Osteoporosis Lifestyle and Prevention

The U.S. Surgeon General's Report on Bone Health and Osteoporosis, published in 2004, indicates that by the year 2020, half of all Americans over age 50 will have weak bones unless they make changes in their diets and lifestyles.

The best way to keep your bones healthy is to establish a healthy lifestyle. This is good advice for everyone, of course, but especially true if you have risk factors for osteoporosis. As a start, you may try to do the following to reduce some of the causes of osteoporosis:

• Stop smoking
• Avoid drinking alcohol
• Take adequate amounts of calcium and vitamin D (which helps your body absorb calcium)
• Do weight-bearing exercises to stay physically fit
• Avoid high doses of thyroid hormone or cortisone-like medications. If you have to take them, work with your doctor to get the lowest possible dose to treat your condition.

Diet and Exercise Make a Difference

Calcium
Diet makes a difference in the prevention of osteoporosis. Calcium, the main element needed to keep your bones strong and healthy, is found mainly in dairy products.

On average, 500 mg. to 600 mg. of calcium is present in an average diet, largely from dairy products. Unfortunately, that is insufficient to meet our needs. The recommended amount for post-menopausal women and men with osteoporosis is 1200 mg. to 1500 mg. daily.

To get the calcium that you need to avoid osteoporosis and keep your bones healthy, you can eat three to four servings of dairy foods daily. Great calcium sources include milk, yogurt, and cheese. Better than average, but not as good as dairy foods, are some green vegetables such as broccoli and kale.

If you are unable to get all the calcium you need from food alone, you may wish to supplement your diet with calcium in tablets. Similarly, if you are lactose intolerant or you limit dairy foods in your diet because of body weight concerns or high cholesterol, you can supplement your diet with calcium in tablets.

Vitamin D
To form and maintain strong bones, vitamin D is essential. Vitamin D helps to maintain a normal level of calcium in the blood by helping the body absorb calcium properly. Fortified milk, egg yolks, liver, saltwater fish, and fish oils contain vitamin D.

Sunlight on your skin can activate the process in your body that makes vitamin D, but many people are not out in the sun enough to make optimal levels of vitamin D. Most people need about 1,000 to 2,000 International Units (IU) of vitamin D each day, although there is a suggestion that even more may be needed. To supplement the Vitamin D you are getting from the sun and from food, women and men over 65 years of age should take about 800 IU per day of vitamin D from a multivitamin or vitamin D supplements. Again, consult a physician if you are thinking about taking vitamin D supplements.

Exercise
Exercise is the other important key to keeping your bones healthy and avoiding osteoporosis symptoms. Exercise improves strength and balance, which may decrease the risk of falling. Before beginning any new exercises or physical activities, however, check with your doctor. On one hand, a 55-year-old woman who is healthy would probably not have trouble beginning a weight-bearing regimen. On the other hand, a 90-year-old woman might get a fracture doing the same type of exercise, because her bones are not as strong.

Once you get your doctor's okay, try walking more and climbing stairs, or jogging and playing racquet sports. Weight-bearing and strength-training exercise can help you stay fit and may lower the risk of fractures. Even men and women in their 90s have benefited from a gradual, personalized weight-training program. Bones remain stronger if they are used in daily weight-bearing activities such as walking or lifting weights. Walking at least 20 minutes a day can reduce bone loss.

Other Things
Preventing fractures is important at any age. Here is a checklist to keep you safe at home:

• Floors — Remove all loose wires, cords, and small rugs. Make sure your rugs are smooth and anchored. Keep furniture in its place so you will know where it is.
• Bathrooms — Install non-skid tape in the tub and shower, and install grab bars.
• Kitchen — Install non-skid mats near sink and stove. Clean spills right away.
• Stairs — Do not leave piles of clothing or other items on your stairs. Make sure the hand rails and carpeting are secure.
• Lighting — Install good lighting in your halls, stairways, and entrances. Install night lights in your bathroom. Turn on your lights if you have to get up during the night.
• Hip protectors — Ask your doctor about hip protectors, which are padded shorts or underwear that are worn over or in place of underwear. They prevent fractures by distributing the force of a fall on the hip to the softer tissue around the buttocks and thigh.
• In general — Ask your doctor if any of your medications might make you dizzy or more likely to fall. If you drink alcohol, drink only in moderation. If you feel unsteady, wear only flat, rubber-soled shoes.

Bone loss is a natural part of aging, but there are steps you can take to stay strong during every milestone in your life. A healthy lifestyle is a great place to start.

Editors:

Hormone Foundation Osteoporosis Task Force

Michael W. Draper, MD, PhD
Medical Fellow
Lilly Research Laboratories; Indianapolis, IN

Steven T. Harris, MD, FACP
Clinical Professor of Medicine
University of California, San Francisco; San Francisco, CA

Eric Orwoll, MD
Professor of Medicine
Oregon Health and Sciences University: Portland, OR

Dolores Shoback, MD
Professor of Medicine
University of California, San Francisco; San Francisco, CA

Nelson B. Watts, MD
Professor of Medicine
University of Cincinnati; Cincinnati, OH

Ada Wolfsen, MD
Associate Director of Internal Medicine
Scripps Mercy Hospital; San Diego, CA

Last Review: January 2008