WHO Standards (DXA scan )

Hips, spine, wrist (-1-> -2.5 osteopenia, below -2.5 is osteoporosis)
Osteoclasts increase (Break bown down) Osteoblsts decrease (Build bone up. Increase these by run, jump, weightlifting) 

Women at high risk : Estrogen, ammenhorrea, menopause

3rd decade - osteoclasts/osteoblasts out of sync

Ethnicity and family history

Low BMI

History of  fracture (weak bone)

Inadequate PA due to lack of loading bones

Smoking adds free radicals that kill osteoblasts and nicotene disturbs balance of sex hormones

Alcohol interveres with calcium balance and vit. D (Ca absorber)

Too much protein, Na+, caffein, vit. A

Some meds and diseases (antidepressants and anticoaggulants) - leads to taking meds to counteract, ciliac and kidny disease

**Compression fracture-loss of height!!**

Exercise Response depends on the orthopedic limitation and coexisting conditions

Flexibility depends on how well they can move

Maximize strength, balance, mobility

Exercise Training: Aerobic, weight bearing, resistance, flexibility

Can slow down decline in bone mineral density, osteopenia

Bone turnover is slow

Adequate CA and vitamin D supplements, eat well.

     Daily Recommendations

           1-3 years: 700 mg
           4-8 years: 1000 mg

           9-18 years: 1300 mg

           19-50 years - 1000 mg

           50+ females 1200, males 1000. Males 71yrs, 1200mg.  

Weight and resisstance training

Be educated

DEXA

Avoid tobacco/alcohol

MEDS: anti resorptive, don't pull CA out

Exercise Testing is similar to older adults.  Screen and understand the person

Exercise Prescription - resistance training, weight bearing

balance training prevents falls

Make sure activity is not causing pain

No explosive mvmts

no high impact mvmts

No twist, bend, compression of spine

Monitor movements requiring balance

No overhead, bent over row, back extension

Warm up/cool down

Cross train to avoid over use