So before we even get into kind of the the work that you're mainly focusing on which is on Taking people who are at risk for osteoporosis and maybe holding them back from that or taking people who are in osteoporosis let's let's first address the question for the parents who are listening because Contrary to popular belief.

骨粗鬆症になるリスクのある人たちを引き留めたり、骨粗鬆症の状態にある人たちを引き取ったりという、あなたが主に焦点を当てている仕事に入る前に、まず聞いている親御さんたちの質問に答えましょう。

We do not have a huge teenage audience to this podcast For reasons, I don't understand.

このポッドキャストには10代の視聴者はあまりいません。

I just my daughter My daughter just she just hasn't found this podcast interesting in her little 16 year old self so What what what can I be doing?

このポッドキャスト、16歳の小さな自分には面白くなかったんだ。

to ensure that my Seven year old ten year old and sixteen year old are set up for the best life possible when it comes to bone health Given that I've already given them something pretty good.

私の7歳、10歳、16歳の子どもたちが、骨の健康に関して可能な限り最高の人生を送れるようにするためだ。

Fortunately knock on wood my wife and I Both have pretty high bone density at least as measured by a DEXA scan We could I'd like to talk about how valid or how we could be misled by that if the case So so from a genetic standpoint, they're not set up on the back foot But I want to make sure that we're going above and beyond What what what needs to be considered for us from a nutrition perspective from an exercise perspective from any other lifestyle perspective To allow our kids to reach their genetic potential Well, let's start with the low-hanging fruit, which is diet I don't think there's Anybody could argue that a balanced diet is important for everything for every to be healthy You need all the nutrients that that we've known about for years and the same can be said for bone that means Particularly and there there are some inertia but the most important one obviously is calcium That the amount that you need throughout your life does vary but by the time you're a teenager, you probably need about a thousand milligrams a day of calcium and You need the vitamin D to go with that otherwise you can't absorb it from your gut so Making sure dairy is by far the most Has the it's most abundant source of calcium.

幸いなことに、私も妻も、少なくともDEXAスキャンで測定した骨密度はかなり高い。 遺伝的な観点からは、子供たちが不利になるようなことはない。しかし、子供たちが遺伝的な潜在能力を発揮できるようにするためには、栄養面や運動面、その他あらゆる生活面において、私たちにとって何を考慮する必要があるのか、それ以上のことをしているかどうかを確認したい、バランスの取れた食事がすべての健康にとって重要であることに異論を唱える人はいないと思うが、骨についても同じことが言える、そうでないと腸からカルシウムを吸収できないので、乳

It's most bioavailable meaning.

最も生物学的に利用しやすいという意味だ。

It's most readily absorbed It's packed with calcium.

カルシウムが最も吸収されやすい。

You can get most of what you need each day from Well, let's say a regular glass of milk so 300 mils is 250 mils that has 300 milligrams of calcium So if you had three of those you'd basically be getting what you needed No, not too many people drinking that amount of milk Although I suppose the number of bowls of cereal my son eats but could possibly be approaching that number So But there are sources You know cheese and yogurt and then there's the discretionary foods if you eat a lot of ice cream and cream that sort of thing You can get from there as well, but we would say yogurt and cheese and milk are the best sources But that but that but but that's that's I mean 750 ml of milk or milk equivalent is is probably less than most kids are consuming Yeah, I would say so particularly as As they move into their teenage years and probably getting more conscious about Weight and are thinking that they might be drinking diet soda Instead of a milk drink and and it doesn't matter what the fat content of the milk is I assume Well, actually curiously, I mean for the vitamin D it probably does but does it matter for the calcium?

例えば、普通のコップ1杯の牛乳を300ミリリットルとすると、250ミリリットルで、300ミリグラムのカルシウムが含まれている、でも、チーズやヨーグルトもあるし、アイスクリームや生クリームをよく食べる人なら、そういうものから摂取することもできる、でも、ヨーグルトやチーズ、牛乳がベストな摂取源だと言えるでしょう。でも、それだと750mlの牛乳、もしくは牛乳に相当する量は、おそらくほとんどの子供が摂取している量よりも少ないでしょう。特に10代になると、体重に対する意識が高まり、牛乳飲料の代わりにダイエットソーダ

Well low-fat milk actually does have more calcium in it Just by virtue of the fact if you take the fat out you can fit more volume It is actually And plus you can buy fortified milk we have physical in Australia Which has more calcium in it and I'm certain you guys fortify a lot of your foods And I believe you do put vitamin D in your milk, I think So it's it's nice to get to get both But by far the easiest way to get vitamin D is the Sun and converting it in the skin we in particular Australia is You know, we are white people if living in a black people's country we have a very high rate of skin cancer here Sun is extremely strong So we're quite scared of the Sun we cover up we slather ourself in sunscreen hats sunglasses the whole bit and to the extent That we've actually set ourselves up to have vitamin D deficiency and particularly in Tasmania very South They you know that there's a high prevalence of vitamin D deficiency so The it's important to figure out when is a safe time to be in the Sun and Ensure that you get a little bit of Sun because it is by far the most efficient way to get your vitamin D Never go even close to getting sunburned, but you don't have to get sunburned in Australia we should be able to get our vitamin D requirement for 10 a.m. and And after to possibly a little later if you're in a really hot area In in Hobart in Tasmania in the middle of winter you would need to stand Shirtless for an hour in the Sun to get what you needed.

