How can I prevent osteoporosis?

Last week we talked about osteoporosis, including risk factors and complications. This week, I wanted to talk about things that you can do to try to prevent osteoporosis. We will also talk about ways that it can be treated, if it does develop, in order to decrease the risk of complications.

As I mentioned last week, bones are living tissue, and they are continually being remodeled with old bone being removed and new bone being created. Bones continue to grow and reach a maximum size and strength (peak bone mass or bone bank deposit) on average sometime between ages 25 and 30. There are two processes that increase your risk for osteoporosis. The first is a decrease in bone bank deposits, and the second is an increase in bone bank withdrawals.

Preventing osteoporosis starts with optimal bone growth and development from a very young age. It is never too early to start depositing into your bone bank! It is estimated that a 10% increase in peak bone mass reduces the risk of an osteoporotic fracture during adult life by 50%.

People of all ages should eat a nutritious diet with adequate calcium intake. We have learned that getting calcium through foods is much more beneficial and causes fewer long term complications than taking calcium supplements. I would not recommend taking a calcium supplement without you discussing it with your doctor first. The amount of recommended daily calcium varies depending on age and other factors.

Here is the recommended dietary calcium intake for children and adults.

• Less than 4 years old	consult your pediatrician
• 4-8 years old	1000 mg per day
• 9-18 years old	1300 mg per day
• 19-50 years old	1000 mg per day
• Men 51-70 years old	1000 mg per day
• Women 51-70 years old	1200 mg per day
• 71 years and older	1200 mg per day

What else can you do to decrease your risk of osteoporosis?

Avoid under-nutrition or malnutrition, especially during childhood and adolescence. Be aware of possible eating disorders and the effects they have on nutritional status.
Maintain an adequate supply of vitamin D, which is often found alongside calcium in fortified foods. Vitamin D is made in your body when your skin is exposed to sunlight.
Participate in regular physical activity, particularly weight bearing exercises, or activities that provide resistance, such as walking, jogging, running, weight training, dancing, aerobics, hiking, stair climbing, and push-ups. Daily activities like gardening, vacuuming, mowing the lawn, or shoveling snow are also beneficial. Remember that weight bearing exercises are the only exercises that enhance bone growth or stop bone loss.
Avoid smoking and second-hand smoke exposure. We learned decades ago that there is a direct relationship between tobacco use and lower bone density.
Avoid excessive alcohol intake. Too much alcohol intake interferes with the body’s calcium balance. It can also cause hormone abnormalities that can affect our bone bank balance, as well as vitamin deficiencies that can affect our bones.
If you have thyroid problems, be sure to have this monitored regularly by your doctor. Excessive thyroid hormone, either from an overactive thyroid, or thyroid replacement at a dose that is too high, can lower your bone mass.
Talk with your doctor about a bone density test. This is a painless test which can detect osteoporosis before a fracture occurs. The age at which you should have this test depends on your risk factors, so discuss it with your family doctor at your next annual exam.

How is osteoporosis treated?

There is no cure for osteoporosis, but there are a number of treatment options. The treatment option recommended as the first line treatment for most women is use of a medication in the bisphosphonate class. This class includes several different medications which may be taken by mouth daily, weekly, or monthly, as well as given by injection on a less frequent basis. There are also several other classes of medications that can be used to treat osteoporosis. Which medication is best for you depends on many things including other medical problems or your risk for other medical problems, other medications that you take, and other factors as well. If you have osteoporosis, you should talk with your doctor about which of treatment option is best for you.

If you have any questions about your risk for osteoporosis or prevention, send a question to one of our doctors. For a list of calcium-rich foods from the National Osteoporosis Foundation, follow this link:
https://www.nof.org/patients/treatment/calciumvitamin-d/a-guide-to-calcium-rich-foods/

If you have any more questions just Ask Hanna, our health advisors are here to help.

Dr. Anita Bennett MD – Health Tip Content Editor