Osteoporosis Prevention: Strategies for Maintaining Strong, Healthy Bones
A variety of preventive health strategies help slow and lessen the effects of osteoporosis, a natural weakening of the bones as we age. Osteoporosis increases the likelihood that a debilitating injury will result from an accidental fall.
The Extent of the Disease
According to the National Osteoporosis Foundation (NOF), low bone mass and osteoporosis affect 52 million Americans. It accounts for two million fractures and $19 billion in related expenses each year.
After the age of 50, women have a 50-percent chance of suffering an osteoporosis-related fracture. The risk increases dramatically after the first occurrence. Men 50 and over have a 25-percent chance of suffering an osteoporosis-related fracture.
Prevention and Treatment Options
The high physical and financial cost of osteoporosis makes prevention or treatment a top priority for seniors. Here are some leading options:
Medications: Most osteoporosis drugs block the effect of bone-destroying cells that increase in number as we get older. A compound called Denosumab helps prevent the formation of the harmful cells. Declaring it one of 2009's "Top 10 Medical Breakthroughs," Time magazine states that two studies showed Denosumab to be effective in preventing fractures in the two largest at-risk populations for osteoporosis, postmenopausal women and men in treatment for prostate cancer.
Other osteoporosis drugs, such as Fosamax, Boniva, Actonel and Reclast, belong to a group of drugs called bisphosphonates. According to the Mayo Clinic, these drugs, much like the female hormone estrogen, inhibit bone breakdown, preserve bone mass and even increase bone density in the spine and hip, reducing the risk of fractures.
The drug Evista also mimics estrogen's positive effects on bone density. Calcitonin, a hormone produced by the thyroid gland, slows bone loss. Forteo is a powerful drug that stimulates new bone growth.
Talk with your physician about these drugs, their benefits and their side effects to help determine if any may be effective and safe for you.
Hormone therapy: Estrogen therapy is generally not the first choice for maintaining bone density due to the availability of other options and the increased risk of blood clots, breast and endometrial cancer, and heart disease.
Diet: The amount of calcium our bones require from food and supplements changes as we age, according to the Institute of Medicine (IOM). It rises from 210 to 270 milligrams a day during the first year of life and peaks at 1,300 milligrams from ages 9 to 18 before declining to 1,000 milligrams from ages 19 to 50 and rising to 1,200 milligrams at age 51 and up.
Natural sources calcium include dairy products, almonds, broccoli, spinach, cooked kale, canned salmon with the bones, sardines and soy products. Those who have trouble getting adequate calcium from their diet may consider a supplement, but the IOM recommends limiting total calcium intake to 2,500 milligrams a day. (Required calcium intake varies by individual. Always check with your doctor before talking a calcium supplement or any other nutritional supplement.)
Vitamin D is also essential to bone health. Many people get adequate amounts of this nutrient from sunlight. But that is not always possible if you live at a high latitude, are housebound, regularly use sunscreen or avoid the sun to reduce the risk of skin cancer. Vitamin D is available in oily fish and egg yolks. If this does not provide enough, a good alternative is a vitamin D supplement or a calcium supplement that includes vitamin D.
While calcium and vitamin D are good for your bones, cigarettes and alcohol are not. Do not smoke, and limit your alcohol consumption. Smoking increases bone loss, as it inhibits production of estrogen and reduces absorption of calcium in the intestine. Consumption of more than two alcoholic drinks a day decreases bone formation and reduces calcium absorption.
Physical therapy and exercise: Often used in combination with medications and other therapies, physical therapy helps improve bone strength, posture, muscle strength and balance, thereby making falls less likely. Exercise also reduces risk of falling. A lifetime of exercise is ideal, but you can realize the benefits no matter when you start. (However, see your doctor before you begin.) For the best overall results, combine weight-bearing exercises, such as walking, and strength training with weights.
Fall prevention: In addition to exercise, you can reduce the risk of falls and broken bones by taking steps toward making your or your loved one's home safer. This can start by checking for and removing hazards, such as electrical cords, area rugs and slippery surfaces, which might cause trips or falls. Also, improve lighting inside your home and around outside areas such as pathways or sidewalks.
There are a variety of means for preventing or treating osteoporosis. Talk to you doctor and find the best way to care for your bones.