How can I prevent Osteoporosis?

Osteoporosis is called a silent disease. You normally don't know it until something like a fracture occurs. In reality, your bones have been loosing strength for years.

There are millions of people with osteoporosis, and the vast majority of them are women. Bone is a living tissue that consistently breaks down and rebuilds. As we enter our 40's and 50's, the rebuilding is having a hard time keeping up with the breaking down...thus a net loss.

While some of the risk factors cannot be modified (family history, small body frame size, racial/ethnic makeup, surgery (removal of ovaries) and menopause), other factors can be, and thus prevent or delay the onset of osteoporosis.

So what can you do?

• Eating a diet rich in calcium throughout life is important. What does that mean? Low fat dairy food, canned fish with soft bones such as salmon, dark green leafy vegetables and calcium fortified foods.
  
  
• If you need a supplement, the current recommendations are for people over 50 to have about 1200mg per day between diet and supplementation. Studies on women with osteoporosis in nursing homes have been shown to have a reduction of fractures just from calcium and vitamin D without other interventions.
  
  
• Vitamin D is necessary for your body to absorb the calcium. Being out in the sun for 20 minutes every day is usually sufficient. Foods that are high in vitamin D include eggs, fatty fish, cereals and fortified milk. Many calcium supplements and multivitamins have vitamin D as well. Recommendations include 400 IU of Vitamin D per day if you are less than 70 years of age, and 600 IU if you are over 70.
  
  
• Exercise! Once again the "E" word presents itself. Weight bearing exercise actually prevents the loss of bone. The stress on bone when you walk, play tennis, jog or dance actually stimulates your bone to increase its density. Not only that, but your improved muscle strength will protect you if you should fall. Once again, the current recommendations for exercise is 30 minutes of activity daily.
  
  
• Some medications can increase your risk for developing osteoporosis. For example steroids, some anti-seizure medications, some cancer medications, and long term use of Depo-Provera (birth control). If you take too much thyroid medication, or your thyroid glad is overactive your bone could be stimulated to break down faster. Talk with your provider to see if any modifications can be made.
  
  
• What else? Smoking, carbonated beverages and excessive alcohol have all been implicated in increasing you risk for osteoporosis. Consider eliminating, or at least reducing these habits from your life.

Recommendations:

Get a gone density scan (DEXA). They are non-invasive and give an accurate measurement of your bone density. The heel test will only give you a ball park figure, and are not always accurate. The DEXA scan will give you a T-score which will tell you and your provider if your density is normal, if you have osteopenia (pre-osteoporosis), or osteoporosis. With that information you and your provider can decide on the best plan of action for you.

If you have osteoporosis, follow the treatment recommendation of your provider, incorporate the dietary and activity recommendation made here, and work to reduce your risk of falls in your home.

Good health practices will go a long way in preventing and treating any problems. Once again, diet and exercise play a major role in this largely preventable disease.

©2005 Barbara C. Phillips, MN, NP