Eat Well for Bone Health

IndexBone Health p2

Preventing Osteoporosis p5

1. Include enough calcium rich foods p6

2. Include enough vitamin D rich foods p11

3. Eat more plant protein and less processed meat p15

4. Chooseunrefinedhigh-fibrecarbohydrates p18

5. Avoid trans fats and certain saturated fats p20

6. Don't add salt p21

7. Eat more natural foods p22

8. Watchquality&quantityof snacks p23

9. Enjoyalcoholinmoderation p24

10. Get Active for Bone Health p25

Sampleof adaywithadequatecalciumand vitamin D p26

Summary:ThreethingsIwanttoconcentrate on and improve on... p27

Notes p28

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Bone healthYour skeleton and bones Boneisalivingtissueandundergoesaconstantcycleofbeingbrokendownandbeingrebuiltinordertorepairdamagedorwornoutbone.Manydifferentnutrientsareneededtobuildnewandhealthybonecellsandwegetthesefromthefoodandmealsweeat.

It’sratherlikeabankaccount,whereyoumake“deposits”ofnutrientsfornewhealthyboneand“withdrawals”ofbonethatneedreplacing.Aswegetolder,moreboneisnaturallylostthanisreplaced.Thereisanaturaldeclineinbonestrength.

Osteoporosis

Peoplewithosteoporosislosemoreboneatafasterratethanisnormal.Osteoporosiscausesbonestobecomefragile.Thereforetheybreakeasily.Evenaminorbumporfallcancauseafracture.Thediseaseaffectsbothmenandwomen.Itismorecommonlyseeninolderpeoplebutosteoporosiscanaffectallagegroups,eventheyoung.

ItisestimatedthatsomeoneintheEUhasahipfractureasaresultofosteoporosisevery30seconds.Themostcommonbonestofracturearethehip,spineandwrist.Howeveritcanaffectanyboneintheskeleton.

The number of Irish people over 50 years with Osteoporosis

•1in3women.•1in5men.

Theincidenceincreasesto•1in2womenover65years.

What are common signs or symptoms of Osteoporosis? •Abrokenbonefromatriporfallfromastandingposition.•Afragilityfracturewhichisatypeoffracturethatoccursasa

resultofnormalactivitiessuchasasneeze,cough,orturningoverinbed.

•Alossofheightofmorethan2cm,duetothecollapsing vertebrae(bonesinspine).

•Developingahunchedbackandprotrudinghead,usuallyassociatedwithlossofheight.

•Suddenseverebackpain,associatedwithlossofheight.Howevermostpeopleexperiencenopainuntiltheyhaveafracture.

Who is at risk of developing Osteoporosis? Therearemanyreasonswhyyoumayhaveanincreasedriskofdevelopingosteoporosis.Herearealistofcommonriskfactors.

Family History:80%ofyourbonestrengthisdeterminedbygenetics.Ifaparentorgrandparenthadosteoporosisoranyoftheabovesymptoms,thenyoumaybeatahigherriskyourself.

Age:Bonelossincreasesinlaterlife.It’sestimatedthatabouthalfofthoseovertheageof75willhaveosteoporosis.Aswegetolder,ourbonesbecomemorefragileandaremorelikelytobreak.

Gender:Afterthemenopause,womenexperienceaccelerationinboneloss.Thefemalehormoneoestrogenhasaprotectiveeffectonbones.Atthemenopause(normallyaroundtheageof50)theovariesalmoststopproducingthishormonereducingprotectionforourbones.

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Eating disorders:Peoplewhohaveahistoryofeatingdisordersmayhavemissedoutonvitalnutrientstonourishtheirbonesatavitalstageofdevelopment.

Gastrointestinal Disorders:suchasCoeliacdisease,Crohn’sdisease,UlcerativeColitisorPrimaryBiliaryCirrhosis.

Rheumatoid Arthritis:thediseaseitselfandsteroidtreatmentscanincreasetherisk.

