What Is Bone Loss (cont.)
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How Can Bone Loss Be Prevented?
Many factors lead to bone loss. Some factors, such as age, cannot be controlled. However, simple steps can be taken to prevent or slow bone loss (see Prevention of Osteoporosis, Treatment of Osteoporosis, and Understanding Osteoporosis Medications).
Eat a Diet High in Calcium
Not getting enough calcium during a person's lifetime significantly increases the risk of developing osteoporosis. A low-calcium diet is associated with low bone mass, rapid bone loss, and broken bones (see Osteoporosis and Calcium). A diet high in calcium is important. Good sources of calcium include the following:
Some foods have added calcium, such as orange juice, cereals, and breads. Calcium supplements are also available.
Eat a Diet High in Vitamin D
Vitamin D is important for the body to absorb calcium from the diet. Without enough vitamin D, people are unable to absorb calcium from the foods they eat. When not enough calcium is absorbed from foods, the body has to take calcium from the bones, causing bone loss and leading to weaker bones.
Vitamin D comes from two sources. Vitamin D is made in the skin through direct exposure to sunlight, and it comes from the diet. Many people get enough vitamin D naturally. It is also found in fortified dairy products, egg yolks, saltwater fish, and liver. However, vitamin D production decreases in older people, in people who are housebound, and during the winter. These people may need vitamin D supplements to ensure a daily intake of 400-800 IU of vitamin D.
Physical activity during childhood and adolescence increases bone density and strength. Children who regularly exercise are more likely to reach their peak bone density (maximum strength and solidness) than those that do not exercise. People who reach their peak bone density, which usually occurs by age 30 years, are less likely to have significant bone loss that leads to osteoporosis.
The best exercise to prevent bone loss is weight-bearing exercise that works against gravity. These kinds of exercises include walking, hiking, jogging, climbing stairs, playing tennis, and dancing. The second type of exercise is resistance exercise. Resistance exercises include activities that use muscle strength to build muscle mass and strengthen bone. These activities include weight lifting, such as using free weights and weight machines found at gyms and health clubs. Exercise has additional benefits in older people as well because exercising increases muscle strength, coordination, and balance and leads to better overall health (see Fall Prevention and Osteoporosis).
Elderly people, people with osteoporosis, and people who have not exercised for most of adulthood should check with their health-care provider before beginning any exercise program.
Smoking is bad for the bones as well as for the heart and the lungs. Women who smoke have lower estrogen levels compared to women who do not smoke. Lower estrogen levels lead to increased bone loss. Women who smoke often go through menopause earlier. Remember that bone loss is most rapid in the first few years after menopause, but it continues even in the postmenopausal years. This means that the earlier menopause occurs, the more years bone loss is experienced and the weaker the bones will become over time. Men and women who smoke may absorb less calcium from their diets. Less calcium from the diet means the body breaks down the bones for the calcium it needs, which leads to bone loss.
Limit Alcohol Intake
Regular consumption of 2-3 ounces of alcohol a day may be damaging to bones, even in young women and men. Heavy drinkers are more likely to have bone loss and fractures. This is related to both poor nutrition and increased risk of falling. However, some evidence indicates that moderate alcohol intake may have beneficial effects on bone mass.
Bruce A Baethge, MD
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