When you think of osteoporosis, you may assume it’s a disease that only impacts older women. You may even put off worrying about bone health until after menopause.
The truth is: the time to think about bone health is now.
Akanksha Kumar, MD, family medicine physician at Methodist Family Health Center – Preston Hollow, gives us the low-down on protecting bones at every stage in life.
Bone Health Before 60
When you’re young, your body constantly breaks down old bone and generates new bone tissue. As you get older, the body’s ability to build up bone slows and you start to lose more than you gain.
Most people reach peak bone mass in their 30s. After that, bone density begins to decline in both men and women. For women, bone loss accelerates in the first few years after menopause and continues post-menopause.
Your chances of developing osteoporosis – a condition in which bones become weak and brittle – are impacted by how much bone mass you build by your 30’s and how quickly you lose it later.
Peak bone-building happens during adolescence and puberty, which is why Dr. Kumar likes to take a proactive approach with her patients during annual physicals.
“I think the biggest thing for me is having our younger patients start the conversation sooner,” says Dr. Kumar. “It is all about prevention and there is a lot out there to help you prevent bone loss.”
Bone Up on Your Diet
Calcium and vitamin D are crucial for bone health. Calcium is a building block of bone tissue and vitamin D helps your body absorb and process it.
Researchers believe most people are deficient in vitamin D, produced by the body when it is exposed to sunlight. In fact, Dr. Kumar says it’s not unusual for a patient to come in with symptoms of fatigue and find out they don’t have enough vitamin D. Drinking fortified milk and eating fish with a lot of unsaturated fat, such as salmon, helps.
When it comes to testing calcium levels, the results are a bit more difficult to correlate with bone health, says Dr. Kumar. Instead, she recommends patients eat a healthy diet with calcium-rich foods including:
- Milk, yogurt, and cottage cheese
- Soy: a good substitute for those who avoid dairy
- Green, leafy vegetables like kale, broccoli, and spinach
- Certain canned fish and seafood (like sardines)
While juices enriched with calcium and/or vitamin D are available, Dr. Kumar says it’s best to steer clear of the excess sugar. And, while supplements may be a good idea for post-menopausal patients, Dr. Kumar recommends checking with a doctor first to avoid a harmful interaction with any other medication.
For most, a daily multi-vitamin and balanced diet will supply enough of the nutrients bones need.
Exercise for Stronger Bones
Many of us workout because we’re worried about our waistlines, but what’s good for muscle tone is also good for bones.
Remember when we told you about bone mass peaking in your 30s? Those who exercise regularly usually achieve greater bone mass, meaning their bones are stronger and denser by the time they reach 30. Even post-menopause, exercise is important because it can slow down bone loss.
A fitness plan that combines weight-bearing exercises and strength training is your best bet.
Weight-bearing exercises, done on your feet, require muscles and bones to work against gravity. Examples include:
- Fast walking or jogging
- Exercises to improve core strength and balance like yoga or Pilates
Add strength training with free weights, exercise bands, or even body weight exercises like squats, lunges, and push-ups to your routine. Dr. Kumar says to focus on longer reps and lower weight to strengthen bones and joints.
The Centers for Disease Control and Prevention recommend healthy adults exercise 150 minutes a week (30 minutes a day, five days a week), so don’t overdo it. Excessive exercise can damage joints.
If you already have osteoporosis, check with your doctor. You’ll want to avoid high impact exercises and workouts that cause you to bend or twist your spine.
Understanding Your Risk at Any Age
Young or old, Dr. Kumar says one of the most important changes you can make is to stop tobacco and excessive alcohol use.
Additional risk factors include:
- Family history of osteoporosis
- Previous fractures
- Gender and race (white and Asian women have the greatest risk)
- Low weight and body mass index
- Taking certain medications that cause bone loss (prednisone, Dilantin, and others)
- Type 1 diabetes, liver disease, or kidney disease
- Thyroid conditions
- Abnormal absence of menstrual periods, low estrogen (in women), low testosterone (in men)
All woman over the age of 65 should have a bone mineral density test or DEXA scan (also called DXA), which is painless. The test helps detect low bone density before a fracture happens, confirm a diagnosis of osteoporosis, or determine the rate of bone loss and monitor the effects of treatment.
Younger women with additional risk factors should also talk to their doctors about a bone health screening.
Although osteoporosis occurs five times more often in women than in men, it’s still a problem for men.
“Osteoporosis doesn’t discriminate when it comes to gender,” says Dr. Kumar who recommends men in their 40s and 50s talk to their doctors about whether they need a bone health scan.
And if you are diagnosed with osteoporosis or osteopenia (a condition marked by weak bones, less severe than osteoporosis), there are medications that can help keep bones stronger.
Osteoporosis does not have to be an inevitable part of getting older. You and your doctor can work together to preserve your bones for years to come.