To reach optimal peak bone mass and continue building new bone tissue as you age, you should consider several factors.
An inadequate supply of calcium over a lifetime contributes to the development of osteoporosis. Many published studies show that low calcium intake appears to be associated with low bone mass, rapid bone loss, and high fracture rates. National nutrition surveys show that many people consume less than half the amount of calcium recommended to build and maintain healthy bones. Food sources of calcium include low-fat dairy products, such as milk, yogurt, cheese, and ice cream; dark green, leafy vegetables, such as broccoli, collard greens, bok choy, and spinach; sardines and salmon with bones; tofu; almonds; and foods fortified with calcium, such as orange juice, cereals, and breads. Depending upon how much calcium you get each day from food, you may need to take a calcium supplement.
Calcium needs change during one’s lifetime. The body’s demand for calcium is greater during childhood and adolescence, when the skeleton is growing rapidly, and during pregnancy and breastfeeding. Postmenopausal women and older men also need to consume more calcium. Also, as you age, your body becomes less efficient at absorbing calcium and other nutrients. Older adults also are more likely to have chronic medical problems and to use medications that may impair calcium absorption.
|Recommended Calcium Intakes
|Birth to 6 months
|6 months to 1 year
|1 to 3 years
|4 to 8 years
|9 to 13 years
|14 to 18 years
|19 to 30 years
|31 to 50 years
|51 to 70 years
|70 years and older
|Pregnant or lactating
|14 to 18 years
|19 to 50 years
Source: National Academy of Sciences, 1997.
Vitamin D plays an important role in calcium absorption and bone health. It is synthesized in the skin through exposure to sunlight. Food sources of vitamin D include egg yolks, saltwater fish, and liver. Many people obtain enough vitamin D naturally, by getting about 15 minutes of sunlight each day; however, studies show that vitamin D production decreases in the elderly, in people who are housebound, and for people in general during the winter. They may need
vitamin D supplements to achieve the recommended intake of 1000 to 2000 IU (International Units) daily.
Like muscle, bone is living tissue that responds to exercise by becoming stronger. Weight-bearing exercise is the best for your bones because it forces you to work against gravity. Examples include walking, hiking, jogging, climbing stairs, weight training, tennis, and dancing.
Smoking is bad for your bones as well as your heart and lungs. Women who smoke have lower levels of estrogen compared with nonsmokers, and they often go through menopause earlier. Smokers also may absorb less calcium from their diets.
Regular consumption of 2 to 3 ounces a day of alcohol may be damaging to the skeleton, even in young women and men. Those who drink heavily are more prone to bone loss and fracture, because of both poor nutrition and increased risk of falling.
Medications that cause bone loss
The long-term use of glucocorticoids (medications prescribed for a wide range of diseases, including arthritis, asthma, Crohn’s disease, lupus, and other diseases of the lungs, kidneys, and liver) can lead to a loss of bone density and fracture. Bone loss also can result from long-term treatment with certain antiseizure drugs – such as phenytoin (Dilantin) and barbiturates; gonadotropin-releasing hormone (GnRH) drugs used to treat endometriosis; excessive use of aluminum-containing antacids; certain cancer treatments; and excessive thyroid hormone. It is important to discuss the use of these drugs with your doctor and not to stop or change your medication dose on your own.
Preventing falls is a special concern for men and women with osteoporosis. Falls can increase the likelihood of fracturing a bone in the hip, wrist, spine, or other part of the skeleton. In addition to the environmental factors listed below, falls can also be caused by impaired vision or balance, chronic diseases that affect mental or physical functioning, and certain medications, such as sedatives and antidepressants. It is important that individuals with osteoporosis be aware of any physical changes that affect their balance or gait, and that they discuss these changes with their health care provider.
Here are some tips to help eliminate the environmental factors that lead to falls.
- Use a cane or walker for added stability.
- Wear rubber-soled shoes for traction.
- Walk on grass when sidewalks are slippery.
- In winter, carry salt or kitty litter to sprinkle on slippery sidewalks.
- Be careful on highly polished floors that become slick and dangerous when wet.
- Use plastic or carpet runners when possible.
- Keep rooms free of clutter, especially on floors.
- Keep floor surfaces smooth but not slippery.
- Wear supportive, low-heeled shoes even at home.
- Avoid walking in socks, stockings, or slippers.
- Be sure carpets and area rugs have skid-proof backing or are tacked to the floor.
- Be sure stairwells are well lit and that stairs have handrails on both sides.
- Install grab bars on bathroom walls near tub, shower, and toilet.
- Use a rubber bath mat in shower or tub.
- Keep a flashlight with fresh batteries beside your bed.
- If using a step stool for hard-to-reach areas, use a sturdy one with a handrail and wide steps.
- Add ceiling fixtures to rooms lit by lamps.
- Consider purchasing a cordless phone so that you don’t have to rush to answer the phone when it rings, or so that you can call for help if you do fall.
A comprehensive osteoporosis treatment program includes a focus on proper nutrition, exercise, and safety issues to prevent falls that may result in fractures. In addition, your doctor may prescribe a medication to slow or stop bone loss, increase bone density, and reduce fracture risk.
The foods we eat contain a variety of vitamins, minerals, and other important nutrients that help keep our bodies healthy. All of these nutrients are needed in balanced proportion. In particular, calcium and vitamin D are needed for strong bones and for your heart, muscles, and nerves to function properly.
Exercise is an important component of an osteoporosis prevention and treatment program. Exercise not only improves your bone health, but it increases muscle strength, coordination, and balance, and leads to better overall health. Although exercise is good for someone with osteoporosis, it should not put any sudden or excessive strain on your bones. As extra insurance against fractures, your doctor can recommend specific exercises to strengthen and support your back.
Several medications are available for the prevention and treatment of osteoporosis. Your physician may prescribe a medication if appropriate.
Information for the Osteoporosis Center web page was obtained from the National Institutes of Health Osteoporosis and Related Bone Diseases ~ National Resource Center.
The National Institutes of Health Osteoporosis and Related Bone Diseases ~ National Resource Center acknowledges the assistance of the National Osteoporosis Foundation in the preparation of this information.
It’s never too late — or too early — to do something about osteoporosis.
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