Bone-Up for Better Health
Warding off osteoporosis isn’t just about drinking more milk. Learn understanding nutrition, exercise and family history can keep bones in peak condition
When you were younger, exercise may have been at the bottom of your to-do list.
Bone-building diet? If you added a splash of milk to your coffee you thought you were set for calcium.
But now that you’re experiencing menopause you may wonder if you’ve set yourself up for osteoporosis.
The answer is probably in your family’s genes, says Richard Dell, MD, orthopedic lead of the Healthy Bones Program at Kaiser Permanente in Southern California.
“Look at your mother. You’re looking in the mirror,” says Dell, an expert in bone health.
You should be paying attention because menopause is when your body goes through accelerated bone density loss as you lose estrogen.
“As soon as you hit menopause you lose 1 to 3 percent of your bone density a year,” says Dell.
But even if you ignored your bone health in your youth, you can take steps to preserve bone or develop greater bone density now, say experts.
Mid-life is a perfect time to talk to your physician about osteoporosis, according to Felicia Cosman, MD, clinical director of the National Osteoporosis Foundation (NOF) in Washington, D.C.
Discuss your risk factors, which include your age, sex, poor nutrition, certain medications, a history of smoking or excessive drinking or lack of exercise, especially weight-bearing routines.
(As many as half of all women and a quarter of men over age 50 will break a bone because of osteoporosis, according to the National Institutes of Health.)
If you fit the osteoporosis profile get screened at age 50, Dell advises. Regardless of your health you should have your bone mineral density checked if you’re a woman over the age of 65.
And if you’re a man, don’t assume you’ll be spared. The Kaiser Permanente physician advises screening for men over age 70.
Talk about your options. Your physician may suggest exercise routines, taking calcium (1,000 milligrams of calcium daily; 1,200 after age 70) and vitamin D (600 International Units, which is a new recommendation) and perhaps prescription medications.
Improving your diet is a critical step.
“The nutrition we think is ideal is high in fruits and vegetables and calcium rich,” says Cosman, author of “What Your Doctor May Not Tell You About Osteoporosis” (Warner Books, 2003).
She advises people to get their calcium in foods, not supplements, if possible.
Get three high-calcium foods daily, such as milk, cheese, calcium-fortified orange juice and cereal.
“If you’re getting three servings a day [of calcium-rich foods] you don’t need supplements,” says Cosman.
As clinical director for NOF, Cosman also supports the need for vitamin D and suggests having your vitamin D blood levels checked for adequacy.
Exercise is another beneficial and inexpensive step you can take.
In one of the most positive outcomes, post-menopausal women who followed a specific exercise regimen and who consumed adequate calcium maintained or increased their bone density, according to research from the University of Arizona, Tucson.
Volunteers who completed one year on the experiment saw improvement at their hips; those who followed the regimen for four years saw improvements in their spines as well, according to Linda Houtkooper, PhD, registered dietitian and head of the Department of Nutritional Sciences.
Exercise that creates torsional stress – slightly twisting the bone clockwise or counterclockwise – was a factor in bone density improvement, according to Houtkooper, co-principal investigator for the BEST (Bone Estrogen Strength Training) Study. (Some women in the study were also on hormone replacement therapy, which was linked to greater bone density improvement.)
“There’s something about the strain that changes the biochemistry of the bone,” says Houtkooper, who advises doing the routine with coaches who are trained in the specific exercises (to view the exercises online visit the website: http://bayerhearts.com/BEST/BEST-Videos.aspx).
Your physician may also recommend medications.
Low-dose estrogen when you’re in the very early stage of menopause might be something to consider to help preserve bone mass, according to Dell.
In the past, women were prescribed drugs when they were diagnosed with osteopenia--below normal bone mineral density.
Experts are rethinking that.
“In general, there’s been some over-treatment in early menopausal women. The idea that all women should be treated is no longer recommended,” says Cosman.
“For osteopenia you need exercise and calcium, not treatment,” says Dell.
That changes if you have osteoporosis.
Bisphosphonates, which slow bone loss and help increase bone density, are often prescribed.
However, these are powerful drugs, with potential complications.
Physicians are now recommending taking the drugs for a prescribed amount of time, then taking a rest.
“The new thinking is a drug holiday; not dropping the drug forever,” says Dell.
“There’s new promise in osteoporosis management with new drugs.”
But don’t wait for a drug to save your bones. Get your calcium, vitamin D and exercise, and stop smoking, says Dell, who in the Healthy Bones program reduced the hip fracture rate by an average of 37 percent.
Bev Bennett, a veteran food writer and editor, is the author of "Dinner for Two: A Cookbook for Couples" and "30-Minute Meals for Dummies"
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