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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