Healthy bone is a balancing act. Our bodies continually remove older bone and replace it with new. As adults, if we lose bone at too fast a rate, replace it at too slow a rate, or both, the result is osteoporosis—weak, porous bones that fracture easily. The National Osteoporosis Foundation estimates that nearly 10 million Americans have osteoporosis, and over 43 million more have its precursor—low bone density. The disorder is more common in older than younger people. Fractured bones from this condition can be life-altering, and even life-threatening, but they are not inevitable. There is much we can do to maintain our bones. The earlier we start the better.
What Causes Bone Loss? Bone mass peaks between ages 18 and 25. This peak mass is determined largely by genetics, but nutrition, physical activity, health status during growth, and hormonal and endocrine factors play a role as well. As we age, hormonal changes (particularly menopause); health problems such as thyroid imbalances and digestive disorders; and long-term use of certain medications (including steroids and some heartburn drugs, as well as chemotherapy) all play a role in creating the imbalance that leads to weaker bones. Smoking is associated with lower bone density, as is alcohol abuse. Nutritionally, high salt intake, low calcium intake, and insufficient vitamin D are all associated with higher risk for bone loss, and emerging research suggests other roles for diet as well.
Protecting your bones is part of a healthy aging strategy. Talk to your doctor about assessing your risk of fractures and devise a strategy to lower the risk, especially if you’ve had a fracture after age 50, according to the Mayo Clinic Health Letter. A comprehensive approach includes optimizing nutrition, reviewing exercise, safe moving practices, and fall prevention, and taking prescription medications if appropriate.
A key factor to maintaining the bone density you have is to make healthy choices to support bone health. These steps are important in both preventing osteoporosis and slowing its progression. They include:
■ Exercise — Weight bearing physical activity such as walking and moderate aerobic exercises can strengthen bones and reduce risk of fracture. Muscle strengthening exercises can help as well. Aim to exercise at least 30 min utes most days of the week. Ask your doctor whether any precautions are recommended, especially if you’re at increased risk of fracture.
■ Eat well — Eat a balanced diet and make certain that you’re getting enough calcium and vitamin D from the food you eat.
■ Don’t smoke — Smoking speeds up bone loss.
■ Limit alcohol — Should you choose to drink, do so in moderation. For healthy adults, that means up to one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men 65 and younger.
A new IOF-led study examining the burden and management of fragility fractures in six European countries reveals an alarming treatment gap, with fracture-related costs projected to increase to €47.4 billion by 2030.
A new study provides an overview and comparison of the burden and management of fragility fractures due to osteoporosis in the five largest countries in Europe (France, Germany, Italy, Spain, and the United Kingdom) as well as Sweden. The publication ‘Fragility fractures in Europe: burden, management and opportunities’ has been authored by an International Osteoporosis Foundation (IOF) steering committee in cooperation with experts from national societies.
Osteoporosis is a chronic condition in which bone mass and strength decrease causing an increased risk of fractures. Fragility fractures are a major cause of disability and early death in older adults, with one in three women and one in five men aged fifty and above sustaining a fracture in their remaining lifetime.
For the most part, osteoporosis is thought of as a women’s affliction because more women get it than men. However, it is an affliction of older age and more women get it because they live longer. A senior man is very likely to contract osteoporosis also. Herewith, Harvard Medical School on the subject.
The best prevention for bone-thinning osteoporosis begins early — during the first two decades of life, when you can most influence your peak bone mass by getting enough calcium and vitamin D and doing bone-strengthening exercise. If you are over age 20, there’s no need to be discouraged. It’s never too late to adopt bone-preserving habits.
If you are a man younger than 65 or a premenopausal woman, these five strategies can help you shore up bone strength as a hedge against developing osteoporosis.
Monitor your diet. Get enough calcium and vitamin D, ideally through the foods you eat. Although dairy products may be the richest sources of calcium, a growing number of foods, such as orange juice, are calcium-fortified. Fruits, vegetables, and grains provide other minerals crucial to bone health, such as magnesium and phosphorus.
Maintain a reasonable weight. This is particularly important for women. Menstrual periods often stop in women who are underweight — due to a poor diet or excessive exercise — and that usually means that estrogen levels are too low to support bone growth.
Don’t smoke and limit alcohol intake. Smoking and too much alcohol both decrease bone mass.
Make sure your workouts include weight-bearing exercises. Regular weight-bearing exercise like walking, dancing, or step aerobics can protect your bones. Also include strength training as part of your exercise routine.
Talk with your doctor about your risk factors. Certain medical conditions (like celiac disease) and some medications (steroids and others) can increase the chances that you will develop osteoporosis. It’s important to talk with your doctor to develop a prevention strategy that accounts for these factors.
Turns out “Nuts to you” isn’t the insult it used to be. Here is a wonderful infographic on the benefits of eating cashews. I am a big fan of nuts in most shapes and forms. I include walnuts in my daily oatmeal.
I have written numerous times about the dangers and negative effects of obesity. You can check out previous posts by typing in o b e s i t y in the search box on the right.
New research published in the Journal of Experimental Medicine highlights the pernicious effect of obesity on the long-term health of blood-making stem cells (hematopoietic stem cells).
Published Dec. 27, the study was led by researchers at the Cincinnati Children’s Cancer and Blood Diseases Institute. Conducted largely in genetic models of obese mice, it shows obesity causes durable and harmful changes to the hematopoietic stem cell compartment – the blood-making factory in our bodies. Continue reading →
While eat less; move more; live longer is the mantra of this blog, I hasten to add that strength training should be an integral part of that move more aspect. Harvard HEALTHbeat has come out with a new publication on strength and power training.
