Studies showed that adequate calcium and vitamin D is vital for bone health, but the importance of calcium and vitamin D in older adults is not clear, while some showed that calcium and Vitamin D supplements help in the reduction of fractures in older people. Experts have raised concerns about a potential effect of a high intake of calcium (with or without vitamin D) from foods and supplements on cardiovascular disease (CVD) outcomes. A meta-analysis of both study- and patient-level data from randomized trials showed that calcium with or without vitamin D supplementation increased the risk for myocardial infarction and stroke Chung et al. (2016).            T-score is the results of the bone mineral density (BMD) of a healthy young adult. The 0 score means a BMD is normal. The difference between BMD of a young adult norm is measured in units called the standard deviation (SDs). The more standard deviations below 0, shows negative numbers, the lower your BMD, the higher the risk for fracture. That is to state that T-score between _1 and _2.5 or lower indicates osteoporosis, the greater the negative number, the more severe the osteoporosis National Institute of Health.gov. (n.d.).

Normal Bone density is within 1 SD (+1 or −1) of the young adult mean.
Low bone mass Bone density is between 1 and 2.5 SD below the young adult mean (−1 to −2.5 SD).
Osteoporosis Bone density is 2.5 SD or more below the young adult mean (−2.5 SD or lower).
Severe (established) osteoporosis Bone density is more than 2.5 SD below the young adult mean, and there have been one or more osteoporotic fractures.
The factors that affect serum uric acid (SUA) levels are age and gender, after puberty, SUA levels increases to reach normal level. In men, levels are higher than women, but at menopause, women SUA levels increase to reach men’s level Ragab et al. (2017). Therefore, gout is in the increase on middle aged men, older men and menopausal women.            Alcohol is well known factor for gout, depending on the amount consumed and the type of alcohol.  Beer is worst in increasing the risk of gout compared to liquor and the lowest risk is wine Ragab et al. (2017).              Management of gout includes the use of colchicine, non-steroidal anti-inflammatory drugs (NSAIDs), and steroids, they can be taken together in severe symptoms. Colchicine when taken 12 hours of the flare up of gout shows to be more effective but the toxicity must be monitored such gastrointestinal intolerance, diarrhea, nausea or vomiting, neutropenia and multi-organ failure. Chung, M., University, F. T., Tang, A. M., Fu, Z., Wang, D. D., Newberry, S. J., . . . Margolis,    K. L. (2016). Calcium Intake and Cardiovascular Disease Risk. Retrieved from             https://www.acpjournals.org/doi/10.7326/M16-1165Föger-Samwald, U., Dovjak, P., Azizi-Semrad, U., Kerschan-Schindl, K., & Pietschmann, P.       (2020). Osteoporosis: Pathophysiology and therapeutic options. EXCLI journal, 19,           1017–1037. https://doi.org/10.17179/excli2020-2591less0 UnreadUnread