Endocrine Disorders:suchashighlevelsofprolactin,cortisolorthyroidandparathyroidhormoneproblems,diabetes,Turner’sSyndrome,Klinefelter’sSyndromeetc.

Chemotherapy or Radiation:AnyadultorchildwhohasreceivedorwhowillbereceivingtreatmentshouldhaveaDEXAscan.

Medications:Somemedicationscanincreasetheriskofosteoporosise.g.corticosteroids,someanticonvulsants,postorgantransplanttherapy,diuretics,etc.

Lifestyle Factors: •Excessivephysiologicalstress.•Lowbodyweight.Ifyouareunsureifyouareunderweightfor yourheight,checkwithyourdoctororadietitian.•Lackofregularweightbearingexercise.•Lowdailyintakeofcalciumand/orvitaminD.•Intolerancetodairyproductsorvegetarians/veganswhodonot eatsufficientcalcium,vitaminDandprotein.•Smoking.•Excessivealcoholconsumption.

Preventing osteoporosis Osteoporosisisthemostcommonbonediseaseintheworld,butitispreventableandtreatableinthemajorityofpeople.Thereisnothingyoucandoaboutyourageoryourfamilyhistory,butyoucanpositivelyinfluencemanylifestylefactors.

Making positive changes Changingwhatyoueatandbecomingmoreactivecanhelpreduceyourriskofosteoporosis.

Thedietaryguidelinesaresimilartothoserecommendedforeveryoneelse!Soyoudon’tneedtoeatanyspecialorexpensivefoods,butyoumayidentifysomeimprovementsorchangestoyournutritionplan.You can list these on page 27 of this booklet.

Let’shavealookatsomewaystobesureyourintakeofcertaincriticalnutrientsareoptimalforbonehealth.

Fast FactsDrinkingmorethantherecommendedintake(morethantwounitsperday)mayincreasetheriskofsufferingafragilityfracture.Seepage24.

Ifyouenjoydrinkingcoffeeorothercaffeine-containingdrinksyouneedtoensurethatyouaregettingsufficientcalcium.Caffeineisastimulant,foundnaturallyincoffee,cocoaandtea.Caffeineisalsoaddedtosoftdrinksandenergydrinks.Moderatecaffeineconsumption—about3cupsofcoffeeaday—won'tbeharmfulaslongasyourdietcontainsadequatecalcium.Pregnantwomenshouldconsumelessthan2cups(<200mg)ofcoffeeperday(FSAI,2019).

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1. Include enough calcium rich foods

Why is calcium important for health? Calciumisrequiredforhealthybloodvesselstocontractanddilate;musclefunction;nervetransmission;hormonalsecretion.Lessthan1%ofourtotalbodycalciumisneededtosupportthesecrucialfunctions.Theremaining99%ofthebody'scalciumisstoredinthebonesandteethwhereitsupportstheirstructureandfunction.Calcium'smostnotableroleisinhelpingtoreducetheriskofosteoporosis.

What foods provide Calcium? Youcangetenoughcalciumbyeatingavarietyoffoods,includingthefollowing:

•Milk,yoghurt,andcheesecontain calciumthatiseasilyabsorbed andutilised.•Fishwithsoftbonesthatyoueat, suchastinnedsardinesandsalmon.•Greenvegetablessuchasspinach andkaleprovidesomecalcium, howeversomeplantsourcescontain oxalicacidandphyticacidwhich interferewithabsorption.•Calciumisaddedtosomebreakfast cereals,fruitjuices,soyaand ricedrinks,andtofu.•Mostgrains(foundinbreads,

pastas,andunfortifiedcereals),whilenotrichincalcium,addtoourcalciumintakebecauseweeatthesefoodsfrequently.

Are you getting enough calcium? Thistableshowsthepercentageofpeoplenotconsumingadequatecalcium.

