As with many things about our health, most of us don’t think about our bones until something goes wrong. But we should pay attention to our bone health throughout our lives.
Most bone mass is formed between the ages of 25 and 30. After that, new bone is produced at about the same rate as older bone is broken down. This means your whole skeleton is renewed over a period of 7 to 10 years. Around 40, bone starts to break down more quickly than it’s replaced. So our bones slowly begin to lose their density.
And that’s when osteoporosis can start. It’s a disease that causes bones to become weak and brittle, which raises the risk of breaks or fractures. Women are especially prone to osteoporosis, so it’s important to take steps to help build strong bones and prevent bone loss.
To find out more about osteoporosis and how to protect our bones, we talked with Suken A. Shah, MD. He’s the vice chair and an orthopedic surgeon at Nemours Children’s Hospital in Delaware and a professor of orthopedic surgery at Thomas Jefferson University.
What happens when you get osteoporosis?
Our bones consist of 2 parts. There’s a thick, hard outer layer called cortical or compact bone. Inside that is a softer, spongy mesh of bone that’s like honeycomb. That’s called the trabecular bone. Osteoporosis literally means spongy (porous) bone. The disease makes the holes in the honeycomb grow larger. This lowers overall bone density. And low bone density is what makes the bone more likely to break.
Why are women at greater risk of osteoporosis than men?
Part of it has to do with the fact that women in general start with less bone density than men. Men’s bones are just larger. And the density begins to drop faster with the onset of menopause because there’s less estrogen in the system.
Among other things, estrogen influences the cells that make new bone. When there’s less estrogen, those cells don’t produce enough new bone, and they don’t properly maintain bone structure. Women can lose 2% of their bone density per year during menopause. After the age of 50, 1 in 3 women will sustain an osteoporotic fracture.
What can I do to prevent osteoporosis?
Building strong bones during childhood and the teen years is important. But there are things you can do as an adult that will help, too. Get enough calcium and vitamin D each day. Focus on weight-bearing exercise (more on that below). Don’t smoke and limit how much alcohol you drink. Both of these increase your risk for brittle bones — as can drinking carbonated beverages such as sodas that have a lot of phosphorous and sugar. Low body weight (under 127 pounds) can also increase your risk.
Unfortunately, there are some risk factors that you can’t change. Those include family history or certain medications you may need to take. Some endocrine disorders such as hyperparathyroidism, hyperthyroidism, diabetes and certain cancers can also increase risk.
How can I make sure I’m getting enough calcium and vitamin D?
There are many foods that contain both calcium and vitamin D. For example, cheese, ice cream and yogurt have both. So do orange juice, fortified cereals and whole grains.
Foods that are high in vitamin D include eggs, dairy, salmon, sardines, avocados, almonds, leafy greens (kale and spinach), Brussels sprouts, broccoli and mushrooms. But sometimes food alone isn’t enough. A vitamin D supplement may be needed, especially among those who don’t eat dairy.
Your physician can do a simple blood test to see if you’re getting enough vitamin D and calcium. If you need a supplement, work with your doctor to figure out the correct amount. There can be side effects to taking too much calcium, including kidney stones.
(If your doctor suggests supplements, you can get them — along with plenty of other health essentials — at the Optum Store.)
What forms of exercise are best for bone health?
Exercise plays a huge role in fending off brittle bones. The focus should be on weight-bearing exercises or activities such as walking, running, dancing and Zumba. Weight-bearing activities put stress and force on the bone, making your bones work harder. That force triggers bone-forming cells into action and leads to denser, stronger bones.
It’s important to keep in mind that lean muscle mass and bone density go together. Lifting weights or doing resistance training can help keep or increase lean muscle mass. And it can help prevent sarcopenia, which is the muscle version of osteoporosis.
Be sure to choose forms of exercise that limit your chances of falling. If you have brittle bones, your risk of severe injury from a simple fall is increased. There are lots of floor and chair workouts available that are safe but still work well.
