Osteoporosis - It's Not Inevitable
Updated: Nov 5, 2020
As people age, they are at a greater risk of developing a variety of adverse health conditions. Cancer, heart disease and certain neurological disorders get most of the attention for threatening our health and quality of life. Other age-related diseases such as osteoporosis are just as prevalent but they don’t receive as much attention. Like cancer, heart disease and dementia, the effects of osteoporosis can be permanently debilitating and deadly. Fortunately, there are lifestyle factors that can greatly reduce the likelihood of developing osteoporosis. It helps to start thinking about disease prevention earlier in life when prevention measures can be more effective, but any time is a good time to integrate healthy bone habits into your lifestyle.
On average, one in two women over the age of 50 will break a bone due to osteoporosis, and one in four men will experience the same fate. For women, osteoporosis is more common than heart attacks, stroke and breast cancer combined. Men are more likely to break a bone due to osteoporosis than develop prostate cancer. In the United States, it is estimated that 10 million people have osteoporosis and 44 million people have low bone density. Osteoporosis is a deadly and life-changing disease. Of the nearly 300,000 hip fractures that occur each year, 24 percent of the patients over age 50 will die in the following year, 25 percent will end up in nursing homes, and half of the patients will never regain their previous level of function. The disease results, on average, in about 2 million broken bones per year, with a cost of 19 billion dollars annually. This rate is increasing.
What exactly is osteoporosis? It’s a health condition where the strength of bones decreases as bone density is lost over time. The inside of a bone appears almost like a honeycomb. Osteoporosis causes the spaces of this honeycomb shape to become wider and the walls to become thinner, making the bone less dense and more brittle. The loss of bone density and increased brittleness result in a higher likelihood of fracture.
When thinking about bone health, it helps to think of bone growth and decay as a kind of bank. The percentage of bone loss is similar to a withdrawal from the bank, while the percentage of bone gained can be seen as a deposit. Starting in childhood, and throughout the teenage years, the quantities of deposits of bone typically outnumber the withdrawals. At this stage of life, bone material is able to grow faster than it is destroyed. Likewise, bone density remains at a healthy percentage during this time. However, between the ages of 18-30, an individual typically reaches the peak of their bone growth and the ratio of deposits to withdrawals starts to fluctuate. The withdrawals can overtake the deposits if preventative measures aren’t employed such as diet, exercise and avoiding unhealthy habits. It’s never too early to begin employing prevention tactics against osteoporosis. Whether you’re young, old or in between, you can begin making lifestyle changes to ensure better bone health.
So, how do you prevent the disease? The first step comes with realizing that there are certain risk factors that you can control, like diet and exercise. There are also factors that you can’t control, such as genetics, medical conditions, and the side-effects of medications that may be necessary for other health conditions.
Starting with the factors you can control, let’s look at diet. Since bones require a large amount of calcium and vitamin D to maintain their durability, eating foods high in these nutrients is a good start. Foods that are beneficial to bone health include dairy products (milk, yogurt and cheese), fish (sardines, salmon, mackerel, and tuna), fruits and vegetables (broccoli, spinach, potatoes, tomatoes, oranges, bananas, peppers, strawberries, and pineapple), and other fortified foods. Fortified foods include certain breads, juices, milk and cereals that have added calcium and/or vitamin D.
It’s advisable to limit daily salt intake to 2,300 mg a day or less. High salt consumption increases calcium loss. Alcohol should be limited as well, and shouldn’t surpass 2-3 drinks per day. Excessive alcohol consumption interferes with the balance of calcium and vitamin D. It also interferes with hormones that stimulate bone formation. Studies have shown a direct relationship between smoking and low bone density. If you smoke, quitting will help improve your bone health.
Participating in regular exercise will also help prevent osteoporosis because it makes your bones stronger. Weight-bearing and muscle-strengthening exercises are the best for bone health. Weight-bearing exercises force your body to work against gravity and include walking, dancing, hiking, climbing stairs, racquet sports, etc. Resistance exercises such as lifting weights and exercising with resistance bands build strength. In addition to making deposits to the bone bank, exercise improves balance and coordination which reduces the chances of a fall that can result in a fracture. Please see the link at the bottom of this article for beneficial beginner’s exercises. Check with your healthcare provider before starting an exercise program.
Risk factors that can’t be controlled include genetics and other medical conditions. If either of your parents had osteoporosis or a history of broken bones, you will probably have a higher risk of developing osteoporosis. Some diseases that contribute to bone loss are autoimmune disorders such as rheumatoid arthritis, cancer, neurological disorders, blood and bone marrow disorders, certain mental illnesses, endocrine disorders, malnutrition, and below or above normal body weight. Age and gender also increases the risk of osteoporosis. The disease is more common in women than men due to the tendency for women to have smaller, thinner bones. Also, changes in estrogen levels during menopause contribute to higher rates of osteoporosis for women. Certain drugs contribute to bone loss such as steroids, diuretics, antidepressants, antacids, some thyroid treatments and medications to treat breast and prostate cancer.
It’s difficult to know if you have osteoporosis or have lower than average bone density unless you break a bone or get tested. Although bones are living tissue, we actually can’t feel them weaken. To test for osteoporosis, a doctor will prescribe a Bone Mineral Density (BMD) test. This is a safe and painless procedure. A BMD test requires an X-ray scan of the hip, spine, forearm, heel, wrist, or a combination of these bones. From this test, a T-score is established which measures bone density. A normal score is -1.0 or higher. A score between -1.0 and -2.5 is a sign of early bone loss (osteopenia), while a score below -2.5 usually signifies osteoporosis. If you are over 65, or have risk factors such as family history of broken bones or medical conditions that contribute to bone loss, talk to your healthcare provider about whether a BMD test should be part of your healthcare plan.
It’s never too late to begin a bone loss prevention plan. It’s even more important to be proactive about your bone health if you have a family history of osteoporosis or medical risk factors. When you start building healthy bone habits earlier in life, your bones will be stronger and less likely to break as you age.
Beginners Exercises to Improve Bone Health:
Lists related to osteoporosis prevention from the National Osteoporosis Foundation: