What is happening to your bones?
You’ve probably see in television commercials how elderly people are at increased risk for broken bones if they happen to fall. Typically, this is caused by osteoporosis. What is this? Why does it happen? Can you prevent it?
Osteoporosis is when bones become weak and brittle to the point that the chance of fracturing (breaking) a bone while doing simple every day tasks, like coughing or bending over, is significantly high. In order to understand why this is the cause, we need to look at bones a little further in-depth. Your bones aren’t just rigid structures but living tissue that are constantly being renewed. Your body is continually breaking down old bone tissue and replacing it with new bone tissue. When you are younger, the growth of new bone tissue exceeds the removal of old bone tissue resulting in increased bone mass. Once you become an adult, this process evens out until you become elderly. Then, the creation of new bone tissue slows down to the point that it no longer keeps up with the removal of old bone tissue. This is what leads to your bones becoming brittle and weak.
It can affect people of either gender and any race; however, it most often is seen in white or Asian women who are past menopause. People who have a smaller body frame, are underweight or have a diet low in calcium are at increased risk for developing osteoporosis. Certain medical conditions (ex. celiac disease, inflammatory bowel disease, cancer) and medications (ex. long-term use of steroids) can also contribute to bone tissue loss. Lifestyle choices, such as smoking, excessive alcohol consumption and not being active, can increase your risk. Symptoms do not appear in the early stages of bone tissue loss. Once osteoporosis has weakened your bones, you may notice back pain, which is usually the result of a fracture or collapsed vertebra (the small bones that form your backbone), loss of height over time, stooped posture and broken bones that occur more easily than expected.
Osteoporosis treatment is based off of the likelihood of your risk of breaking a bone in the next 10 years. This is established by doing a bone density test, which is when you lie on a table and low-level X-rays are use to take pictures of your bones to determine the density (amount of minerals) of your bones. Usually only a few bones are checked to limit the amount of radiation you receive. Since the hip, wrist and spine are the most commonly broken bones for those with osteoporosis, these are the ones that are checked most frequently. If you are found to be at increased risk, your doctor will prescribe a medication that helps to increase your bone density. Some examples of these are alendronate, risedronate, ibandronate and zoledronic acid. They typically come in a pill form that is taken either once a week or once a month. There is an intravenous (IV) injection available that can be done quarterly or yearly, but it’s more expense than the pills. For some individuals, they benefit from taking hormone-replacement therapy medications that help to maintain bone density. It is important to stop smoking and reduce the amount of alcohol intake to no more than two alcoholic drinks a day. Preventing falls is a good way to decrease the chances of a fracture. You can do this by wearing shoes with non-slip soles, keeping electrical cords/slippery area rugs out of the way, making sure your house has adequate lighting, installing grab bars in the bathroom near shower/toilet and using assistive devices to get in and out of bed, if needed.
Osteoporosis is best prevented through good nutrition and regular exercise. It is important to get enough protein, calcium and vitamin D. Protein is considered a building block of bones and if your diet doesn’t have an appropriate amount throughout your life, it can impact the density of your bones as you age. Also, as you age, you need more calcium in your diet. Your body’s needs increases from 1000 milligrams a day to 1200 milligrams a day for women over 50 and men over 70. Besides low-fat dairy products, some other sources of calcium include dark green leafy vegetables, canned salmon/sardines with bones, soy products (tofu) and calcium-fortified foods (cereals and orange juice). Vitamin D plays an important role in your body’s ability to absorb calcium. Most people get an adequate amount of vitamin D from sunlight. If you are housebound or use sunscreen/avoid sun exposure due to the risk of skin cancer, you may need to take a vitamin D supplement. Exercise is vital to good bone health. By combining strength training with weight-bearing and balance exercises, you will help your body build strong bones and slow the rate of bone loss. Strength training focuses on the muscles and bones in your upper body; whereas, weight-bearing (walking, running, stair climbing) focuses on your lower body. Balance exercises (tai chi, yoga) help to decrease your risk of falling as you age. Good nutrition and exercise also helps you to maintain appropriate weight, which is key since being underweight has been proven to increase the risk of osteoporosis. Also, don’t smoke and drink alcohol sparingly as both of these decrease your bone density.
Osteoporosis is not something that we think about until we start feeling the effects of it. By doing what you can before and maintaining after it starts, you will prevent your bone density from declining at an increased rate. If you have any questions or concerns about osteoporosis, please speak with you doctor. If you would like more information, please visit the National Osteoporosis Foundation at https://www.nof.org/patients/