Male (%) Female (%)

Children(5-12years)* 28 37

Teenagers(13-17years)** 23 42

Adults(18-64years)*** ---- 16

Olderadults(>65years)**** ---- 13*NationalChildren’sFoodSurvey(2003-2004).Aged5-12years

**TheNationalTeen’sFoodSurvey(2005-2006).Aged13-17years***NationalAdultNutritionSurvey(2008-2010).Aged18-64years****NationalAdultNutritionSurvey(2008-2010).Aged≥64years

What is your Recommended Daily Calcium Intake?

Population Group Servings of Calcium Rich Foods (FSAI, 2011)

Children(5-12years) 3servings

Teenagers(13-18) 5servings

Adults(18+) 3servings

Pregnantandlactatingwomen 3servings

Lactose IntoleranceIfyouaresensitivetolactoseyoumaynotneedtoeliminatedairyconsumptioncompletely:lactose-freemilks,yoghurtswithlivecultures,andsomehardcheesesarenormallytolerated.Anotheralternativeistotakelactasetabletsordropsalongwithdairyfoods.Peoplewhoarelactoseintolerantshouldconsultwiththeirdoctortodiscussthebestwayofensuringadequatecalciumintake,eitherthroughdiet,orifnecessary,throughtheuseofsupplements.

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Vegan DietsVegandietsdonotcontainanyfoodproductsofanimalorigin.Vegansdonoteatmeat,poultry,fish,dairyoreggs.Thisrestrictivedietrequirescarefulplanningtoensureitmeetsnutrientneeds.Particularattentionshouldbegiventoensurethatcalcium,vitaminD,ironandvitaminB12needsaremet(FSAI2019).Supplementationisusuallynecessary.Discusswithyourhealthcareteam.

What does a serving look like? •1/3pint(200ml)milk•1carton(125ml)yoghurt•1oz(25g)cheese(smallmatchboxsize) Note: Low fat servings are generally recommended

Why choose lower fat cheese, milk and yoghurt? •Choosinglowerfatdairyfoodscanhelpyoutoreduceyour calorieandsaturatedfatintake.•Lowerfatdairyfoodsstillcontainproteinforgrowthandrepairof healthymuscle.•Thenutrientstheyprovideareessentialforhealthybones,blood pressureandmetabolism. Note: Check yoghurt labels to make sure there is no additional sugar added to lower fat version.

How you can meet your daily calcium requirement? •200mlsmilkincerealforbreakfast 240mg•1lowfatyoghurtat11am 203mg•1ozcheddarinsandwichatlunch 210mg•100mlsmilkintea/coffee 120mg Total 773mg (97% RDA) Note: Low fat servings are generally recommended

Are supplements necessary?TheremaybeinadequateamountsofCalciumandVitaminD3inthediet,andsupplementationisnecessarywhendietaryintakeofCalciumandespeciallyvitaminD3isinadequate(IrishOsteoporosisSociety).

Easy ways to boost your Calcium intake•Mashnaturalyoghurtintosweetpotato.•Addmilkornaturalyoghurttosoupsandsauces.•Mixfreshberriesorbananawithyoghurtandtopwitha tablespoonofgranola.•Mixhot/coldmilktoahighfibrebreakfastcerealforsupper.•Makecustardwithmilkinsteadofusingcreamwithdessert.•Addgratedcheesetoabakedpotatoorfrittataforlunch.•Chopsmallchunksofbrieorfetaintoasaladandtopwithseeds•Makeavegetablebaketoppedwithmozzarella.•Haveafrothycappuccinoorhotchocolateasanoccasionaltreat!

