Men and women can take steps to curb effects of osteoporosis

Written by Chronicle Staff. Posted in Featured, Health & Wellness, Senior Living

Published on July 07, 2021 with No Comments

Good nutrition and regular exercise 

Physiotherapist working with elderly patient in modern clinic

Osteoporosis causes bones to become weak and brittle — so brittle that a fall or even mild stresses, such as bending over or coughing, can cause a fracture. Osteoporosis-related fractures most commonly occur in the hip, wrist or spine. The disease affects men and women of all races. But white and Asian women, especially older women who are past menopause, are at highest risk.

Treatment recommendations often are based on an estimate of your risk of breaking a bone in the next 10 years. This estimate uses information such as the result of a bone density test. If your risk isn’t high, treatment might not include medication. Rather, treatment may focus on modifying risk factors for bone loss and falls.

For anyone at increased risk of fracture, the most widely prescribed osteoporosis medications are bisphosphonates. Another common osteoporosis medication is denosumab, which is unrelated to bisphosphonates. Denosumab may be used in people who can’t take a bisphosphonate for various reasons, including reduced kidney function.

If you’re undergoing osteoporosis treatment, you’re taking a step in the right direction for your bone health. But perhaps you have questions about your therapy. Here’s what you need to know.

Osteoporosis

Osteoporosis is a disease of the bones that causes bones to become weak and break easily. Osteoporosis affects mostly older women, but prevention starts when you are younger. No matter your age, you can take steps to build bone mass and prevent bone loss. Broken bones from osteoporosis cause serious health problems and disability in older women.

Overview

Osteoporosis causes bones to become weak and brittle — so brittle that a fall or even mild stresses such as bending over, or coughing can cause a fracture. Osteoporosis-related fractures most commonly occur in the hip, wrist or spine.

Bone is living tissue that is constantly being broken down and replaced. Osteoporosis occurs when the creation of new bone doesn’t keep up with the loss of old bone.

Osteoporosis affects men and women of all races. But white and Asian women — especially older women who are past menopause — are at highest risk. Medications, healthy diet and weight-bearing exercise can help prevent bone loss or strengthen already weak bones.

Symptoms

There typically are no symptoms in the early stages of bone loss. But once your bones have been weakened by osteoporosis, you might have signs and symptoms that include:

  • Back pain, caused by a fractured or collapsed vertebra
  • Loss of height over time
  • A stooped posture
  • A bone that breaks much more easily than expected

When to see a doctor

You might want to talk to your doctor about osteoporosis if you went through early menopause or took corticosteroids for several months at a time, or if either of your parents had hip fractures.

Causes

Your bones are in a constant state of renewal — new bone is made, and old bone is broken down. When you’re young, your body makes new bone faster than it breaks down old bone and your bone mass increases. After the early 20s this process slows, and most people reach their peak bone mass by age 30. As people age, bone mass is lost faster than it’s created.

How likely you are to develop osteoporosis depends partly on how much bone mass you attained in your youth. Peak bone mass is somewhat inherited and varies also by ethnic group. The higher your peak bone mass, the more bone you have “in the bank” and the less likely you are to develop osteoporosis as you age.

Risk factors

A number of factors can increase the likelihood that you’ll develop osteoporosis — including your age, race, lifestyle choices, and medical conditions and treatments.

Lifestyle choices

Some bad habits can increase your risk of osteoporosis. Examples include:

  • Sedentary lifestyle. People who spend a lot of time sitting have a higher risk of osteoporosis than do those who are more active. Any weight-bearing exercise and activities that promote balance and good posture are beneficial for your bones, but walking, running, jumping, dancing and weightlifting seem particularly helpful.
  • Excessive alcohol consumption. Regular consumption of more than two alcoholic drinks a day increases your risk of osteoporosis.
  • Tobacco use. The exact role tobacco plays in osteoporosis isn’t clear, but it has been shown that tobacco use contributes to weak bones.

Complications

Bone fractures, particularly in the spine or hip, are the most serious complications of osteoporosis. Hip fractures often are caused by a fall and can result in disability.

In some cases, spinal fractures can occur even if you haven’t fallen. The bones that make up your spine (vertebrae) can weaken to the point of crumpling, which can result in back pain, lost height and a hunched forward posture.

Prevention

Good nutrition and regular exercise are essential for keeping your bones healthy throughout your life.

Protein

Protein is one of the building blocks of bone. However, there’s conflicting evidence about the impact of protein intake on bone density.

Most people get plenty of protein in their diets, but some do not. 

Older adults might eat less protein for various reasons. If you think you’re not getting enough protein, ask your doctor if supplementation is an option.

Body weight

Being underweight increases the chance of bone loss and fractures. Excess weight is now known to increase the risk of fractures in your arm and wrist. As such, maintaining an appropriate body weight is good for bones just as it is for health in general.

