Simple steps for healthy bones
While many people think that aging and weak bones go hand in hand, the National Osteoporosis Foundation offers a different message: Osteoporosis. It’s Beatable. It’s Treatable.
This call to action is worth noting because osteoporosis is a major public health challenge. Currently, about 10 million Americans suffer from the disease (8 million women; 2 million men). Another 34 million individuals are at increased risk because they have low bone mass.
It is also vital because very few people are being screened and treated for weak bones. “Due to limitations on visit time, primary care physicians generally focus on more apparent problems, such as heart disease, diabetes and cancer,” said Dr. Marie L. Villa, medical director of the Healthy Bones Clinic at Harborview Medical Center. “As a result, patients have little knowledge of their skeletal health and even less about how to keep their bones healthy.”
Although it is common to think of bones as hard and brittle, they are actually living organs that go through a continuous process of loss and replacement. For children and young adults, the building process predominates, and bones become denser until peak bone mass is achieved around age 30. Afterwards, the balance begins to shift, resulting in potential bone loss. For women, this may be especially true after menopause, when estrogen levels drop sharply.
Osteoporosis occurs when bones begin to fracture easily due to the loss of minerals, such as calcium, and other structural changes. While any bone can be affected, common sites for these “fragility” fractures are the hip, spine and wrist. Often, the results are devastating. For instance, a hip fracture usually requires hospitalization and major surgery. In addition to marking the end of independent living for some older people, it is associated with an increased risk of death during the year following the injury.
According to Dr. Villa, the best way to develop and maintain strong bones is through a healthy diet, regular weight-bearing exercise and lifestyle choices, such as not smoking:
- A healthy diet starts with calcium, which provides bones with their strength and hardness. Recommended daily intakes range from 210 mg for newborns to 1,300 mg for children and young adults (ages 9 to 18). Good food sources are dairy products, including low-fat or nonfat milk, yogurt and cheese, and calcium-enriched cereals and juices.
- Vitamin D plays an equally important role because it is needed for the body to absorb calcium effectively. Recommended daily intakes range from 200 units for infants to 2,000 units for the elderly. Although some people obtain enough vitamin D through the skin from sun exposure, others may need food sources, such as egg yolks, fish oils and fortified milk.
- Regular daily exercise is as important for building strong bones as it is for muscles. But, for bones, it must be weight-bearing exercise that works against gravity. Examples are lifting weights, walking, climbing stairs, tennis, dancing and Tai Chi. A related benefit of exercise is that muscle strength, coordination and balance help to prevent falls and fall-related fractures.
While following these steps is a good prescription for healthy bones at all stages of life, two diagnostic tests can provide more specific information about the risk for developing osteoporosis. The first is a blood test, which can identify seasonal variations in vitamin D levels. In the Northwest, where vitamin D production from sunlight only occurs during the six months between the spring and autumn equinoxes, checking for lower levels in January or February can help to determine whether increased intake of vitamin D from food or supplements is needed.
Bone density tests use enhanced X-ray technology to measure bone mass at various sites of the body. These tests can detect osteoporosis before a fracture occurs, predict chances of fracturing in the future, determine the rate of bone loss and monitor the effects of treatment. They are recommended for people with known risk factors for osteoporosis, including women over the age of 65, men over the age of 70, people on certain medications such as prednisone or with certain illnesses such as rheumatoid arthritis, and people who are unable to walk.
If these tests indicate lower than normal bone mass or osteoporosis, the good news is that effective treatment are available. Along with providing guidance for diet, exercise and lifestyle changes, your health-care provider may prescribe medications that slow down bone loss or contribute to bone formation. In other words, even when not beatable, keep in mind the call to action: “Osteoporosis. It’s treatable.”