10 Ways to Safeguard Your Bones

One in two women and nearly one in four men over 50 will suffer an osteoporosis-related fracture. Fortunately, there are simple ways to slash your risk. Here's how.

Health Monitor Staff
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One of the biggest problems with osteoporosis is that it's silent: You can't feel your bones becoming thinner and weaker. In fact, many people don't find out they have a problem until it's too late, after they've already fallen and broken a bone. But you don't have to become a statistic. Talk with your healthcare provider about how to lower your risk of developing osteoporosis. Then follow this 10-step plan to start preserving your bone health today.

1. Know your risk.
Because they naturally have lower bone mass and smaller bones, women are at much greater risk than men. Plus, in the five to seven years after menopause, women can lose up to 20% of their bone density because of the drop in estrogen, according to the National Osteoporosis Foundation (NOF). If you are 45 or older, thin, tall or a smoker, you have an increased risk of developing osteoporosis, says Carlos Isales, MD, professor of orthopedic surgery at Georgia Health Sciences University in Augusta. Other risk factors include drinking alcohol excessively, not exercising, having an eating disorder and not getting enough calcium.

2. Take stock of your family history.
If one of your parents has osteoporosis or has fractured a hip, tell your doctor. More than 50% of osteoporosis cases are genetic, says Dr. Isales.

3. Schedule a screening.
Since osteoporosis is a silent disease, you won't know you have it unless you are tested for it or you break a bone. If you have any risk factors, ask your doctor to test you for osteopenia (low bone density), the precursor to osteoporosis. Women 65 and older should be tested, as should men 70 and older, according to the NOF. If you break a bone after age 50 and/or have risk factors, ask about testing earlier. "After age 50, when you get screened is usually up to your doctor," says Sara Gottfried, MD, a gynecologist in Berkeley, California.

4. Have your bone density test on the same machine each time.
The results of your bone density test (the most common one is called a DXA—for “dual energy x-ray absorptiometry”) can vary from machine to machine, so if possible get your DXA test done at the same location each time, preferably on the same machine, to ensure uniform results, says Nathan Wei, MD, a rheumatologist in Frederick, Maryland.

5. Get enough calcium and vitamin D.
We lose calcium every day through our shed skin, hair and sweat and urine—and therefore need to replace it daily because our bodies can't make it on their own. Vitamin D is important too, since it improves the body’s calcium absorption. The goals: The NOF recommends adults under age 50 get 1,000 mg of calcium daily along with 400-800 IUs of vitamin D. If you're older than 50, the target is 1,200 mg of calcium daily with 800-1,000 IUs of vitamin D.While your body best absorbs calcium through food, it’s not always easy to meet calcium and vitamin D requirements from diet alone. For example, if you’re a postmenopausal woman who typically consumes only one or two servings a day of dairy, you may need to modify your food intake or talk with your healthcare provider about taking a calcium and vitamin D supplement.

6. Focus on bone-building foods.
To try and meet the nutrient goals above through food, aim for three servings of calcium daily, including at least 1½ cups of fruits and two cups of vegetables. Dairy foods, such as milk, yogurt and cheese, are your best bets. You can also stock up on calcium-fortified juices and breakfast cereals, sardines, canned salmon (with the bones), almonds and dark green, leafy vegetables. Collard greens, kale, okra, Chinese cabbage, mustard greens and broccoli contain the most calcium, according to the NOF. Spinach, rhubarb, beet greens and certain beans, however, shouldn’t be counted as sources of calcium due to their high levels of oxalates, known to reduce calcium absorption.

7. Pay attention to your meds.
Certain drugs increase your fracture risk, so tell your doctor what you're taking, advises Dr. Isales. This includes long-term use of steroids and antiseizure meds. Also to blame are certain cancer treatments, meds used to treat endometriosis or the thyroid and the use of aluminum-containing antacids, according to the National Institutes of Health. Ask your doctor whether a bone-building medication could help block the damaging effects of other medications.

8. Do something you love.
A Swedish study revealed that women over 50 who routinely participated in activities such as walking the dog had fewer hip fractures than women who were less active. "Any movement that puts stress on the spine, hips and other bones helps you stay healthy and strong," says Dr. Gottfried.

9. Stretch to stay limber.
"This will help prevent falls," says Dr. Wei. "Every time you feel stiff, take five minutes to stretch." Here's a simple move: Hold onto a chair for balance and stand with your legs together. Bend at your knees and grab one foot and hold it behind you. This will open your hips and lengthen your quadriceps muscles, says Dr. Gottfried.

10. Move to slow bone loss.
Exercise as often as possible. "I recommend doing an aerobic activity four days a week," says Dr. Gottfried, "plus two non-consecutive days of light weight training for 15 to 20 minutes."

January 2012