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Dr Sandra Iuliano-Burns

04 July 2011

Dem bones, dem bones, dem dry bones,
Dem bones, dem bones, dem dry bones,
Dem bones, dem bones, dem dry bones,
Now shake dem skeleton bones!



The leg bone’s connected to the knee bone,
The knee bone’s connected to the thigh bone,
The thigh bone’s connected to the hip bone,
Now shake dem skeleton bones!

The very last thing Sandra Iuliano-Burns want us to be experiencing is the dry, cracked bones conjured up by this old folk song’s lyrics. In fact, Sandra’s whole working life has been devoted to studying the benefits of physical activity, calcium and other nutrients on bone growth and health to create strong, supple bone mass.

Sandra’s also a runner, having represented Australia five times and been a former World Age Group Triathlon champion.

“I moved from Triathlons to Marathons,” says Sandra. “Training for marathons means running more than 5000kms a year and I did that for eight years. I guess I’ve run over 100,000kms in my life.”

A qualified nutritionist, Sandra’s PhD combined her backgrounds in exercise physiology and nutrition. She has completed research studies as diverse as comparing the benefits of calcium from dairy and non-dairy sources on bone accrual in children, to studying the effects of sunlight deprivation on bone density in adults using members of Antarctic expeditions on assignment as her target group, and looking at falls and fracture risk reduction in the elderly in aged care using a dairy-based protein, calcium and vitamin D supplement.

What really matters
For Sandra translating her work from its purely academic, rigorous peer review beginnings into real tangible outcomes for people is all-important. After all, she notes, those elderly patients in her research are first and foremost someone’s loved one.

Not surprisingly, explains Sandra, “the highest risk for fractures is in the elderly. They also fall more often. By incorporating a supplement into the foods they ate we saw a reduction in the number of falls and we know that reduced fractures because most of our fractures come from falls.”

The research surprise comes in the fact that the treatment stopped people falling – and so provided the wanted result of less fractures.

“There are a number of factors that contribute to breaking a bone,” explains Sandra. “The first is falling and two factors contribute to falling: muscle weakness and poor balance.”

Sandra’s results in the research project found that the vitamin D assisted with muscle strength, overcoming muscle weakness, and that along with the protein, which helps people maintain their lean mass and so their strength, thus reduced the likelihood of people falling in the first place. Of course, various aspects of the supplement also contributed to healthier bone mass, so if people did fall, they were less likely to fracture.

As a researcher, Sandra believes the opportunity to ask questions that she can then go through the process of answering to produce beneficial outcomes for people is a great privilege and something she loves about her work.

How the Antarctic helped the elderly
Take for example, her research on vitamin D deficiency using Antarctic expedition members, which has gone on to produce life-enhancing results for the elderly, helping to minimize the risk of fracture. The Antarctic work is also – minus the problem of no gravity – a wonderful microcosm for working with people in space, something Sandra would very much like to get her research teeth into.

“I was caught completely off-guard with the interest generated by the study I did on sunlight deprivation and the effect on bone in Antarctic expeditioners,” says Sandra. “It was done to help expedition members but fascinated the general public and received a lot of media coverage. There’s been a lot of work done in the Northern Hemisphere on sunlight, vitamins and bones, so the vitamin D link was well known. Countries in those particular areas fortify their foods to ensure vitamin D is available. In Australia, we don’t have foods fortified and we are beginning to see more vitamin D deficiency here than previously.

“Our Antarctic expeditioners are an extreme example of this. Nine months with no sun and the remainder of the time fully covered. It was the perfect opportunity to study people who are sunlight deprived and the effects that has on bone and then we went on to do the supplement trial to see what level of vitamin D was of benefit. We now know how much needs to be supplemented and that has been incorporated into the Antarctic routine. The logistics behind the study were complicated. Everything had to be pre-prepared and shipped down and there was no recourse if something was wrong or forgotten. It would be great practice for something done on people living on space stations.”

The study also highlighted how quickly vitamin D levels can drop in people who can’t get outside and are not supplemented, such as elderly patients in aged care, and what amount is needed to maintain vitamin D levels: 400-800 international units per day are enough.

From Italy with love
Sandra Iuliano-Burns was born in Melbourne’s inner west. The youngest of three girls, she explains that her surname, pronounced as if the “I” were a soft “J”, is unusual for the phonetically driven Italian language.