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A list of food sources of Calcium to choose from:

Food/Drink Portion Size Calcium (mg)

Fullfatmilk 200ml 236

Lowfatmilk 200ml 240

Soyamilk(calciumenriched) 200ml 178

Goat’smilk 200ml 200

Lowfatyoghurt 125g 203

Lowfatcheddarcheese 25g/1oz 210

Cottagecheese 75g/3oz 95

Bakedbeans 200g 106

Driedapricots 40g 37

Brazilnuts 30g 51

Salmon(tinned) 100g 93

Tofu(cooked) 100g 510

Boiledbroccoli 80g 32

VitaminDisafat-solublevitaminthatisfoundincertainfoods.Itisbothanutrientandahormoneourbodiescanmakethroughtheactionofthesunlightonourskin.That’swhyitissometimesreferredtoasthe‘sunshinevitamin’.HoweverIrelandisverynortherlyinlatitude,andinthemonthsbetweenNovemberandMarchthereisaninsufficiencyofboththequalityandquantityofsunlightnecessarytoproduceadequatevitaminDbythebody.

Evenonsunnydaysinthewinter,thesun’sraysarenottherighttypefortheproductionofvitaminD.Moreover,withmostpeopleworkingindoorsandusingsunscreenwhenoutside,vitaminDfromsunlightexposurehasdecreased.

Who is most at risk? DarkerskinnedpeoplelivinginIrelandareparticularlyatriskastheyrequireovertentimesmoresunlighttoproduceenoughvitaminD.

Elderlypeoplewhodon’tgetsufficientskinexposuretosunalongwithapoordietaryintake,thosewhocoverthemselvesforreligiousorculturalreasons,thosewithmalabsorptionconditionsandthosewithkidneydiseaseareparticularlyatriskofbeingdeficientinvitaminD.

Certainmedicationsmayinterferewiththebody'sconversionofvitaminD.ThereforetheelderlyandpeoplewhoareconfinedtoindoorsmayalsobenefitfromavitaminDsupplement.

2. Include enough vitamin D rich foods 2

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Vitamin D Recommended Daily Amounts (RDAs)TheRDAforadultsis0-10µg.However,asignificantproportionof18-64yearoldshavelowvitaminDintakes,with72%ofmenand78%ofwomenhavingaveragedailyvitaminDintakesoflessthan5µg(IUNA,2011).

Dietary Sources of vitamin DVeryfewfoodsarenaturallygoodsourcesofvitaminD.Oilyfishincludingsalmonandmackerelarethebestsources.Eggcontainsasmallamountnaturally.Therestarefortifiedfoods.VitaminDisaddedtosomemilksandtosomebrandsofotherdairyproducts,orangejuice,soyamilkandfortifiedcereals.CheckthefoodlabeltoseeifvitaminDhasbeenaddedtoaparticularproduct.

Considerabloodtesttodetermineyourlevelsandasupplementifdietaryintakeispoor.IfthereisinadequateCalciumandVitaminD3inyourdiet,supplementationisnecessaryespeciallywhenvitaminD3isinadequate(IrishOsteoporosisSociety).

Why is vitamin D important for health?ThebodyneedsvitaminDtoabsorbcalcium.Withoutit,wecanabsorbnomorethan15%ofthecalciumweconsume.Whenthishappens,thebodymusttakecalciumfromitsstoresintheskeleton,whichcanweakentheexistingboneandpreventtheformationofstrong,newbone,potentiallyresultinginosteoporosis.

RecentresearchhasalsolookedatvitaminD'sroleinavarietyofdiseasesotherthanbonehealth.ManystudieshavehighlightedanassociationbetweenhavingalowvitaminDstatusandcardiovasculardiseases,diabetes,somecancers,cognitivedecline,depressionandautoimmunediseases.ThesestudiessuggestthattheroleofvitaminDfarexceedsitspreviousremitofgoodbonehealth.

How to get enough vitamin D daily? •100mlfortifiedMilk 2ug•Servingoffortifiedbreakfastcereal 1.5µg•1egg 1µg•Smalltinoftuna 4.5µg Total 9µg (90% RDA)

Tips to boost vitamin D intake•TryincludingaFishyFridayinyourweekandenjoyoilyfish

regularlye.g.salmon,trout,mackerel,herrings,freshtunaandsardines.

