Osteoporosis: Preventing Bone Loss
Osteoporosis affects more than 10 million Americans, and 80 percent of all those who have osteoporosis are women. A disease which causes bones to become thin and weak, osteoporosis occurs mostly in women after menopause when bone loss is the most rapid. Studies have shown that estrogen plays a key role in maintaining bone density. Therefore, from age 35 and beyond menopause, bone mass slowly declines as the supply of estrogen decreases. Most men do not begin to lose bone until their 50s, and the rate is not as rapid.
When bones lose density, they become porous and fragile, leading to an increased risk of fracture, especially in the back, hips, and arms.
Risk factors for osteoporosis:
- Advancing age
- Being female
- Being small-boned and/or thin
- Being white (Caucasian) or Asian
- Engaging in little or no physical activity
- Use of cigarettes
- Heavy alcohol intake
- A diet low in calcium
- Estrogen deficiency as a result of amenorrhea (the abnormal absence of menstruation)
Ways to reduce risk of osteoporosis:
- Eat a diet rich in calcium
- Participate in a regular program of weight-bearing exercise and include resistance training
- Take calcium supplementation, if needed
- If menopausal, take hormone replacement therapy (consult your physician)
- See your physician regarding medications
There is a safe and accurate test available today to measure bone mineral density (BMD). The standard is the dual energy X-ray absorptiometry (DEXA) measurement of the spine and hip. Bone density testing is recommended for women at age 35 to establish a baseline reading. After that, it is every five years unless otherwise clinically indicated. For men, the baseline age is 60. After that, men should have the test when clinically indicated.
Calcium
Calcium requirements vary for men and women and also change as people age. More calcium is needed during the growing years to build strong bones and again in the later years to reduce bone loss.
Recommended Daily Allowance of Calcium
Children Milligrams (mg)
Children (5-12 years) 1000
Adolescents, teens, and young adults (13-21 years) 1200-1500
Women
22-50 years 1200-1500
Over 50 years 1500
Men
22-50 years 1000
Over 50 years 1000-1200
Note: The maximum intake of calcium that is likely to cause no risk for all age groups (male or female) is 2000 to 2500 mg.
Source: Cooper Clinic Supplement Recommendations
Calcium intake can be increased by eating more calcium-rich, low-fat or non-fat dairy products. Calcium-Rich Foods
If insufficient calcium is obtained from the diet, take a calcium supplement. Calcium citrate provides 21 percent elemental calcium. Studies have shown that calcium citrate is easily absorbed and can be taken without regard to food. Calcium is best absorbed if consumed in split doses throughout the day. Other forms of calcium can be taken, such as calcium carbonate or calcium phosphate. Some prescription medications and iron supplements interfere with absorption and retention of calcium supplements and vice versa. Please consult your physician about the possibility of such an interaction.
Vitamin D
Vitamin D promotes bone mineralization in the body. It regulates calcium and other minerals, directing their addition into bone. Vitamin D is produced in the body when sun shines on the skin. People with regular exposure to adequate sunlight have no need for vitamin D from foods. Cooper Clinic recommends a daily intake of 400 IU.
Get Regular Exercise
To build and maintain bone mass and density it is important to incorporate exercises that are both weight bearing and resistant into your routine. Choose the degree of impact that is safe and appropriate for you.
Weight-bearing / High Impact / Resistance activities
Stair climbing, hiking, dancing, jogging, downhill and cross-country skiing, aerobic dancing, volleyball, basketball, gymnastics, weight lifting.
Weight-bearing / Low impact activities
Walking, treadmill walking, cross-country ski machines, stair-step machines, rowing machines, water aerobics, deep-water walking, low-impact aerobics.
Non-weight-bearing / Non-impact activities
Lap swimming, cycling, stretching or flexibility exercises (avoid forward bending exercises).
Safety
With osteoporosis, you need to learn how to live safely to prevent falls and back injury. Make your home safe by getting rid of hazards. Use caution when lifting, bending, or reaching. Think about personal safety, wear slip-proof shoes and use handrails. These safety measures can help protect against falls that could result in fractures.
Prevention of osteoporosis should begin in childhood and continue throughout life. Specific approaches to prevention differ for each stage of life. Requirements common to all age groups are adequate calcium intake, regular exercise, and appropriate levels of estrogen in women and testosterone in men.
Edited by Rebecca Stolz, RN, BSN
This material was presented at the Spring 1999 Women's Lecture Series