Here’s what Harvard has to say on the subject: “Most of us know that strength training (with free weights, weight machines, or resistance bands) can help build and maintain muscle mass and strength. What many of us don’t know is that strong muscles lead to strong bones. And strong bones can help minimize the risk of fracture due to osteoporosis.
“A combination of age-related changes, inactivity, and poor nutrition conspire to steal bone mass at the rate of 1% per year after age 40. As bones grow more fragile and susceptible to fracture, they are more likely to break after even a minor fall or a far less obvious stress, such as bending over to tie a shoelace.
“Osteoporosis should be a concern for all of us. Eight million women and two million men in the United States have osteoporosis. It is now responsible for more than two million fractures a year, and experts expect that number will rise. Hip fractures are usually the most serious. Six out of 10 people who break a hip never fully regain their former level of independence. Even walking across a room without help may be impossible.”
Just two days ago I posted on older men being at risk of osteoporosis. “As I reported here, after the age of 50 men are as likely to get osteoporosis as prostate cancer. More to the point, older people of both sexes have great vulnerability to it.”
Now comes a new study that explains how weight-bearing exercises affect our bone structure and fight that disease.
Osteoporosis affects more than 200 million people worldwide and is a serious public health concern, according to the National Osteoporosis Foundation. Now, Pamela Hinton, associate professor in the Department of Nutrition and Exercise Physiology, has published the first study in men to show that long-term, weight-bearing exercises decrease sclerostin, a protein made in the bone, and increase IGF-1, a hormone associated with bone growth. These changes promote bone formation, increasing bone density. Continue reading →
Women are vulnerable to bone density loss as they age.
Anti-inflammatory diets – which tend to be high in vegetables, fruits, fish and whole grains – could boost bone health and prevent fractures in some women, a new study suggests.
Researchers examined data from the landmark Women’s Health Initiative to compare levels of inflammatory elements in the diet to bone mineral density and fractures and found new associations between food and bone health. The study, led by Tonya Orchard, an assistant professor of human nutrition at The Ohio State University, appears in theJournal of Bone and Mineral Research.
Illustration of bone which has lost density.
Women with the least-inflammatory diets (based on a scoring system called the Dietary Inflammatory Index) lost less bone density during the six-year follow-up period than their peers with the most-inflammatory diets. This was despite the fact that they started off with lower bone density overall.
Furthermore, diets with low inflammatory potential appeared to correspond to lower risk of hip fracture among one subgroup of the study – post-menopausal white women younger than 63.
The findings suggest that women’s bone health could benefit when they choose a diet higher in beneficial fats, plants and whole grains, said Orchard, who is part of Ohio State’s Food Innovation Center.
“This suggests that as women age, healthy diets are impacting their bones,” Orchard said. “I think this gives us yet another reason to support the recommendations for a healthy diet in the Dietary Guidelines for Americans.” (my emphasis)
Because the study was observational, it’s not possible to definitively link dietary patterns and bone health and fracture outcomes. Continue reading →
Exposure to bisphenol A (BPA) and other endocrine-disrupting chemicals (EDCs) may reduce levels of vitamin D in the bloodstream, according to a new study published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.
The study is the first to find an association between EDC exposure and vitamin D levels in a large group of U.S. adults. EDCs are chemicals or mixtures of chemicals that can cause adverse health effects by interfering with hormones in the body. The Society’s Scientific Statement on EDCs examined more than 1,300 studies that found links between chemical exposure and health problems, including infertility, obesity, diabetes, neurological problems and hormone-related cancers. Continue reading →
As much as folks seem to know and care about the fat and the muscles in their body, they remain pretty ignorant about their bones. This is a shame because in the case of the skeleton you don’t know can hurt you.
It’s important to remember that our bones are living tissue as much as our muscles. We need to work them with weight bearing exercise throughout our lives. Aerobic work is fine for our cardiovascular system, but get some weight work in regularly. Happily, going for a walk is weight bearing exercise.
With apologies to George Thorogood, whose Bad to the Bone is a true rock classic, you really don’t want to be bad to your bones.
WebMD has produced a slideshow demonstrating things we do and don’t do that damage our bones. Our bones are as strong as cast iron yet remains as light as wood. Keep in mind that our bones are not all solid. The outside is solid surrounded by a few small canals. The inside, however, looks like a honeycomb.
The way we strengthen our bones is with weight-bearing exercise and good diet choices. As a bike rider, I am very aware of this. My regular riding is super cardio exercise, but does nothing for my bones. Not long ago, Tour de France riders, started integrating weight lifting with their workouts as they were coming down with osteoporosis.
WebMD offers eleven examples in a slide show that is worth checking out.
Here are a few examples in case you don’t have time right now. Skip that next pitcher of Margaritas. “When you’re out with friends, one more round might sound like fun. But to keep bone loss in check, you should limit the amount of alcohol you drink. No more than one drink a day for women and two for men is recommended. Alcohol can interfere with how your body absorbs calcium.”
I have written a Page about the damage smoking does and it turns out smoking damages your bones, too. “When you regularly inhale cigarette smoke, your body can’t form new healthy bone tissue as easily. The longer you smoke, the worse it gets.
Smokers have a greater chance of breaks and take longer to heal. But if you quit, you can lower these risks and improve your bone health, though it might take several years.”
How many times have you read in these pages eat less, move more, live longer? More than I can count. So it was nice to learn that farmers in Sweden seem to have stronger bones as a result of their outdoor activity.
A team of UK and Swedish researchers has released the findings of a new study which assessed the hip fracture risk of farmers in Sweden.
Sweden is one of the few countries which tracks hip fractures through a national registry. It is therefore possible to assess how hip fracture risk across the country varies according to occupation, economic status, level of education, latitude, and urban versus rural residence. Although hip fracture risk is known to be correlated to physical activity, that’s one of the variables, among others, which the registries can’t track. Continue reading →