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Bad breaks

Prevention and treatment of osteoporosis and bone loss

by JACKIE DUDA

Bones are amazing—lightweight, yet strong enough to hold us upright, with the body absorbing and replacing bone tissue throughout most of our lives.

However, with osteoporosis, new bone creation may not keep up with old bone loss, putting us at risk for fractures and breaks.

“Osteoporosis is a progressive thinning and even loss of bone that can accumulate over time and cause fractures,” says Dr. Kendall F. Moseley, medical director of the Johns Hopkins Metabolic Bone & Osteoporosis Center in Baltimore.

Breaking down bones

The Bone Health & Osteoporosis Foundation (bonehealthandosteoporosis.org), the largest U.S. organization dedicated solely to osteoporosis and bone health, reports that approximately 10 million Americans have osteoporosis and 44 million others have osteopenia (low bone density), placing them at increased risk for fracture. That’s about half of all adults age 50 and older.

“One in two women and one in five men will experience an osteoporotic fracture in their lifetime,” says Jane Cauley, distinguished professor in the Department of Epidemiology at the University of Pittsburgh Graduate School of Public Health in Pittsburgh.

For people who are older, these fractures can lead to chronic pain, loss of mobility and independence, and even death. “That’s mainly because, as you get older, you don’t recover as well,” explains Dr. Kathryn Diemer, senior clinical director of the Bone Health Program at the Washington University School of Medicine in St. Louis.

Building up bones

Some bone loss is natural with age. But it can be slowed. And osteoporosis, where bones become weak and brittle, does not have to be inevitable.

“We really shouldn’t think about osteoporosis or fracture as being a normal part of aging,” Moseley says. “We have to consider the early stages of life as a way that we are set up for bone health much later on in life.”

Moseley says it’s helpful to think about bone along the course of one’s lifetime. “We gain bone until we’re about 30, both men and women,” Moseley explains, adding that there is a maintenance phase until women go through menopause, typically in their 50s, and for men, around age 70, after which bones break down faster than new bone is built. This causes overall bone loss, osteoporosis and increased risk for fracture.

Exercising and eating right help build your bone bank. “Maximize your peak skeletal mass when you’re younger, so that when you’re older and start to lose bone, you have more to start with,” says Cauley.

Diemer says it’s important to eat a well-balanced diet; put a lot of color on your plate. Vitamin D, calcium and protein are essential. “Low protein intake is associated with an increased risk of hip fracture,” Cauley explains. In addition to milk, Diemer notes, there are many foods rich in vitamin D, such as fatty fish, egg yolks and fortified orange juice, and calcium, such as yogurt, nuts, broccoli and kale.

Ask your physician if you need a supplement. “Calcium carbonate or calcium citrate can help, and are easily absorbed,” says Diemer.

Moseley recommends engaging in physical activities at least three to five days a week, for roughly 30 minutes per session. “It doesn’t have to be pumping iron,” she explains. “Remember that even walking counts. Get outside for a brisk walk, get off the couch, lift light weights, dance if you enjoy it—anything that keeps you moving. Do your best, and remember that if you don’t move it, you lose it.”

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