Emigrating here from Italy in the 1950s, her parents, not necessarily focused on academia, did provide her with a “background of hard-working commitment”. Inspired at school by her science teacher, Sandra’s choice to go to university to study human movement and then on to a masters in nutrition, and eventually a PhD in bone growth in children and the various factors influencing it, have come about by her ability to take opportunities when she saw them and to enjoy the outcomes of where they have led her. Her career path has fallen well-outside family expectations, as did her self-driven interest in athletics and sport from a young age continuing right through her life to include a career as an elite athlete.

The amazing solitude of running
“I grew up valuing commitment and security and to look for integrity in what I do – whether that is in sport or academic research. I like the goals that you work toward and complete in running,” says Sandra. “There’s a solitude in running, especially in long distance running, that allows me my thinking time. I have my best ideas out running. It means I have to hurry home to get them down on paper. It’s not just the physical benefits but the mental as well that I like to tell people about.”

When it comes to racing, the experience is very different. Then, she says, she clears her mind while at the same time thinking about her goals: doing the marathon sub-3-hours, which is “everyone’s major goal”; working toward certain points in the race in distance and time; focusing on someone ahead and thinking about catching them.

“It’s very much a hear-and-now sort of thinking. It’s an everything-and-nothing thinking with rarely any residual, any memory of what’s been thought at the end of the race,” explains Sandra.

Such physical and mental challenges have recently been outstripped by the juggling game that is motherhood. Blending her academic, health and fitness lives with home and family in order that she give each of them the best she can takes Sandra longer to achieve now. But the slower progress to her goals is worth it in the end.

“I’m passionate about watching my daughter grow: recognizing quirks and mannerisms in her; seeing family resemblances. Children become the centre of your life as they should be.”

Top tips
1. Get into the property market sooner rather than later. I bought my first apartment in my 20s and that has been my best financial decision. I started small but you can grow once you’re in. My parents instilled in my sisters and me the importance of saving and having a home. Coming home to your own place is a lovely feeling. There are times when everything might not be working but there’s always your own home.

2. There are perceived and real barriers stopping women from fulfilling their potential but the more women trailblaze and become role models the more those coming up behind will follow and see that those barriers and limitations can be hurdled. In the end it’s not about gender. It’s about having the tools to get where you want and that’s a matter of finding and developing those tools in ourselves.

National Healthy Bones Week
During National Healthy Bones Week in August, Dairy Australia is asking people to host their own dairy rich event — be it a schoolyard snack, a brunch or an office morning tea.

Now in its 17th year, the annual event will focus on the importance of a calcium-rich breakfast for bone health.

Dr Sandra Iuliano-Burns will be speaking at various events throughout the week on bone health, nutrition and exercise.

“Adequate daily calcium, regular weight-bearing exercise, and adequate vitamin D are essential at all ages for healthy bones and the prevention of osteoporosis in later life,” she explains. 

According to recent research, 75 percent of Australian adults recognise that calcium-rich foods such as dairy are important in the prevention of osteoporosis. Yet only 17 percent say they make sure they have enough dairy each day.

Three serves of dairy foods every day will provide most Australians with the calcium they need to build and maintain strong bones. A serve is equal to 250ml milk, 1 tub yogurt or 40g of cheese.

This year Dairy Australia is making it easy for Australians to meet their daily, recommended calcium intake, with an online calcium planner at www.healthybones.com.au

National Healthy Bones Week Activities
Learn more about having a bone friendly eating plan during National Healthy Bones Week, resources will be available online from the NHBW website www.healthybones.com.au providing information on ways to improve and maintain bone health, delicious calcium-rich breakfast recipe ideas, calcium meal planners for all age groups and other tips and suggestions for the prevention of osteoporosis.

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1 comments

  • Max Jackson

    Max Jackson 3 years ago

    Yoga or any types of physical exercise is so necessary in today’s life.These activities can help you to remain physicaly and mentally healthy. Triathlon is the best option if you want to enjoy with your family. Because it includes a number of sports and swimming as its main event. Next upcoming triathlon is Beginner triathlete Long Island by http://nytriexpo.com/ . Me and my friends are going to take participate in this event. It's going to start from 19th march 2016 at citi fields.