Osteoporosis Prevention

Early Osteoporosis Prevention

By: Jacob R

Many recent scientific studies have drawn attention to the prevalence of osteoporosis, the condition of low bone mineral density, especially in the elderly population.  While these studies bring necessary attention to bone health in senior citizens, it is equally important to understand why these problems in bone structure arise, and what can be done to prevent them.

At the age where most people discover that they have low bone density, there are no proven ways to increase the amount of bone mass, only programs that aim to prevent the further deterioration of bone mineral density (BMD).  Much of the research done suggests that peak bone mass accrual occurs between the ages of 25-30. This means that BMD should be highest during this time period, and the years following this point are just a maintenance phase. One way to interpret this data is to say that in order to prevent the development of osteoporosis as one ages, they must be proactive when they are young in order to build up enough bone mass to prepare for the decline in BMD that is inevitable later in life.

The two main factors that contribute to an increase in BMD are physical activity and adequate diet.  Firstly, a person should actively engage in some sort of weight-bearing exercise, whether it is cardio or resistance training. This gives the body the opportunity to reform the bone after a bout of exercise, much in the same way that muscle begins to build when repetitively stressed. There must be a stress placed on the different structures in order for there to be any kind of accumulation of material. These types of exercises include walking, running, jumping rope, or even recreational sports, with the exception of swimming. Swimming is not included in this cardio section because it does not have a load bearing component to it, since you are floating in the water.  Resistance training can also be a great way to achieve the adaptations needed in the accumulation of bone mass.  Bone mass accrual is very site specific, which means if you do an exercise that targets your legs, your leg bones will get the added benefits of positive bone turnover. It is for this reason that it is important to train a variety of muscle groups.

The trainers at the HIT Center in Mesa are always thinking of new exercise programs that will help in the fight against osteoporosis.  An aspect sometimes slightly overlooked is the fact that we as Americans do not have the most wholesome and nutritious of diets. Although we get usually consume enough calories to survive (or perhaps more than enough), they often do not fulfill the vitamin and nutrient requirements of our body to keep them running smoothly. There are two main types of calcium in our foods, calcium carbonate and calcium citrate, and both are equally good for you. However, taken in supplement form, both have been known to cause some slight indigestion, so pick one that is right for you. The minimal intake for anyone over the age of ten is 1000 mg, with teenagers requiring slightly more in order to attain some increase in bone mass. For kids under the age of ten, the range is about 250-500 mg, although too much calcium can cause indigestion problems just as in adults.

Most people understand that calcium is essential in positive bone growth, but many do not realize that Vitamin D is just as essential in the absorption of calcium.  Vitamin D aids in calcium uptake by shuttling the calcium from the stomach to the parts of the body where it is needed most.  It also helps regulate blood calcium levels in order to effectively use it in positive bone remodeling. Without Vitamin D, bones can become brittle and misshapen a precursor to osteoporosis later in life. There are very few sources of food with naturally-occurring Vitamin D, but reactions in our skin can use the sun manufacture it. Just ten minutes of sun exposure a day is sufficient for most people to get their daily allowance of Vitamin D. More than this may be needed during the wintertime, or if you live further north than Los Angeles. The recommended daily allowance of Vitamin D is 5 micrograms per day, moving up to 15 micrograms throughout life.  Although these are very small amounts, the absence of Vitamin D has a strong negative impact on overall bone health.

Listed are websites further detailing these two key nutrients:

http://ods.od.nih.gov/factsheets/calcium.asp

http://ods.od.nih.gov/factsheets/vitamind.asp

Further, this is a great place to start for osteoporosis prevention:

http://www.mayoclinic.com/health/osteoporosis/ds00128/dsection=prevention



Osteoporosis Prevention

I was talking to a family friend over the weekend who was very surprized when she was recently diagnosed with Osteoporosis. She had no symptoms – just went to the doctor for a regular checkup and he decided to perform a bone density test. With one of my specialities in Senior Performance, I wanted to make others aware that Osteoporosis can be prevented and helped but there is no cure so please start early and make the right decisions!

From the National Osteoporosis Foundation (NOF):

Building strong bones, especially before the age of 30, can be the best defense against developing osteoporosis, and a healthy lifestyle can be critically important for keeping bones strong.

Osteoporosis is largely preventable for most people. Prevention of this disease is very important because, while there are treatments for osteoporosis, there is currently no cure. There are five steps to prevent osteoporosis. No one step alone is enough to prevent osteoporosis but all five may.

NOF’s Five Steps to Bone Health and Osteoporosis Prevention:

• Get your daily recommended amounts of calcium and vitamin D.
• Engage in regular weight-bearing exercise.
• Avoid smoking and excessive alcohol.
• Talk to your healthcare provider about bone health.
• When appropriate, have a bone density test and take medication.

Calcium

Calcium is needed for the heart, muscles and nerves to function properly and for blood to clot. Inadequate calcium is thought to contribute to the development of osteoporosis. National nutrition surveys have shown that many women and young girls consume less than half the amount of calcium recommended to grow and maintain healthy bones.

According to NOF recommendations, adults under age 50 need 1,000 mg of calcium daily, and adults age 50 and over need 1,200 mg of calcium daily. If you have difficulty getting enough calcium from the foods you eat, you may take a calcium supplement to make up the difference.

Vitamin D

Vitamin D is needed for the body to absorb calcium. Without enough vitamin D, you will be unable to absorb calcium from the foods you eat, and your body will have to take calcium from your bones. Vitamin D comes from two sources: through the skin following direct exposure to sunlight and from the diet. According to NOF recommendations, adults under age 50 need 400-800 IU of vitamin D daily, and adults age 50 and over need 800-1,000 IU of vitamin D daily. There are two types of vitamin D supplements. They are vitamin D3 and vitamin D2. Previous research suggested that vitamin D3 was a better choice than vitamin D2. However, more recent studies show that vitamin D3 and vitamin D2 are equally good for bone health. Vitamin D3 is also called cholecalciferol. Vitamin D2 is also called ergocalciferol. Vitamin D can also be obtained from fortified milk, egg yolks, saltwater fish, liver and supplements.

Exercise

Exercise is also important to good bone health. If you exercise regularly in childhood and adolescence, you are more likely to reach your peak bone density than those who are inactive. The best exercise for your bones is weight-bearing exercise such as walking, dancing, jogging, stair-climbing, racquet sports and hiking. If you have been sedentary most of your adult life, be sure to check with your healthcare provider before beginning any exercise program.

Medications for Prevention and Treatment

Although there is no cure for osteoporosis, currently bisphosphonates (alendronate, ibandronate and risedronate), calcitonin, estrogens, parathyroid hormone and raloxifene are approved by the US Food and Drug Administration (FDA) for the prevention and/or treatment of osteoporosis.

Bone Mineral Density Test (BMD Test)

A Bone Mineral Density test (BMD) is the only way to diagnose osteoporosis and determine your risk for future fracture. Since osteoporosis can develop undetected for decades until a fracture occurs, early diagnosis is important.

A BMD measures the density of your bones (bone mass) and is necessary to determine whether you need medication to help maintain your bone mass, prevent further bone loss and reduce fracture risk. A bone mineral density (BMD) test is a special type of test that is accurate, painless and noninvasive.

It is never too early or too late to start your prevention program.