Keeping Your Bones Strong
The skeleton is the supporting matrix of the body, and low bone mass and structural deterioration of bone (also called osteoporosis) can really become a problem as we age. Bones are always being broken down and rebuilt in the body as we age - in fact bone structure is actually strongest at the age of 16 in women and age 20 in men. Once we get into our 30s, bone gets resorbed faster than it is recreated and our skeleton is never quite the same again.
At least 8 million women and 2 million men have osteoporosis, and over 35 million Americans have osteopenia, its milder form. Nearly half of all women will experience an osteoporotic fracture sometime during their lifetime, and hip fractures in the elderly can have a 20% mortality. So it certainly pays to do everything possible to keep our bones as strong as they can be for as long as possible.
How is osteoporosis diagnosed? Generally it is found clinically (an obvious fracture or a noticeable bowing of the skeleton) or radiographically. Often it can be detected in X-Rays done looking at a different problem, but as we age screening tests generally predict which cases are most advanced. A bone mineral density test, also known as a DEXA scan, is recommended by the U.S. Preventative Services Task Force for all women aged 65 and older, as well as women between 60 and 65 who have an increased fracture risk. Men at age 70 with an increased risk also should be scanned, and this is usually covered by most provincial health insurers. Higher risks include increasing age, low body weight, personal or family history of early fractures, low level of physical activity, and low calcium or Vitamin D intake. Excessive alcohol use and certain medications also raise the risk of osteoporosis.
You can’t cure osteoporosis, but you can certainly slow down its progression and keep your bones strong. One way is to increase calcium in your diet. Most men and women need at least 1200-1500mg/day of calcium, found in a normal diet in foods such as bananas, almonds, oranges, and green vegetables. When diet isn’t supplying enough, oral supplements of elemental calcium are given, usually in the form of calcium carbonate, which is the least expensive.
Vitamin D is also a must. As we age, we shy away from the major source of Vitamin D in our body - exposure to sun. The body needs Vitamin D to absorb calcium and Vitamin D is found in milk, eggs, fish, and margarine. Vitamin D can also be taken as a supplement and both Vitamin D and calcium levels can be followed by doctors, who may measure levels each year and adjust the supplemental amount taken appropriately.
Exercise and strength training are also essential for strong bones. While not needing to be a body builder, flexibility training, stretching, and some strength training go a long way. Tai Chi and swimming also increase flexibility and mobility and aid in maintaining balance and avoiding falls.
Authored by Dr. Bob Goldstone, M.D.
The information contained on this page is not intended to provide medical advice, which should be obtained directly from your physician.