•Choosetinnedfishforlunch.•Chooseafortifiedbreakfastcerealwithafortifiedmilk.•Includeacoupleofeggomelettesorscrambledegglunches eachweek.•Spend15-20minutesoutsideinsunshine2-3timeseachweek withoutsuncream(ifappropriateandnotatpeaktime).But rememberinIrelandwecanonlyreallymakevitaminDinthe SpringandSummermonths,sofocusmoreonincreasingyour dietarysourcesofvitaminD.•Discussabloodtestandsupplementationwithyourdoctorifyou

can’tmeetyourintakethroughdietalone.

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Food Portion Size Vitamin D (µg)

Salmon,steamed 150gfillet 15

Mackerel,smoked 150gfillet 13

Sardines,tinnedintomatosauce 100gtin 5

Tuna,tinnedinbrine 150g,smalltin 4.5

Lowfatfortifiedmilk 200ml 4.0

Branflakes 30g,smallbowl 1.3

Egg,boiled 1 2

Food sources of vitamin D:

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3. Eat more plant protein and less processed meat

Eat MORE •Chickpeasincasseroles•Hummus(madefromchickpeas)•Kidneybeansinchilli•Butterbeansinsoup•Cannelinibeansinsalad•Lentilsinsoupsandsalad•Frozensoyabeansasadinnervegetable

Why? •Peas,beansandlentilscontainlotsoffibrewhichkeepthe

digestivesystemhealthy,theyaregoodfortheheart.•Theyarenaturallylowinfat.•Proteinunder-nutritioncanleadtoreducedmusclemassand

strengthinolderpeople,whichisariskfactorforfalls. Note: Plant proteins can help boost your protein intake. As well as enjoying oily fish, white fish, shellfish and chicken, include up to three portions of red meat (lean cuts of beef, lamb and pork) per week. These proteins are good sources of iron, zinc and selenium.

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Watch protein portion sizesTwoservingsofprotein-richfoodswillmeetthedailyrequirementsofmostadults.

Thefollowingaretheexamplesofservingsizesforprotein:

A serving is the size of1chickenfillet1salmoncutlet2smallporkchopswithfatremoved1pieceofsteak(sizeofpalmofyourhand)1andahalfcupsofbeansorpulses2eggs(upto7inaweekifyourcholesterolisnormalorlessthan5eggsifyouhaveahighcholesterol)

Additional bone nutrientsFruitsandvegetablesareexcellentsourcesofmagnesium,potassium,andvitaminsC,KandA.Allplayaroleinmaintainingbonehealth.

Vitamin KFoundinleafygreenvegetables,spinach,cabbageandkale,liveranddriedfruit.

TIP:Snackon4prunes,agoodsourceofvitaminK

MagnesiumFoundingreenvegetables,beans,lentils,nuts,seedsandfish.

TIP:Aserving(30g)ofalmondshasupto40%ofyourdailyneeds

ZincFoundinleanredmeat,poultry,wholegraincereals,peas,beansandlentils.

TIP: Roastedandseasonedchickpeasareagoodplantsnack

Carotenoids precursors to vitamin AFoundinmanyvegetables,includinginleafygreenvegetables,carrotsandredpeppers.

TIP: 50gofrawcarrotsmeetyourdailyneeds.

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Carbohydrateisyourbody’sprimarysourceofenergy.Yourbodybreakscarbohydratedownintoasugarcalledglucose.Glucoseisessentialforyourbrainandyournervoussystemandisthepreferredfuelforyourworkingmusclesduringexercise.1gramofcarbohydrateproduces4kcal(calories)ofenergy.

Notallcarbohydratesarethesamethereforeweneedtowatchthetypeandquantityweeat.Certaincarbohydrateshelpustocontrolourbloodsugarlevelsbetterthanothers.

