Protecting your bones: An action plan

While the basics of protecting your bones — such as getting enough calcium and engaging in weight-bearing exercises — remain the same throughout your life, there are different factors to consider as you age. The following tips can help you put together a plan to boost your bone strength, no matter what your age.

Stage 1: An early start

If you’re a man under age 65 or a premenopausal woman, the best approach is to concentrate on attaining and maintaining a high peak bone mass. The good news is that many of the factors that reduce the risk for osteoporosis also limit your chances of developing cancer, heart disease, and adult-onset diabetes.

Monitor your diet. Get the recommended amounts of vitamin D and calcium each day. Read food labels for calcium content. Although dairy products may be the richest sources, a growing number of foods, such as orange juice, are calcium-fortified. Fruits, vegetables, and grains are also important, because the plant kingdom is a good provider of other minerals that contribute to bone, such as magnesium and phosphorus. While the Nurses’ Health Study found that consuming 95 grams or more of animal protein a day may increase the risk for osteoporosis, some protein is essential for maintaining muscle mass.

Maintain a reasonable weight. In women, a body mass that is too low to support menstruation — because of anorexia or excessive exercise — is usually a sign that estrogen levels are too low to promote bone growth.

Avoid cigarettes and too much alcohol. Both decrease bone mass, and heavy alcohol use can also make you more apt to fall.

Perform weight-bearing exercises regularly. Just 30 minutes of weight-bearing exercise each day can protect your bones. Exercise offers a wide array of health benefits, including reducing your risk of developing heart disease, lowering blood pressure, boosting your energy level and your mood, and decreasing your chances of developing colon cancer and diabetes.

Review your health status. Ask your doctor if any conditions you have or medications you take may reduce bone mass, and what you can do to counteract these effects.

Stage 2: Early postmenopause

If you are a woman in the early years of menopause, you are probably in the period of your greatest bone loss. All of the suggestions for younger women still apply, and you should do the following as well.

Assess your risk. Talk to your clinician about whether or not you should have a bone density evaluation — the decision will depend on your risk factors.

Discuss preventive medications with your doctor. Consider talking to your doctor about medications — such as alendronate, risedronate, raloxifene, or hormone therapy — that can help prevent osteoporosis. Each medication has its own benefits and risks, and your doctor can help you determine which one may be best suited for you.

Check your calcium and vitamin D. Get at least 1,000–1,200 mg of calcium a day. Also, be sure that you are getting the vitamin D you need. Many experts are now recommending 800 – 1,000 IUs of vitamin D daily. But don’t take more than 2,000 IUs per day.

Re-evaluate your exercise regimen. Exercise not only builds bone, it also increases strength, flexibility, and balance. As you age, it becomes more difficult to maintain muscle mass, so you may need to add more exercise to keep from losing ground. Now may be a good time to incorporate weights into your routine, if you haven’t already been using them.

Stage 3: If you are 65 or older

At this point, bone loss has tapered off for women. Estrogen deficiency is no longer the primary thief of bone; decreased absorption of minerals plays a significant role. But for men, bone loss has speeded up. Regardless of your sex, you are still losing bone as you age. All of the previous suggestions for bone maintenance still apply, and you should be vigilant in following them. In addition, consider these suggestions.

Increase your calcium intake and get plenty of vitamin D. The recommended intake of calcium is 1,200 mg for everyone. Adequate vitamin D intake is equally as important as enough calcium. Make sure that take at least 600 IU of vitamin D daily to enhance absorption. Many experts are now recommending 800 – 1,000 IUs of vitamin D daily. But don’t take more than 2,000 IUs per day.

Keep up your exercise routine. It’s necessary not only to preserve bone, but also to maintain muscle mass, which helps protect bones should you fall. Exercise also helps improve balance and lessens the likelihood of falling. Consider learning tai chi or other types of exercises that improve balance and coordination.

Consider medication. Now you have more choices than ever before. Alendronate, risedronate, and raloxifene have all been shown to reduce bone loss, and are approved for the prevention and treatment of osteoporosis. Parathyroid hormone and calcitonin are approved for treatment. Each has its own benefits, risks, and side effects. You may want to talk to your doctor about whether you should take a preventive medication and, if so, which one may be best for you.

Each year, osteoporosis contributes to more than 1.5 million bone fractures. Thankfully, osteoporosis symptoms need not threaten the health of your bones or your overall well-being. With Osteoporosis: A guide to prevention and treatment, a special health report from Harvard Medical School, learn how to practice osteoporosis prevention through diet, exercise, and medications. You’ll also find advice on choosing a calcium supplement, tips on fall-proofing your home, and help with putting together a personalized plan to preserve or boost your bone strength.

---------------------------------------------------------------------------------------

Click here to join the group Harvard Med: Talking About Health

All about osteoporosis: Test and expand your knowledge

Can strontium help treat osteoporosis?

The consequences of osteoporosis