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Posted on: March 3, 2011

Bone-Up to Avoid Osteoporosis

New information helps pre- and post-menopausal women avoid brittle bones

By Bev Bennett
CTW Features

People in their twenties have the luxury to count shoe shopping as strenuous physical activity, and if that daily large coffee has a splash of milk, well, that is enough calcium for the week.

But for women who have or are about to hit the middle years, and have begun taking a closer look at an aging mother, they often wonder if her fragile bones and bent spine will be in their own futures as well.

It’s an appropriate concern, especially for women approaching menopause, which results in accelerated bone density loss as estrogen is lost.

“As soon as you hit menopause you lose 1 to 3 percent of your bone density a year,” says Richard Dell, M.D., orthopedic lead of the Healthy Bones Program at Kaiser Permanente in Southern California.

But even if you ignored your bone health in your youth, you can take steps to preserve bone or develop greater bone density now, say experts.

Mid-life is a perfect time to talk to your physician about osteoporosis, according to Felicia Cosman, MD, clinical director, National Osteoporosis Foundation, Washington, D.C.

Discuss your risk factors, which include your age, sex (women are at greater, though not exclusive risk), slight frame, poor nutrition, a history of smoking or excessive drinking or lack of exercise, especially weight-bearing routines.

If you are at heightened risk get bone mineral density (BMD) testing at age 50, say experts.

Talk about your options. Your physician may suggest exercise routines, taking calcium (1,000 milligrams of calcium daily; 1,200 after age 70) and vitamin D (600 International Units, which is a new recommendation) and perhaps prescription medications.

Improving your diet is an critical step.

“The nutrition we think is ideal is high in fruits and vegetables and calcium rich,” says Dr. Cosman, author of “What Your Doctor May Not Tell You About Osteoporosis” (Warner Books, 2003).

“We prefer that people get most of their calcium from diet, if possible; get three high-calcium foods daily,” she says.

Exercise is another beneficial and inexpensive step you can take.

In one of the most positive outcomes, post-menopausal women who followed a specific exercise regimen and who consumed adequate calcium maintained or increased their bone density, according to research from the University of Arizona, Tucson.

Volunteers who completed one year on the experiment saw improvement in their hips; those who followed the regimen for four years also saw improvements in their spines as well, according to Linda Houtkooper, PhD, registered dietitian, head of the Department of Nutritional Sciences.

Exercise that creates torsional stress – slightly twisting the bone clockwise or counterclockwise—was a factor in bone density improvement, according to Houtkooper, co-principal investigator for the BEST (Bone Estrogen Strength Training) study. (Some women in the study were also on hormone replacement therapy, which was linked to greater bone density improvement.)

“There’s something about the strain that changes the biochemistry of the bone,” says Houtkooper, who advises doing the routine with coaches who are trained in the specific exercises (to view the exercises online visit the website: http://bayerhearts.com/BEST/BEST-Videos.aspx).

Your physician may also recommend medications.

Low-dose estrogen when you’re in your very early stage of menopause might be something to consider to help preserve bone mass, according Dell.

In the past, women were prescribed drugs when they were diagnosed with osteopenia – below-normal bone mineral density. That’s no longer the case, say the medical experts.

“For osteopenia, you need exercise and calcium, not treatment,” Dell says.

That changes if you have osteoporosis.

Bisphosphonates, which slow bone loss so you maintain or increase your bone density, are often prescribed.

However, these are powerful drugs, with potential complications.

Health experts are now recommending taking the drugs for a prescribed amount of time, then taking a rest.

“The new thinking is a drug holiday; not dropping the drug forever,” Dell says.

He also suggests “There’s new promise in osteoporosis management with new drugs.”

But don’t wait for a drug to save your bones. Get your calcium, vitamin D and exercise, and stop smoking, Dell says, who in the Healthy Bones program, reduced the hip fracture rate by an average of 37 percent.

Bev Bennett, a veteran food writer and editor, is the author of "Dinner for Two: A Cookbook for Couples" and "30-Minute Meals for Dummies"