Beat osteoporosis by building better bones

May is National Osteoporosis Month, and a good time to take steps toward improving your bone health. Healthy bones give us good posture, allow us to stay active, and contribute to our overall physical health. However, as we age, our bones can weaken. This condition is called osteoporosis.

Why do our bones change as we get older?

We build bone mass through childhood and into young adulthood. During our twenties, our bones are at their strongest. However, after age 30, a woman’s body starts making less bone. And, after menopause, hormonal changes cause our bodies to make less estrogen, which in turn, makes us start to lose bone. In fact, a woman can lose up to one-third of her spinal bone mass during the first six years of menopause. These weakened bones lead to a risk of fractures, reduce the ability to be active, and can give a woman a stooped appearance.

Can we prevent osteoporosis?

Yes, by remembering that our bones are alive and always changing. They are continually making and losing bone. New bone is formed from calcium and other minerals. This allows bones to repair themselves after injury. When the bone-making system is healthy, the same amount of bone is rebuilt as is lost. This way, bones stay strong and able to support the body.

With osteoporosis, the bone-making system is out of balance and the amount of bone lost is greater than the amount of bone rebuilt. However, by taking a few simple steps — changing your diet, exercising, and in some cases, using supplements — you can tip the bone-making system back into balance and keep osteoporosis at bay.

Diet: A key tool

Make sure you get enough calcium. Women should start increasing their calcium intake in their thirties to help ward off the effects of menopause in later years. (Children and teens should also be encouraged to get enough calcium. Strong bones in your youth will aid you when you get older.)

Daily calcium needs are:

Age 14 to 18: 1,300 mg per day.

Age 19 to 30: 1,000 mg per day. 

Age 31 to 50: 1,000 mg per day.

Age 51 and up: 1,200 mg per day.

Note: These amounts are for prevention, not treatment, of osteoporosis.

Good sources of calcium:

Low-fat milk.

Oranges.

Low-fat yogurt.

Tomato soup with soy milk.

Low-fat cheese.

Tofu made with calcium sulfate.

Ice cream.

Puddings made with milk.

Canned salmon with bones.

Calcium-fortified soy milk.

Canned sardines with bones.

Calcium-fortified fruit juices.

Bok choy.

Calcium-fortified bread.

Collard greens.

Calcium-fortified cereal.

Broccoli.

Calcium-fortified breakfast bars.

Kale.

The vitamin D connection

Without adequate amounts of Vitamin D, our body’s capacity to retain calcium is compromised. The good news is that getting Vitamin D is very simple — when our skin is exposed to sunlight, our bodies make Vitamin D. The National Osteoporosis Foundation states that exposing your arms, hands and face to sunlight for as little as 15 minutes per day, two to three times per week, is enough to provide the right amount of vitamin D. However, some folks cannot tolerate sunlight, and others live in climates where outdoor exposure in the winter months might be difficult. Plus, we have to balance sunlight exposure with preventing skin cancer risks. For these reasons, ask your doctor or health care provider about taking a vitamin D supplement. The National Osteoporosis Foundation is recommending that adults under age 50 take vitamin D supplements of from 400 to 800 IU per day, and adults age 50 and up take 800 to 1,000 IU per day. Your doctor can advise you as to what dosage is right for you.

Add in exercise

Being active is important because your bones need exercise. Activity places force on your bones and they respond by growing stronger. When used as part of an overall prevention plan, exercise is even more effective.

Weight-bearing exercise works especially well. Some examples are walking, jogging, tennis, aerobics, dance and, in winter, cross-country skiing and skating. Chores such as gardening and yard work, and vacuuming, also provide weight-bearing exercise.

Resistance exercises are also good. These might include archery, using free weights, rubber-like stretch bands, or weight machines. These activities apply force to bones by way of the muscles. Both muscles and bones are strengthened when doing these exercises.

Non-weight bearing activities include swimming and bicycling. These do not benefit your bones, but do help you reduce weight, which is also important.

A good overall fitness plan should include weight-bearing activity, resistance activity, and a flexibility program, such as yoga, pilates, or dance.

Bone density tests

If you are concerned about the health of your bones, you might want to have a discussion with your doctor. A bone density test may be helpful in some cases. These tests are quick, easy and painless — much like an X-ray. In general, women of menopausal age and older should definitely have a bone density test.

About Dr. Maribeth DiNicola

Dr. Maribeth DiNicola is an obstetrician/gynecologist with Partners for Women’s Health in Exeter. She is board-certified in obstetrics and gynecology and is a Fellow of the American College of Obstetrics & Gynecology. Dr. DiNicola is also a member of the American Society for Colposcopy and Cervical Pathology. For information about Partners for Women’s Health, visit www.womenshealthexeter.com or call 778-0557.