those over 50 or those younger adults at high risk (with osteoporosis, multiple fractures, or conditions affecting vitamin D absorption) should receive 800 – 2,000 IU daily.

What are the sources of Vitamin D?

Food and Supplements

There are very few foods in the nature that contain significant amounts of vitamin D. These include the flesh of oily fish such as salmon, tuna, sardines, and mackerel and fish liver oils. We can also get small amounts of vitamin D from foods such as beef liver and egg yolks. Some yogurts contain vitamin D if they are made with vitamin D fortified milk. In Canada, vitamin D fortification is mandated for margarine, infant formula, formulated liquid diets, cow’s milk and its substitutes, egg products, foods for use on a very low energy diet, meal replacements and nutritional supplements. Fortification is voluntary for butter substitutes, condensed milk, goat’s milk and goat’s milk powder.

It is nearly impossible to get enough vitamin D from your diet. You would need to eat a lot of these foods to reach the recommended level. Osteoporosis Canada recommends that all Canadian adults take a vitamin D supplement (specifically, vitamin D3 or cholecalciferol) year-round. This is the most common type of vitamin D found in supplements in Canada.

Examples of foods rich in vitamin D

Food Serving Size IU’s per Serving
Cod Liver Oil 5 mL/1 tsp 426
Egg Yolk, cooked 2 Large 64
Margarine, fortified 5 mL/1 tsp 25-36
Milk (all types) 1 c/250 mL 103-105
Mushrooms, white 125 mL/ 1/2 c 4
Orange Juice, Fortified 1/2 c/125 mL 50
Salmon (Sockeye), Baked or Broiled 75 g 394
Salmon, pink, Canned, Drained with solids and bones 75 g 435
Snapper, Baked or Broiled 75 g 392
Soy Beverage, Enriched 1 c/250 mL 86

Sun exposure

Vitamin D and Sun ExposureVitamin D, the “sunshine vitamin,” is produced when the sun’s rays interact with our skin. It helps build stronger bones by increasing the absorption of calcium. It also improves the function of muscles, which can improve your balance and decrease the likelihood of falling and suffering a fracture.

Canadians, particularly women,  have reduced their sun exposure and use sunscreen (which blocks UV rays) to prevent damage from the sun.  As well, Because of our latitude, we cannot produce vitamin D between October and March.

Furthermore, the skin’s ability to make vitamin D decreases as we age.

All this supports the need to get vitamin D through food and/or supplementation.

WRITTEN BY

Hassan Vatanparast is a member of Osteoporosis Canada’s Scientific Advisory Council.  He is a Professor with Joint Appointment to the College of Pharmacy and Nutrition and School of Public Health, University of Saskatchewan. He is actively involved in research and health promotion initiatives targeting bone health. Hassan is leading several projects at the local, national, and global levels aimed to improve the nutritional health of the general population, newcomers and indigenous communities.

References:

National Institutes of Health. (2018). Vitamin D, Fact Sheet for Health Professionals. Retrieved from https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/#en26 (assessed May 28, 2019)

Institute of Medicine. (2011). Dietary reference intakes for calcium and vitamin D: Washington, DC: The National Academy Press.

Janz, T., & Pearson, C. (2013). Vitamin D blood levels of Canadians: Statistics Canada Ottawa (Canada).

Libon, F., Courtois, J., Le Goff, C., Lukas, P., Fabregat-Cabello, N., Seidel, L., . . . Nikkels, A. F. (2017). Sunscreens block cutaneous vitamin D production with only a minimal effect on circulating 25-hydroxyvitamin D. Arch Osteoporos, 12(1), 66. doi:10.1007/s11657-017-0361-0

Wacker, M., & Holick, M. F. (2013). Sunlight and Vitamin D: A global perspective for health. Dermato-endocrinology, 5(1), 51-108.

Whiting, S. J., Langlois, K. A., Vatanparast, H., & Greene-Finestone, L. S. (2011). The vitamin D status of Canadians relative to the 2011 Dietary Reference Intakes: an examination in children and adults with and without supplement use. Am J Clin Nutr, 94(1), 128-135.

Canadian Food Inspection Agency. (2018). Foods to Which Vitamins, Mineral Nutrients and Amino Acids May or Must be Added. Retrieved from http://www.inspection.gc.ca/food/requirements/labelling/industry/nutrient-content/reference-information/eng/1389908857542/1389908896254?chap=1 (assessed May 31, 2019)

Pinault, L., & Fioletov V. Sun exposure, sun protection and sunburn among Canadian adults. Health Reports. Statistics Canada. Health ReportsCatalogue no. 82-003-X. ISSN 1209-1367.

Did you know?

A Registered Dietitian or your doctor can help you regarding supplementing vitamin D in your daily diet.

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