低脂肪牛乳の方がカルシウムが多いんだ。脂肪分を取り除けば、より多くのカルシウムを摂取することができる、白人が黒人の国に住んでいると、皮膚ガンの発生率が非常に高くなる。特にタスマニアでは、ビタミンD欠乏症の有病率が高いことをご存じでしょう。だから、いつが太陽の下にいても安全な時間なのかを見極め、少しでも太陽の光を浴びるようにすることが大切です、しかし、オーストラリアでは日焼けする必要はない。真冬のタスマニア州ホバートでは、必要なビタミンDを摂取するためには、シャツを脱いで太陽の下に1時間立っている必要がある

So, you know, then you've got to start thinking possibly about supplementation What what level matters Belinda?

だから、サプリメントについて考え始めなければならない。

Do you I know in kids?

子供で知っている人はいますか？

It's I mean, I don't think any of my kids have ever had a vitamin D level checked Although in an adult we do this all the time Is there a level?

うちの子供たちはビタミンDを測ったことがないと思うんだけど、大人になってからはいつも測っているんだ。

beneath which You would say we've got to be supplementing you if you can't do better than this with sunlight the problem with vitamin D is that Nobody can agree.

ビタミンDの問題は、誰も同意できないということだ。

There are two schools of thought There are two levels that have been published and people will die in a ditch over those If you've got people smart people feeling that strongly about two different levels It tells me that nobody really knows.

二つの流派があり、公表されている二つのレベルがあり、そのレベルをめぐって人々が溝で死ぬことになる。

What are the two levels that people are dying over?

人々が死にそうになっている2つのレベルとは？

30 is probably one of them, right?

30歳はそのうちの一人だろう？

30 seems to be one of the cutoffs 30 is is the I believe is the deficiency cutoff 30 Yeah, nanograms a milliliter and we're in 50 is considered sufficient.

30というのは欠乏症のカットオフのひとつだと思います。30は1ミリリットル当たりナノグラムで、50で十分と考えられます。

So in between that you would have Insufficiency But other people say it's 75 so I and I Because this isn't really my area Don't want to go out on a limb and say which is which they're easily searchable What there's been a lot of research done probably it's dropped off a little now as we've discovered that you Hyperdosing with vitamin D is not safe and increases falls The to get somebody's vitamin D up quickly you have to hyperdose so People have sort of moved away from vitamin D as a strategy to prevent osteoporosis It's really important that you try to encourage people to be sufficient.

ビタミンDの過剰摂取は安全ではなく、転倒を増加させる。ビタミンDの過剰摂取は安全ではなく、転倒を増加させる。

And so possibly They will need a supplement of a certain dose.

だから、ある量のサプリメントが必要なのだろう。

That's going to depend on the person and All manner of other things so I don't think it's necessarily How I mean most people are going to require a supplement to be above 50 I do I mean I live in Texas and our son is a lot like yours and I'm in the Sun Every single day and I don't even put sunscreen on anything but my face.

でも、ほとんどの人は50歳以上でないとサプリメントを必要としないと思う。

So my arms and legs I'm not, you know shirtless usually but my arms and legs are constantly exposed and I Think if I'm not Supplementing vitamin D.

腕や脚は、普段はシャツを着ないけど、常に露出しているから、ビタミンDを補給していないといけないと思うんだ。

I'm lucky to be above 40 So I I do supplement with 5,000 IU daily and that takes me to 50 to 60 Which again Suggests I'm probably okay But but it's not uncommon here in the u.s.

だから毎日5,000IUのサプリメントを摂っていて、それで50から60になる。

To see people Unsupplemented You know easily being in the 30s.

サプリメントを飲んでいない人たちを見て、あなたは30代であることを簡単に知っている。

That's that's not on that's not uncommon Well, if was there a reason that you started supplementing did you have any symptoms No, none whatsoever.

サプリメントを摂り始めた理由は何ですか？

I literally supplement for no apparent reason other than Some loosely held belief that I'm gonna be better off at 55 than 35 Yeah, but I don't I don't it's more the precautionary principle It's more that I haven't found any compelling evidence that I'm worse off at that level and there there may be you know Sort of benefits to it, but but I don't you know, I don't feel Immensely strongly about it.

35歳より55歳のほうがいい暮らしができるという、ゆるやかな信念がある以外に、明確な理由もなくサプリメントを飲んでいる。

But again, I'm thinking about this through the lens of children where I Would worry more about supplementing a kid Because a we don't it's just too much it's harder to measure vitamin D levels in them You don't want to go and poke them for blood all the time.

だって、ビタミンD濃度を測るのは難しいし、いつも血を採りに行くのも嫌でしょう。

I mean like so So you and you wouldn't wonder you'd you would just you would hope you could get it all from milk Dairy and sunlight, I guess would be my point Yeah, that would be my recommendation You know, the other thing is to vitamin D assays are notoriously Dodgy so, you know from one of one to the next you may not get the same result.

牛乳と乳製品と日光からビタミンDを摂取できればいいんだけどね。

So I don't know I've never had my measured and I track my bones to make sure they're doing okay and You know, that's how I choose to manage it And I think as you say, it's just gonna have to be whatever your tolerance whatever your belief is.

だから、僕は自分の骨を測定したことがないし、自分の骨が大丈夫なのかどうか追跡しているんだ。

That's that's pretty much Get as much education as you can and probably follow the guidelines that make the most sense to you You

つまり、できる限り多くのことを学び、おそらく自分にとって最も理にかなったガイドラインに従うということだ。