Sugar is a type of carbohydrate.Sugarisfoundinmanyfoodsincludingsweets,biscuits,cakesandfruit.However,thereisabigdifferencebetweenapieceoffruitandsomebiscuitsthatcontainthesameamountofsugar!Somakeyoursnackscountnutritionally.

It’sbesttoreduceyourconsumptionoftablesugar,softdrinks,juices,sweets,andsticktofoodsthatcontainalittlenaturalsugar,butalsootheressentialnutrients(seecomparisonofanappleandbiscuitsbelow).

2.Chooseunrefinedhigh-fibrecarbohydrates4

A medium apple 3 ginger nut biscuits

11g sugar 11g sugar

2gfibre Verylittlefibre

nofat 4gfat

othervitaminsandnutrients littleornovitaminsandminerals

Why do we need unrefined high-fibre carbohydrates? •Essentialforproperbrainandnervoussystemfunction•Preferredfuelforworkingmuscles•Thefibreitcontainsfeedsgoodgutbacteriaandincreasesthe

moodenhancinghormoneserotonin

Eat MORE nutrient dense carbs•Porridge,unsweetenedoatbasedmuesli,highfibre

breakfastcereals•Sourdoughbread,wholegrainbread,ryebread•Pasta,wholewheatorplain•Brownrice,wildriceandbasmatirice•Allpulsesandlegumessuchasbeans,peasandlentils•Freshfruit.Twoservingsadayisusuallyenough•Nuts,seeds.Sticktoasmallhandfulasasnack•Ryeorwholegraincrackersorcrispbread

Eat LESS highly refined carbs•Tablesugar•Foodswithaddedsugare.g.sweets,biscuits,cakes,bakery

products,etc.•Refinedbreakfastcereals,sugarcoatedorveryprocessed•Slicedpanbreads–brownorwhite•Sportsdrinks,softfizzydrinks,energydrinksandjuicedrinks•Fastfood,veryprocessedfood

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2. Avoid trans fats and certain saturated fats 5

Eat LESS Transfatsandcertainsaturatedfatsfoundinfriedandprocessedfoodse.g.cakes,biscuitsandpastries.

Eat MORE (Omega 3 fatty acids) •Oilyfish*likesalmon,mackerel,sardines,trout•FlaxseedorLinseed•Walnuts•Camelinaoil

Fats and fatty acids

Animal fats, lard, cream, butter andspreads, fried and processed foodse.g. cakes, biscuits and pastries.

Unsaturated fats

Polyunsaturated fats Monounsaturated fats

Omega 3 fatty acids

Oily fishFlaxseed, linseed andwalnuts

Omega 6 fatty acids

Corn oilSafflower oilSunflower oil

Omega 9 fatty acids

Olive oil, rapeseed oil andpeanut oilAvocado and nuts

Eat Less Eat Some Eat More

Saturated fats & Trans fats

Eat MODERATELY (Omega 6 fatty acids) •Cornoil•Saffloweroil•Sunfloweroil

Eat MORE (Omega 9 fatty acids) •Olive,rapeseedandpeanutoils•Avocado(halfanavocadoisaportion)•Nuts(asmallhandfulofmixednutsisaportion)

* Note: Official advice on oily fish has changed. Although fresh tuna is a good source of protein and Vitamin D, it no longer counts as an oily fish. This is because current data show that levels of omega 3 fatty acids in fresh tuna are no greater to those found in most white fish. Advice on canned tuna remains the same; it does not count as an oily fish.

Eat MORE•Garlic•Herbs•Spices•Blackpepper•Lemonjuice•Balsamicvinegar

2. Don’t add salt 6

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2. Eat more natural foods 7Aimtoeat5to7servingsoffruitandvegetablesaday.Thatistwotothreefruitsandtherestvegetables(alwaysincludeonegreenvegetableandamixofothercolours).

