How to Keep Bones Strong Longer

Eight steps to avoid osteoporosis.

The North American Menopause Society
Weight training is great for helping you maintain bone mass.
Photograph: iStock

Postmenopausal osteoporosis is a skeletal disorder in which bone strength has weakened to a point that bone is fragile and at higher risk of fracture. Women undergo a rapid bone loss because of hormonal changes around menopause. This bone loss slows down but continues during the postmenopausal years. Some statistics help paint a clearer picture of the impact of osteoporosis:
•    In the United States, 10 million individuals have osteoporosis and 34 million more have low bone mass, placing them at increased risk for this disease.
•    One in two women over age 50 will have an osteoporosis-related fracture in her lifetime.
•    Osteoporosis causes more than 1.5 million fractures annually, including about 300,000 hip fractures, 700,000 vertebral fractures, 250,000 wrist fractures, and more than 300,000 fractures at other sites.
•    In Canada, 1.4 million individuals suffer from osteoporosis; it affects one in four women and one in eight men over age 50.

There are preventive steps women can take to avoid osteoporosis and resulting fractures or to keep osteoporosis from worsening.
Recommendations include:
•    Eat a balanced diet high in fruits, vegetables, calcium, and vitamins. Dietary sources are best, though these nutrients can also be obtained from supplements (see below).
•    Get enough calcium. The recommended total intake is 1,200 mg daily; for best absorption, if taking supplements, divide doses into 250-500 mg doses throughout the day and don’t take at the same time as fiber or iron supplements. 
•    Get enough vitamin D. NAMS recommends at least 800 to 1,000 IU per day for women at risk for deficiency due to inadequate sun exposure, including those who live in northern latitudes. The National Osteoporosis Foundation recommends 800 to 1,000 IU per day for adults age 50 and over.
•    Avoid alcohol and smoking. Heavy alcohol intake (more than 7 drinks per week) increases the risk of falls and hip fracture and women smokers tend to lose bone more rapidly and have lower bone mass than nonsmokers. Stopping smoking is one of the most important changes women can make to improve their health and decrease risk for disease.
•    Be physically active every day. Weight-bearing exercise (for example, fast walking, hiking, jogging, stair-climbing, weight training, tennis, and dancing) may strengthen bones or slow the rate of bone loss that comes with aging. Balancing and muscle-strengthening exercises can reduce the risk of falling and fracture.
•    Consider therapeutic medications. Currently, several types of effective drugs are available. Healthcare providers can recommend the type most appropriate for each woman. Drugs that are approved in both the United States and Canada include bisphosphonates, raloxifene, estrogens, parathyroid hormone, and calcitonin.
•    Eliminate environmental factors that may contribute to accidents. Falls cause nearly 90% of all osteoporotic fractures, so reducing this risk is an important bone-health strategy. Measures include ample lighting, removing obstructions to walking, and using nonskid rugs on floors and mats and/or grab bars in the shower.
•    Be aware of medication side effects. Some common medicines make bones weaker. These include a type of steroid drug called glucocorticoids used for arthritis and asthma, some antiseizure drugs, certain sleeping pills, treatments for endometriosis, and some cancer drugs. An overactive thyroid gland or using too much thyroid hormone for an underactive thyroid can also be a problem. If you are taking these medicines, talk to your doctor about what you can do to help protect your bones.

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