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What You Can Do To Improve Your Bone Health

Bettiann Wing, PT

 

Bone health is not a subject many ever think about.  However, the sequalae of bone disease is associated with a high incidence of morbidity (injury) and mortality (earlier death).  Let us start with some background.

Osteoporosis: What Is It and Who Has It?

Osteoporosis (OP), the most common bone disease, is a progressive loss of bone density and deterioration of the bone microarchitecture weakening the bone tissue leading to an increased risk of fracture.  According to the surgeon general OP is the most common cause of fractures.  OP is almost twice as common in women as in men and is typically asymptomatic until a fracture occurs.  There is an increasing prevalence of OP worldwide with hundreds of millions affected and an estimated 9 million osteoporotic fractures every year, 1 occurring every 3 seconds.  40% of women with fragility fractures will lose the ability to walk, twice that will lose the ability to perform one task of daily living.  Men also experience reduced bone formation and thinning with aging, but at a decreased rate compared with women.

Osteoporosis: How Does It Develop?

Bone is living tissue that is continuously renewing itself, a process that is dependent on many factors including nutrition, hormonal balance, and physical loading.  When this process is upset bone loss can develop.

Osteoporosis: What Are the Risk Factors?

  • Poor diet, including calcium and vitamin D deficiency;
  • Nutritional and hormonal compromise due to unhealthy eating behaviors (ie: self-induced vomiting, binge eating, laxative abuse);
  • Sedentary lifestyle;
  • Smoking;
  • Sequala of other diseases and treatments such as diabetes, hyperparathyroidism and use of glucocorticoids;
  • Hormonal imbalances as occur in menopause;
  • Late first menstruation cycle;
  • Female;
  • Caucasian;
  • Older age;
  • Genetic/familial history

Osteoporosis: What Are the Signs & Symptoms?

OP is primarily asymptomatic until a fracture occurs.  However, bone deformities, kyphosis and loss of height can be a sign that the integrity of the bone is compromised.

 Osteoporosis: How Is It Diagnosed?

OP is diagnosed via X-ray densitometry (DXA) to determine Bone Mineral Density (BMD).  Despite the high prevalence, morbidity and mortality associated with OP screening and treatment rates are low.

“Osteoporosis and the broken bones it can cause are not part of normal aging. There is a lot you can do to protect your bones throughout your life. You are never too young or too old to improve the health of your bones. Osteoporosis prevention should begin in childhood. But it shouldn’t stop there. Whatever your age, the habits you adopt now can affect your bone health for the rest of your life. Now is the time to take action.” (National Osteoporosis Foundation, https://www.nof.org/preventing-fractures/prevention/)

Lifestyle Optimization Strategies to Improve Your Bone Health:

  • Weight bearing exercise:
    • High impact exercise such as jumping, multidirectional hopping, jogging, climbing stairs and dancing are best for improving bone health;
    • High impact exercise effects all fracture parameters including fall risk, fall impact, and overall bone strength;
    • Weight training;
    • Low impact exercise including walking provide less improvement in bone health than high impact exercise but is better than a sedentary lifestyle;
    • It is best to exercise at least 30 minutes a day including warm up and cool down, at least 2-3 times / week;
  • Healthy diet:
    • Adequate calcium (best through foods vs pills) and Vitamin D intake;
      • Calcium rich foods including cheese, yogurt, milk, sardines, dark leafy greens (like spinach, kale, turnips, and collard greens), soybeans, fortified soymilk;
      • Vitamin D rich foods: salmon, herring, sardines, cod liver oil, canned tuna, egg yolks, mushrooms.
    • Polyphenol-rich foods including olive oil, fruits and vegetables, tea and soy;
    • Bone Health Recipes: https://www.nof.org/preventing-fractures/nutrition-for-bone-health/recipes/
  • Smoking cessation
  • Limited alcohol consumption
  • Limited caffeine consumption

by Bettiann Wing, PT

References:

Berry, M. E. (2019). Preventing and Treating Osteoporosis. Radiologic Technology, 90(3), 286–293.
French, K. D., & Emanuele, D. (2019). Osteoporosis: Increasing Screening and Treatment for Postmenopausal Women. Journal for Nurse Practitioners, 15(5), 347–350.
Howe TE, Shea B, Dawson LJ, et al. Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst Rev. 2011(7):CD000333.
Kalkim, A., Daghan, S., Ercan, E., & Ibci, S. (2018). Use of Complementary and Alternative Medicine by Osteoporosis and Osteopenia Patients. International Journal of Caring Sciences, 11(3), 1546–1556.
Matzkin, Elizabeth G. MD; DeMaio, Marlene MD; Charles, Julia F. MD, PhD; Franklin, Corinna C. MD, Diagnosis and Treatment of Osteoporosis: What Orthopaedic Surgeons Need to Know, Journal of the American Academy of Orthopaedic Surgeons: October 15, 2019 – Volume 27 – Issue 20 – p e902-e912
McCance, K. L., & Huether, S. E. (eds.). (2018). Pathophysiology: The Biologic Basis for Disease in Adults and Children (8th ed.). St. Louis, MO: Elsevier/Mosby.
Nuti, R., Brandi, M. L., Checchia, G., Di Munno, O., Dominguez, L., Falaschi, P., … Isaia, G. C. (2019). Guidelines for the management of osteoporosis and fragility fractures. Internal & Emergency Medicine, 14(1), 85–102.
Orr, Sarah BSN, RN, Osteoporosis, Otterbein University, Ohio
Tabatabaei-Malazy, O., Salari, P., Khashaya, P., & Larijan, B. (2017). New horizons in treatment of osteoporosis. DARU, 25, 1–16.
Polyphenol-Rich Foods and Osteoporosis, Current Pharmaceutical Design, Volume 25, Number 22, 2019

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