Itisn'tonlythevitaminsandmineralsthatareprotective.Flavonoid-richplantfoodssuchasplumsandberriesareassociatedwithbonebenefitstoo.

A serving of fruit and vegetables1mediumsizedfreshfruit(e.g.apple,orange,banana)2smallsizedfreshfruit(e.g.plums,kiwi,mandarin)3dessertspoonsoffreshfruitsalad1smallglassoffruitjuice(Nomorethan150ml)1smallbowlofvegetablesoup3-4dessertspoonsofcookedvegetablesorsalad

Inject your diet with colourIt’salsogoodtoeatawidevarietyoffruitandvegetablestogetallthedifferentvitamins,mineralsandphytonutrientsyourbodyneeds.

Trytoeat3mealseachdayandonlytheoccasionalsnackifyouneedit.Chooseproteinandcalciumrichsnacksornutritioussnackssuchasayoghurt,handfulofnutsormixedroastedseeds,aminidarkchocolatebar,wasabipeasorroastededamamebeans.

Snack Attack? ChoosethesconeinsteadoftheDanishPastry,3timesaweekandover1year,youcouldsaveyourselfputtingon1½stoneofweight.

2.Watchthequality& quantityof snacks8

LargeDanish: 673 Calories – 32g Fat FruitScone:174 Calories – 7g Fat

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2.Enjoyalcoholin moderation 9

Excessive consumption of alcohol increases the risk of bone loss and fractures.

The recommended intake of alcohol is

•Men–17 standard drinks per week

•Women–11 standard drinks per week

1'standarddrink'=halfpintbeer=glasswine(125ml)=pubmeasurespirits.

Enjoytheseunitsbyspreadingthemthroughouttheweekandhavetwotothreedrink-freedays.

Note: A glass of wine or spirit poured at home is usually much bigger than a standarddrink size.

Alcohol and hidden calories•1glassredwine85kcal•1glasssweetwhitewine118kcal•1pintLager167kcal•1pintCider208kcal•1pintStout210kcal

Drink more water and watch the calories in other non-alcoholic drinks

•Upto8glassesperdaywater0kcal•60mlespresso1kcal•200mlgrapefruitjuiceunsweetened66kcal

•200mloforangejuiceunsweetened72kcal•200mlapplejuiceunsweetened76kcal•330mlcola131kcal•472mlcappuccino140kcal•472mllatte144kcal•360mlhotchocolate186kcal•472mlmocha208kcal

2. Get Active for Bone Health 10

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Therearesomanyhiddenbenefitsfromexercise.Ithelpskeepyourbones,jointsandmusclesstrongandhealthy.Itwillalsohelpyoutostayahealthyweightforyourheight.

Exerciseisessentialforthebodybecauseit:

•Reducesyourbloodpressure•Reducesbad‘LDL’cholesterol•Burnscalories•Protectsagainstmuscle/boneloss•Improvesmoodandmentalwellness

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SAMPLE OF A DAY WITH ADEQUATE CALCIUM AND VITAMIN D

BREAKFASTPorridge with 200mls low fat milk and sliced banana.

SNACK Natural yoghurt and slices of fresh peach

LUNCH2 egg omelette with 25g grated reduced fat cheddar cheese, Slice wholegrain bread and green side salad

SNACK30g unsalted cashews and 2 satsumas

DINNERSteamed salmon, brown rice, carrots and broccoli

1450 kcals, 1063mg calciumand 10.65µg vitamin D

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SUMMARY: THREE THINGS I WANT TO

CONCENTRATE ON AND IMPROVE ON...

MY GOOD HABITS

Make a list here of the good habits w

hich you want to adopt

1. 2.

3.

2726

NOTES

Paula Mee, Dietitian, BSc, Dip Dietetics, MSc in Health Sciences, MINDIwww.paulamee.com @paula_mee

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Dateofitem:June2019 UKIE-NPC-162-0516-130462a(1) IE-BH-1Datepublished:June2019

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