Calcium

Men and women between the ages of 18 and 50 need 1,000 milligrams of calcium a day. This daily amount increases to 1,200 milligrams when women turn 50 and men turn 70.

Good sources of calcium include:

  • Low-fat dairy products
  • Dark green leafy vegetables
  • Canned salmon or sardines with bones
  • Soy products, such as tofu
  • Calcium-fortified cereals and orange juice

If you find it difficult to get enough calcium from your diet, consider taking calcium supplements. However, too much calcium has been linked to kidney stones. Although yet unclear, some experts suggest that too much calcium especially in supplements can increase the risk of heart disease.

The Health and Medicine Division of the National Academies of Sciences, Engineering and Medicine (formerly the Institute of Medicine) recommends that total calcium intake, from supplements and diet combined, should be no more than 2,000 milligrams daily for people older than 50.

Vitamin D

Vitamin D improves your body’s ability to absorb calcium and improves bone health in other ways. People can get some of their vitamin D from sunlight, but this might not be a good source if you live in a high latitude.

To get enough vitamin D to maintain bone health, it’s recommended that adults ages 51 to 70 get 600 international units (IU) and 800 IU a day after age 70 through food or supplements.

People without other sources of vitamin D and especially with limited sun exposure might need a supplement. Most multivitamin products contain between 600 and 800 IU of vitamin D. Up to 4,000 IU of vitamin D a day is safe for most people.

Exercise

Exercise can help you build strong bones and slow bone loss. Exercise will benefit your bones no matter when you start, but you’ll gain the most benefits if you start exercising regularly when you’re young and continue to exercise throughout your life.

Combine strength training exercises with weight-bearing and balance exercises. Strength training helps strengthen muscles and bones in your arms and upper spine. Weight-bearing exercises — such as walking, jogging, running, stair climbing, skipping rope, skiing and impact-producing sports — affect mainly the bones in your legs, hips and lower spine. Balance exercises such as tai chi can reduce your risk of falling especially as you get older.

Swimming, cycling and exercising on machines such as elliptical trainers can provide a good cardiovascular workout, but they don’t improve bone health.

How to keep your bones strong

It’s never too early — or too late — to protect your bones from osteoporosis. What follows is an action plan to develop and maintain strong bones for a lifetime. These steps will help reduce your risk of osteoporosis.

Even if you’ve been told that you have osteoporosis or an increased risk of fracture, these same steps can help keep your bones as healthy as possible.

Follow a bone-healthy diet

If your mother told you to drink milk to keep your bones strong, that was sound advice. Good bone health starts with good nutrition. Your body needs protein, minerals and vitamins to make and regenerate bone. Even though as an adult you might not still be drinking milk, there are plenty of other ways to get the nutrients needed for bone health.

To keep your bones healthy, you need a balanced diet that includes enough calcium, vitamin D and other nutrients.

Calcium

Because calcium is a major component of bone, you need adequate amounts of this mineral throughout life to achieve and maintain peak bone mass. A diet that is low in calcium contributes to diminished bone density, early bone loss and an increased risk of fractures.

Women between the ages of 19 and 50 need 1,000 milligrams (mg) of calcium a day to maintain strong bones, and for women over age 50, the recommended daily amount is 1,200 mg. Men ages 19 to 70 need 1,000 mg of calcium a day to maintain strong bones, and for men over age 70, the recommended daily amount is 1,200 mg.

Dietary sources of calcium include dairy products, almonds, broccoli, kale, canned salmon with bones, sardines and soy products, such as tofu. An 8-ounce (240 milliliter) glass of milk provides 300 mg of calcium. Many calcium-fortified foods are also available, including cereals, juices, breakfast bars and pastas. Because the typical diet provides much less calcium than recommended, a calcium supplement can help make up the difference. Calcium supplementation has been shown to improve bone mineral density by 1 to 2 percent. Taking calcium without vitamin D may not prevent fractures.

Vitamin D

Although most people know that calcium is critical for bone health, vitamin D is just as important. Your body needs vitamin D to absorb calcium. A lack of vitamin D can weaken bones and increase the risk of fracture.

The dietary sources of vitamin D are fatty fish, such as tuna and sardines, as well as egg yolks and fortified milk or other products. The primary source of vitamin D is sunlight; however, many people, especially those who live in northern latitudes and older people, don’t get enough sun exposure to provide adequate vitamin D. Therefore, a dietary supplement may be recommended. The supplemental amount of vitamin D recommended by the Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine (formerly the Institute of Medicine) is 600 to 800 international units (IU) daily. However, some experts recommend a higher daily amount, especially for individuals who have a vitamin D deficiency. A health care professional can order a simple blood test to determine a possible deficiency.

Source: Mayo Clinic

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