Week of July 30, 2012
Contact: Alice Bender, (202) 328-7744

AICR HealthTalk
Karen Collins, MS, RD, CDN
American Institute for Cancer Research

Q: What exercises should a person diagnosed with osteoporosis perform – and avoid – to maintain bone density and prevent worsening of their condition?

A: Exercise is one of the best things you can do after a diagnosis of osteoporosis, as long as you consult your doctor for exercise clearance and cautions about particular movements you should avoid. Low-impact walking, stair climbing and weight training are forms of weight-bearing exercise recommended to avoid compression fractures. Movements that pose risk are those that compress the spine or involve significant twisting. That’s why experts advise avoiding golf, tennis or bowling for some people with osteoporosis. Risk also comes with bending forward at the waist to touch toes, performing sit-ups and rowing. Even some gentle yoga can pose risk for you if they require bending (such as in downward dog) or involve too much twisting of the spine. Stretches, yoga and Pilates are safe for improving flexibility if you avoid these movements. Mind-body exercises such as Tai Chi improve balance to prevent falls. Water exercise provides a buoyant environment to safely maintain cardiovascular endurance, muscle strength and flexibility. People with osteopenia – low bone density not low enough to be classified as osteoporosis – should take steps to prevent its progression and consult their doctor for exercise guidelines. The National Osteoporosis Foundation offers tips on their Web site.

Q: What’s the difference between a nutritionist and a registered dietitian? Or are they the same thing?

A: Although registered dietitians (RDs) may call themselves nutritionists, nutritionists are not necessarily RDs. The “RD” title can only be used by those who have earned at least a bachelor’s degree from an accredited dietetics program, completed an approved 1,200-hour internship and passed a national exam. To maintain RD status, they must then meet requirements for continuing education. The training of people who call themselves nutritionists depends upon where they live. Some states have licensure laws that restrict use of the title “nutritionist” to people with certain credentials, which could include RDs as well as professionals who might have PhD degrees in nutrition but are not RDs. In states without licensure laws, people who call themselves nutritionists can include both highly trained individuals as well as people with an interest in nutrition but no training, or with minimal training from groups that promote nutrition practices not backed up by solid research. You may wish to consult an RD if you are diagnosed with a health condition such as diabetes, hypertension or celiac disease; have gastric bypass surgery and must meet nutrient needs with smaller portions; have an eating disorder; or simply want a personalized nutrition plan. To locate an RD in your area, including those with a particular area of expertise, you can go to the website of the Academy of Nutrition and Dietetics and use their Find a Registered Dietitian tool.

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