What is osteoporosis?
Osteoporosis is a bone disease that occurs when bone density is lost, and the body does not create enough bone matter to replace it. The insides of our bones are naturally porous, but people with osteoporosis have larger spaces without bone matter than do people with normal, healthy bones. This puts them at far greater risk of breaking their bones, whether through major trauma like a fall or, in more severe cases, trauma as minor as a violent sneeze.
The bones most typically affected by osteoporosis are the hips, wrists, and spine. Particularly with spinal bones, fractures due to osteoporosis can be very minor and painless, sometimes even going unnoticed. However, these breaks lead to poor posture and back problems and should not be taken lightly.
How common is osteoporosis?
Around 1 in 2 women and 1 in 4 men in the US will experience osteoporosis, making the disease about twice as common in women than in men. Although osteoporosis can occur at any age, the vast majority of patients are over the age of 50. Women are at higher risk for osteoporosis because our bones tend to be smaller and thinner than men’s, due to our typically smaller stature. After menopause, women stop producing the hormone estrogen, which actually helps maintain strong bones. This accounts for the risk increase that accompanies menopause. However, if our bones are sufficiently dense and strong before we reach menopause, we can reduce our risk of developing osteoporosis.
Although many people develop osteoporosis sometime in their life, many do not know they have it until they have experienced a break. The lack of tangible symptoms makes it even more important to take early, preventative steps. Even if you don’t think you’re at risk, the disease may already be developing.
How can I prevent osteoporosis?
Although osteoporosis has certain risk factors that cannot be avoided, like being a woman and being over 50, preventative steps can still be taken. The most important lifestyle choices to prevent osteoporosis are maintaining a good diet to ensure sufficient calcium and vitamin D intake, engaging in regular exercise, eating plenty of fruits and vegetables, and avoiding smoking and excessive alcohol consumption.
1. Get enough calcium and vitamin D
Calcium is a mineral that helps keep our bones and teeth healthy and strong, as well as regulate muscle and nerve signals. In women under 50, recommended daily calcium intake is 1000mg. This increases to 1200mg once a woman reaches 50. It is vital to get enough calcium in your daily diet because if you do not, your body will pull calcium from the reserves in your bones, weakening them. If your calcium intake is sufficient, your bone density will not need to decrease and you will remain healthier. The best source of calcium is in dairy products like milk, yogurt and cheese. Calcium can also be found in dark leafy vegetables like kale, and is often added to products like soymilk. If you are worried about your calcium intake, talk to your doctor about whether you need calcium supplements.
Vitamin D is another vital nutrient that we need to get from outside sources. This vitamin protects bones primarily by allowing for calcium absorption. Women under 50 should get 400-800 international units (IU) of vitamin D per day. From age 50 on, it is recommended that women up their daily vitamin D intake to 800-1000 IU. We get vitamin D mainly from sunlight, so people who stay indoors most of the time or cover up when going outdoors are at risk for becoming deficient in vitamin D. Many milks and juices are fortified with vitamin D, however, to ensure sufficient intake. If you are worried about your vitamin D intake, talk to your doctor about vitamin D supplements.
Keeping a generally balanced diet, including eating lots of fruits and vegetables, will ensure that you get sufficient amounts of all the vitamins and minerals your body needs to stay healthy, and will decrease your risk of developing osteoporosis.
2. Exercise regularly
Exercise forces your bones and muscles to work, thereby increasing their strength and decreasing the likeliness of injuring yourself. Weight-bearing exercises like dancing, jogging, hiking and walking all build strong bones, which make them less likely to break. Exercises like this are recommended for 30 minutes 5 to 6 days a week. Muscle-strengthening exercises, also called resistance exercises, like weight lifting and push-ups, build up muscle around the bone. These exercises are recommended 2 to 3 times per week. The last group of exercises is called non-impact exercises and includes balance, posture, and functional exercises. These help you get in tune with your body movements and tweak them so that you are at lower risk for breaking bones if you lose bone density.
3. Avoid smoking and excessive alcohol consumption
Smoking and consuming more than 2-3 alcoholic drinks per day has been shown to decrease bone density, thereby increasing the risk of developing osteoporosis. Additionally, excessive caffeine consumption has been linked to bone density loss.
How is osteoporosis treated?
If you already have osteoporosis, the good news is that it is treatable through medication and lifestyle changes. Used together, these can be extremely effective in maintaining quality of life for osteoporosis patients.
There are two kinds of medication used to treat osteoporosis: antiresorptive medications, and anabolic drugs. Normally, bone tissue is broken down and created constantly to replace old bone with newer tissue and keep the bones healthy. This process is called remodeling and typically occurs in close sequence to balance loss and regeneration. However, in osteoporosis this balance is thrown off and medication is required to regain it.
Antiresorptive medications slow bone density loss by inhibiting the natural breakdown of bones if your body cannot reproduce bone matter quickly enough. This allows your body more time to generate new tissue, keeping the process balanced.
Anabolic drugs speed the natural production of bone to ensure that bone is being produced at the same rate as it is broken down. This makes the new tissue grow faster to maintain the remodeling balance.
Lifestyle changes include performing the exercises described above, although some may need to be modified to ensure that they are not causing damage. Particularly high-impact exercises like running may increase the chances of breaks in osteoporosis patients.
People living with osteoporosis also need to learn to move more carefully than they once may have in order to prevent potentially dangerous falls. Weaker bones mean that falls are more likely to lead to breaks, which can be painful and, in rare but serious instances, lethal. It is important that people living with osteoporosis be particularly mindful of their surroundings to prevent falls.
Although osteoporosis is a disease that many live with, prevention and treatment are possible. As you move through your life, always keep in mind that your decisions have consequences and strive to maintain as healthy a lifestyle as possible.