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Be Good to Your Bones
When’s the last time you saw a checkout-counter magazine with a screaming
headline that touted six steps to a sexy skeleton?
You’re more likely to
hit the gym or watch your diet because you want to lose your belly or tone your
buns. And taking care of your bones doesn’t generate the short-term payoff of,
say, losing 10 pounds and being able to squeeze into your skinny jeans.
But if you care about your future, you can’t afford to ignore your
underpinnings. Healthy bones can make the difference between a vigorous, active
old age or golden years that are restricted, painful or even cut short.
Bones that are neglected to the point of becoming brittle and porous can
cause deformity, fractures, severe pain and loss of height.
The bones of
the spine, hips and wrist are common fracture sites, and breaks can occur from a
minor fall or even a sneeze. Surprisingly, hip fracture can be fatal: The risk
of death in the year after breaking a hip is 20 percent to 25 percent.
Fortunately, protecting your bones is easy if you’re also taking care of
the rest of you. Read on for specific ways to save your skeleton.
Risk Factors For Weak Bones
We think of bones as static
tissue, but in fact they’re constantly being broken down and built up through a
process called remodeling. When the process is in balance, they maintain their
mineral density. But if they lose more minerals than they absorb, density and
strength go down.
The terms “bone mass” and “bone density” are
interchangeable and simply mean how much or little mineral content can be
measured at specific sites.
Bones reach peak density in women between
ages 25 and 30 and in men from 30 to 35, according to the U.S. Food and Drug
Administration (FDA). Nutrition, movement, genetics, hormones, lifestyle factors
and medications taken also determine whether you maintain, lose or gain bone.
Some key risk factors for weak bones include:
- Low intake of calcium and vitamin D – both of which are necessary for bone
health
- Smoking
- Sedentary lifestyle
- Being small and thin
- Cutting calories severely
- Alcohol abuse
Specific drugs, for example glucocorticoids such as
prednisone, also cause loss of bone, as do some other prescription medicines.
Women who are bulimic, are anorexic, or who exercise to the point of
losing their periods are also at much greater risk of losing bone mass.
Women are four times more likely than men to develop osteoporosis –
which literally means “porous bone.” Men aren’t immune, though. In 2008 the
American College of Physicians released new guidelines, stating that in men the
disease is under-diagnosed and under-treated.
Whites and Asians have a
higher incidence of osteoporosis than African-Americans or Hispanics. Age and
hormonal changes play a part, too. In women significant bone loss typically
occurs around menopause and after age 70.
From 40 percent to 50 percent
of women and one in eight men over age 50 will experience a fracture related to
bone loss, the FDA says.
An estimated 44 million Americans have
osteoporosis, and an additional 34 million have low bone mass, or osteopenia,
and are at risk of developing osteoporosis, according to a 2008 report published
in the Annals of Internal Medicine.
Measuring Bone Density
Osteoporosis is a sneaky disease. You can’t feel a loss of bone mass until
something breaks.
But thanks to a new and sophisticated imaging
technology, health providers can painlessly scan your spine and hips to
determine how densely packed with calcium and other minerals your bones are.
Dual energy X-ray absorptiometry, also called a DEXA scan, exposes you to only
about 10 percent as much radiation as an average chest X-ray.
Doctors
don’t customarily recommend a DEXA scan until women reach age 65. But if you
have a family history of osteoporosis, weigh less than 154 pounds, or have other
risk factors, your doctor may recommend one much sooner.
Once your
physician has the results of your scan, she will know whether your bone-mineral
density is within normal limits. A diagnosis of osteopenia means bone mass is
below normal and might lead to osteoporosis.
Exercise Your
Skeleton
When it comes to building bones, the key is resisting gravity.
The most effective cardio exercise is weight-bearing, for example, walking,
jogging, jumping rope or participating in high-impact aerobics.
Swimming
and cycling, which don’t require you to work against gravity, help your heart
but do nothing for your skeleton. In fact, a 2007 U.S. study of competitive male
cyclists and runners found that 63 percent of the cyclists had osteopenia of the
spine or hip, compared with 19 percent of runners.
