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Osteoporosis in WomenLosing Height With Age
|How Can I Prevent Osteoporosis?
Knowing your risks of osteoporosis is one of the first steps. Women identified at risk due to fixed factors (such as genetics and gender) or modifiable factors (lifestyle choices) can then work with their doctor to develop a strategy to keep bones healthy. The risks can be significantly reduced if any of the following apply to you:
• Underweight - body mass index (BMI) 19 or less is considered underweight. Some studies suggest that less than 126 pounds/9 stone/57kg, regardless of height put a woman at risk.
• Insufficient exercise - if you do not exercise enough, particularly not enough weight-bearing exercise (e.g. walking, jogging, dancing).
• Diet - you have a low calcium and vitamin D intake.
• Drink - more than 1 units of alcohol a day (women) and 2 for men.
• Smoke - Increases the risks of fractures.
• Osteopenia - A scan shows you have osteopenia (low bone density).
• Eating disorder - you suffer a disorder such as bulimia or anorexia.
What About Exercise?
Weight-bearing exercise, that is exercise performed against gravity, puts stress on bones (specifically the 'long bones') and increases their mass. It also improves mobility, balance and well-being. Brisk walking is one of the best forms of weight-bearing exercise and most women find it easy enough to incorporate a walk into their everyday routine. Other good options are jogging, running, stair climbing, hiking, dancing, skipping, skiing, tennis and rollerblading. While swimming and cycling are great aerobically, they are considered low-impact and do not stress the bones as much as the other forms of exercise. Swimming can however provide relief to pain from a vertebral fracture. Experts disagree over how much exercise is enough to prevent bone degeneration, or other bone and joint problems. Starting off slowly is always recommended and working up to an hour a day, three times a week is a good goal. Women with diagnosed osteoporosis should discuss appropriate exercises with their doctor as those that involve pounding a surface (such as jogging) may damage weakened bones. For some interesting stats see: Osteoporosis Statistics.
What About Nutrition?
As many as 35 percent of Americans do not consume enough calcium and calcium is essential for good bone health. Adolescents and pregnant women require about 1,200 mg a day. Pre-menopausal women require 1,000 mg and postmenopause women between 1,200 mg to 1,500 mg. Those women taking ERT can stick to 1,000 mg a day. The average American woman only ingests between 800 mg to 1,000 mg a day, while the typical postmenopausal woman about 400 mg to 500 mg a day. As there is an obvious shortfall, most doctors traditionally recommended women to take calcium supplements in the form of calcium carbonate (for example, Tums).
However, just to confuse you...
A recent study (published 2012) from Europe involving 24,000 participants investigated the effects of calcium supplements on the body. It had some startling results which are now causing doctors all over the world to review their advice on osteoporosis prevention. It found that taking calcium supplements (with or without vitamin D) increases your risk of a heart attack by 86 percent. It also seemed to significantly increase the risk of stroke and other cardiovascular events. The research showed that the optimal amount of calcium to prevent osteoporosis (but not incur other health risks) was 820mg a day. This is lower than the current recommended dosage. And there is a catch - you need to take it naturally through your diet. Good dietary sources include, dairy foods as well as spinach, canned salmon, sardines, soy foods and almonds.
What the National Osteoporosis Foundation (NOF) says...
In response to the latest research, the NOF says more research is necessary before they change their guidelines. They still insist that women under 50 need about 1,000 mg of calcium a day, and women over need 1,200 mg. Ideally they suggest you should get it from your diet, but if you don't, you should still take a supplement. They insist the risk of bone fractures is much more real than that of having a heart attack.
Read also, alternative treatment for osteoporosis.
Another essential ingredient for bone health: without vitamin D, the body cannot absorb or utilize calcium. One excellent source is natural sunlight. Those who are bed-ridden, or cooped up in offices all day are unlikely to be exposed to enough sun to utilize this resource. Some studies show that vitamin D deficiency is becoming more common in Northern climates. Women in their reproductive years need about 200 IU of vitamin D a day. Pregnant and postmenopausal women need about 400-800 IU a day. Those diagnosed with osteoporosis may be recommended upwards of 800 IU. Today many foods are fortified with vitamin D but milk is still one of the best sources. 2 glasses of fortified milk will provide 400 IU. So who is likely to be deficient in vitamin D? Those who won't/can't drink milk (lactose intolerant), who are not exposed to enough sunlight and do not take a daily multi-vitamin. Doctors can now measure vitamin D levels with a blood test. A measurement of less than 25 mg/dl is considered to be low. See also osteoporosis diagnosis, for information on testing for the condition.
Phosphate, a form of phosphorus makes up nearly 50 percent of bone mineral. For this reason, up to 700 mg of phosphorus a day is important. Fortunately most western diets contain enough phosphorus which is found in large amounts in soft drinks and processed foods.
Check: Do I Have symptoms of osteoporosis?
Other Useful Tips
1. Avoid adding salt to your food. Excess sodium chloride (table salt) increases the loss of calcium through urination.
2. Moderate your caffeine intake. Excess coffee or caffeine drinks can upset the body's natural balance of calcium and phosphorus. One or two 8 oz cups of coffee a day is usually fine.
3. Moderate alcohol intake. No more than one unit for women and two units a day for men. Excess alcohol can decrease bone formation and reduce the body's ability to absorb calcium.
4. Quit smoking. Studies show that smokers are 150 percent more likely to develop osteoporosis than non-smokers.
Maintaining A Healthy Body Weight
Maintaining an appropriate body weight is important given the connection between osteoporosis and being underweight or losing weight rapidly. Doctors consider a BMI of 20 to 25 as ideal. Above this is considered overweight and a BMI of 30 is obese. A BMI of 19 or under is considered underweight. Excessive dieting which leads to anorexia or missed periods (amenorrhea) can cause low bone density which lasts a lifetime. Osteoporosis is less common in overweight people, as estrogen levels are related to body fat. However those who have excess weight have other issues to contend with, including increased risk of heart disease in women and diabetes.
Preventing Falls & Fractures
Osteoporosis leads to 700,000 vertebral compression fractures and 250,000 wrist fractures every year in America. What is more worrying is that 20 percent of people with vertebral fractures receive another injury within 12 months and patients have a 9 times higher risk of premature death than healthy people. For this reason, anything that can be done to prevent falls is useful. This may mean addressing poor vision or balance problems. Exercising regularly can help improve strength and balance, Tai Chi is especially good. Some women wear padded hip protectors which can help prevent hip fractures resulting from a fall. Simple steps like clearing the house of excess clutter or furniture or tacking down slippery rugs can also help. Consider installing 'grab bars' in the bathroom and only using cordless phones. Those who are elderly and live alone should think about installing some sort of panic alarm.