Osteoporosis prevention: what you need to know

Many of the things that raise your chances for osteoporosis are things you can’t change, like your genes, your age, and your sex. But that doesn’t mean you can’t prevent the disease. The things you do every day can be part of your plan to build strong bones.

Women typically start out with lower bone density than men, and loss of estrogen over time can increase the risk for osteoporosis. Older adults are at highest risk of osteoporosis, with nearly 75% of hip, spine and wrist fractures occurring in people aged 65 years old or over. In fact, osteoporosis prevention begins in childhood, when a bone-healthy diet and plenty of exercise helps children achieve their highest possible ‘peak bone mass’. This is important because the more bone mass you have when you reach adulthood, the less likely you are to have weak and breakable bones at older age. The sooner you start keeping your bones healthy, the better off you will be in your 50s and beyond.

Exercise your bones

Just like your muscles, your bones get stronger if you give them a workout. Weight-bearing exercises are best for your bones. They’re the ones that force your body to work against gravity as you move. That prompts the body to make new bone.

Weight-bearing exercises include:

• Aerobics
• Climbing stairs
• Dancing
• Jogging
• Tennis and other racket sports
• Running
• Tai chi
• Walking
• Water aerobics
• Yoga.

Strength training is also key to preventing osteoporosis. Your muscles pull on your bones when you work them. That builds bone strength. These workouts also make you more flexible and lower the chances that you’ll fall — the No. 1 reason for broken hips.

Any of these workouts can help you build muscle and bone:

• Lifting canned goods or bags of groceries
• Lifting free weights
• Lifting young children
• Using ankle and wrist weights
• Using elastic resistance bands
• Using weight machines or free weights
• Doing pushups, squats, or other moves that use your own body weight.

To promote bone health, try doing weight-bearing and resistance exercises 3 or 4 days a week.

Calcium, vitamin D, and protein build bones

When your body doesn’t have enough calcium, it will start to break down your bones to get what it needs. That means you lose bone mass. So it’s important to make sure you have this nutrient every day in your diet or from supplements. Get it from:

• Low-fat or fat-free dairy products
• Calcium-fortified juices and foods, like cereal, soy milk, and tofu
• Sardines and salmon with bones
• Dark green vegetables, like kale and broccoli.

You should strive to hit the daily intake recommendation:

• 1,000 mg for women 50 and younger
• 1,200 mg for women 51 and older.

Vitamin D helps your body absorb the calcium you eat. Not many foods naturally have the nutrient, but you can get it in:

• Fatty fish, like salmon, mackerel, and tuna
• Beef liver, cheese, and egg yolks
• Fortified foods like milk, cereal, and orange juice.

Your goal of vitamin D should be:

• 600 international units (IU) of vitamin D per day if you are 70 or younger
• 800 IU if you are 71 or older.

Your skin also naturally makes vitamin D when sunlight hits it. You can get at least some of what you need if you spend a little time outdoors every day. But don’t overdo it — too much time in the sun raises your chances for skin cancer.

Protein is a building block for strong bones and muscles. It provides the body with a source of essential amino acids necessary for health.

It is important for young people to eat enough protein-rich foods so their bones develop and grow optimally. In seniors, protein plays a role in preserving bone and muscle. Lack of protein robs the muscles of strength, which heightens the risk of falls, and contributes to poor recovery in patients who have had a fracture.

Foods contain protein:

• Lean red meat, poultry and fish, as well as eggs and dairy foods, are excellent sources of animal protein.
• Vegetable sources of protein include legumes (e.g. lentils, kidney beans), soya products (e.g. tofu), grains, nuts and seeds.

The currently recommended daily allowance for healthy adults is 0.8 g of protein per kilogram (kg) of body weight, per day.

What else prevents osteoporosis?

• Don’t drink too much alcohol

Having more than two drinks per day is linked to higher chances of bone loss.

• Quit smoking

It doubles the chance of bone loss and fractures by keeping the hormone estrogen in your body from working well.

• Avoid the “female athlete triad”

Women who exercise and train intensely can have three issues — thin bones, lack of a menstrual cycle, and eating disorders. It often happens to young women who stick to very restrictive diets even though they work out a lot. Athletes who have problems with their periods have lower estrogen levels. This often leads to lower bone mass.

• Drink less soda

Some findings show that colas, more than other carbonated soft drinks, lead to bone loss. It may be that the extra phosphorus in them keeps your body from absorbing calcium. Or it may just be that women are replacing calcium-rich drinks, such as milk, with soda.

• Maintain a healthy body weight

The ideal body mass index (BMI) should be between 20 – 25, and a BMI below 19 (being too thin) is a risk factor for osteoporosis.

• Know your risk factors

Be aware of your osteoporosis risk factors, and get an early diagnosis, and treatment if needed. What’s more, be cautious about preventing falls, inside the home and out.

Will medicine prevent osteoporosis and fractures?

Some drugs can help the body maintain or build bone. Doctors often prescribe them for people, especially women, who have higher chances of getting osteoporosis or bone fractures. Ask your doctor if these drugs are a good idea for you.

Do I need a bone density test?

A bone density test measures a small part of one or a few bones to see how strong they are and can tell how likely you are to have osteoporosis. The most common one is called a dual-energy X-ray absorptiometry (DXA or DEXA) scan. It uses a small amount of radiation to measure your bone density.

But the scan isn’t right for everyone. The U.S. Preventive Services Task Force says people who should get DXA scans for bone density include:

• Women ages 65 or older
• Younger women who have a higher-than-normal chance of fracture for their age.

Talk to your doctor about whether the test is a good idea for you.

Source: WEB MD, INTERNATIONAL OSTEOPOROSIS FOUNDATION, JOHNS HOPKINS MEDICINE

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