Healthy Bones

Steps To Head Off Osteoporosis

By 2020, one in two Americans over age 50 will have or be at high risk for developing osteoporosis unless they start taking better care of their bones, warns the latest US Surgeon General's report on bone health and osteoporosis.

Osteoporosis is a disease that weakens bones and makes them easy to break. Ten million Americans over 50 have osteoporosis and another 34 million are at risk.

"Most osteoporosis fractures themselves do not cause death, but they are responsible for serious disability, pain and suffering," says Dr. Susan M. Ott, a bone specialist at the University of Washington. "After a hip fracture, many people who were independent have trouble walking and must move to a nursing home. Vertebral (spine) fractures cause height loss, a disfiguring curve and may cause some difficulty breathing."

Who's at risk?
Many factors can raise the risk of osteoporosis, including being female, menopause, a small or thin build, a family history of fractures, being Caucasian or Asian, smoking, excessive alcohol intake, and taking some medications. Moreover, aging itself reduces bone density and weakens bones.

"Aging accounts for 0.5% to 1% bone loss per year after age 60. And women can lose 1% to 3% bone mass per year for up to 10 years following menopause," explains Kathy M. Shipp, a physical therapy specialist at Duke University. Luckily, just as with retirement savings, you can plan ahead to maximize how much bone you have "in the bank."

Reduce your risk
You reach your peak bone mass by age 20. The good news, says Jeri W. Nieves, a nutrition and bone health expert at Columbia University, is that healthy lifestyle choices promote bone building in youth and strengthens bones in adulthood. A key way to reduce the risk of developing osteoporosis is banking enough calcium and vitamin D.

"Calcium helps to preserve bone mass at any age," explains Nieves. You need about 1,000 milligrams of calcium per day if you're under 50 and 1,200 milligrams if you're older. For vitamin D, 200 to 600 IU (International Units) daily is currently recommended, although research suggests that many people may need 1,000 IU per day for optimal bone health.

Eat your calcium
Rich sources of calcium include milk, leafy green vegetables, soybeans, canned salmon or sardines with bones, yogurt, and cheese. Vitamin D is produced in the skin by exposure to the sun and is found in fatty fish (e.g., mackerel, salmon) and fortified foods, including milk and some brands of soy milk, rice milk, orange juice, yogurt, breakfast cereals and energy bars. If you can't meet your daily requirements, ask your doctor about supplementation.

Weighing in
Maintaining a healthy weight and staying physically active are key factors, too. Being underweight raises the risk of fractures and bone loss.

"Exercise can help maintain bones even into your 90s and beyond, and it builds balance and coordination, which can help minimize the risk of falls and fractures," says Shipp. Adults need at least 30 minutes a day of exercise and kids need 60 minutes, emphasizing weight-bearing or resistive exercise (e.g., walking, push-ups, weight training), which is best for strengthening bones.

Check your bones
If you really want to know your chances of developing osteoporosis, get a bone mineral density test, which measures bone density in different parts of the body using x-rays or sound waves. If results show low bone density, your doctor can prescribe special calcium and vitamin D supplements or medications that help slow down bone loss or increase bone mass.