Resistance training –
working with free weights, weight machines or calisthenics – is highly effective
as well. When you perform resistance movements muscles pull on bones, and the
resulting strain stimulates the production of new bone tissue as well as
stronger muscles.
Pre- and post-menopausal women can increase bone
density by 2 percent to 3 percent with just six months of resistance training
three times a week, says University of Missouri researcher Pamela Hinton, Ph.D.
That might not sound like much, but even a 1 percent improvement in bone density
translates to a 5 percent reduction in the risk of fracture.
If you’re
cutting calories to lose weight, make sure you get your exercise, too. A 2006
study published in the Archives of Internal Medicine found that women and men
who lost weight through calorie-cutting alone lost a little more than 2 percent
of their bone mass in the hip, lower spine and the top of the femur. A similar
group who lost weight through exercise alone maintained their bone mass.
Nutrition And Supplements For Strong Bones
Everywhere you
look, you see ads encouraging you to drink milk. One key reason is bone health,
as milk contains not only calcium but also added vitamin D. Milk and milk
products are the most abundant food sources of calcium, but not the only ones.
You can also get calcium through a variety of foods such as:
- Fortified cereals and breads
- Vegetables like collard greens and kale
- Orange juice with added calcium
- Cheese
Adults under age 50 need 1,000 milligrams of calcium a day
and 1,200 milligrams daily at 50-plus. An 8-ounce glass of milk contains 300
milligrams as does the same quantity of OJ with added calcium.
If you
don’t drink milk, a calcium supplement may be good insurance. Absorption is
better when the dosage is less than 500 milligrams at a time. Superior
supplements bear on the label the initials USP, for U.S. Pharmacopeia. Stay away
from calcium whose sources include oyster shell, bone meal or dolomite, advises
Mayo Clinic dietician Katherine Zeratsky, R.D., L.D. It could contain toxic
chemicals such as lead or mercury.
Some calcium supplements can reduce
the effectiveness of prescription medicines, so if in doubt, get your
pharmacist’s or doctor’s advice.
Vitamin D plays a significant role in
bone health by helping move calcium from the intestines into your bones. The
best food sources include fatty fish, milk with added vitamin D, and fortified
cereals. Adult men and women from ages 19 to 50 need 5 micrograms a day
(equivalent to 200 international units). From age 51 to 70, people need twice as
much – and three times as much over age 70.
Vitamin A is necessary for
bones, too, but most Americans get enough in their diet, says the National
Center for Health Statistics. Too much vitamin A has actually been linked to
bone loss and an increased rate of hip fracture. If you take a vitamin
supplement, make sure it does not contain megadoses of vitamin A.
Medical Intervention Can Help
In recent years highly
effective prescription drugs have made it possible to reduce, stop or even
reverse loss of bone in patients with osteopenia or osteoporosis.
Most
of the drugs used to treat bone loss are antiresorptive, meaning that they slow
the process of bone remodeling and thus increase bone density. Brand names
include Fosamax and Actonel. These medications can reduce the risk of fractures
of the hip, spine and wrist by 40 percent to 50 percent.
Other
medications are also available – for example, a drug called Forteo that may be
especially effective at strengthening bones in arthritic patients who have
osteoporosis caused by the use of prednisone.
How You Can Help
Employees
Any health initiative you implement is likely to benefit
employees’ bones. Especially good are programs to discourage smoking and
encourage weight-bearing exercise such as walking or jogging.
The
American Cancer Society’s Workplace Solutions program helps employers help
staffers quit tobacco, become active and eat right. For information, visit
www.acsworkplacesolutions.com.
Set an exercise example
by spending your breaks or part of your lunch hour walking. If there’s room,
provide a treadmill for staff use. And consider conducting informal meetings
while walking around the block or in a neighborhood park.
For More
Information
To learn more about building healthy bones visit at these
Web sites.
The National Osteoporosis Foundation
www.nof.org
The Mayo Clinic’s osteoporosis page
www.mayoclinic.com/health/osteoporosis/OP99999
The National Institutes of Health osteoporosis page
www.health.nih.gov/topic/Osteoporosis