Managing Osteoporosis

Follow these tips to keep your bones healthy.

Osteoporosis, which means “porous bone,” is a disease that causes bones to become weak, fragile and susceptible to fracture. The condition affects nearly 54 million Americans, especially adults aged 50 or older. People with osteoporosis often do not experience obvious symptoms — they don’t actually feel their bones getting weaker — but their risk of bone fractures is much greater, which is why Touro’s Dr. Meredith Maxwell says that a bone density and fracture risk assessment is essential to preventing and managing osteoporosis.

WHO IS AT RISK?
While osteoporosis affects both women and men, post-menopausal women are at a greater risk, primarily because estrogen, which protects bones, decreases sharply when women reach menopause. Other risk factors include advanced age, genetics and family history, personal history of bone fracture, low body weight, smoking, excessive alcohol consumption (greater than 2 drinks per day), rheumatoid arthritis and early menopause.

MANAGING WITH DIET
A healthy diet that includes proper amounts of calcium and vitamin D, in the form of whole foods as well as supplements, is essential to healthy bones. Older men and post-menopausal women need 1,200 mg of calcium per day in divided doses. Premenopausal women should consume 1,000 mg of calcium daily to prevent osteoporosis later in life. For vitamin D, older men and post-menopausal women should aim for 800 IUs per day, which is essential to absorbing calcium and phosphate.

It is important to speak with your doctor before beginning a vitamin regimen. Dairy products, such as milk, cheese and yogurt, are some of the best sources of calcium, but dark green, leafy vegetables, canned sardines and some fortified juices also supply calcium. Vitamin D can be found in fatty fish, such as mackerel, salmon and tuna, as well as fortified milk. Sunlight is another source, but, as we age, we do convert sunlight into vitamin D as efficiently — so supplements are needed.

MANAGING WITH LIFESTYLE
Though important, calcium and vitamin D are not enough for preventing osteoporosis. Dr. Maxwell encourages the following exercise and lifestyle measurements to keep bones healthy:

• Perform low-impact, weight-bearing exercises 30 minutes per day, three days per week, including resistance training, jogging or walking. “You want to achieve that impact with the ground,” Dr. Maxwell says. “Of course, enjoyment is most important,” so choose an activity that you enjoy and that you will stick with in order to reap the benefits.

• Quit smoking. Dr Maxwell warns that smoking one pack per day is associated with a 5 to 10 percent decrease in bone density.

• Focus on fall prevention. “Get your eyes checked regularly; be knowledgeable about your surroundings; and be aware of the side-effects of any medications, which may include dizziness,” Dr. Maxwell says.

• Limit alcohol consumption.

• Avoid drugs that increase bone loss, such as steroids.

OTHER TREATMENT OPTIONS
Dr. Maxwell recommends getting a dual-energy x-ray absorptiometry (“DEXA” or “DXA”) scan every two years to evaluate bone mineral density and measure bone loss. Prescription medications called bisphosphonates, such as Fosamax, are also used to treat and prevent osteoporosis because they alter the cycle of bone formation and bone breakdown. Talk to your physician about what treatment options are appropriate for you.