Osteoporosis
What is Osteoporosis?
Osteoporosis is the weakening of bone over time. As you age, bones can decrease in bone density. This decrease in the density of the bone makes it weaker and more likely to break.
Bones seem to be large, solid objects. But actually, they are intricate lattices that are constantly being torn down and rebuilt. Osteocytes constantly add calcium and phosphorus to the bone structure, while osteoclasts break down bone. When you are young and your bones are growing and getting stronger, osteocytes add more bone than osteoclasts take away and the bones grow denser and larger. As adults, the breakdown and rebuilding should be in balance and the bones stay at about the same density and strength. However, as you get older, the osteoclasts start to remove more bone than the osteocytes can rebuild. This leads to the weakening of the bones, called osteoporosis.
How Common is Osteoporosis?
It is estimated that 20% (or 1 in 5) of American women over the age of 50 have osteoporosis. About half of all women over 50 will have a fracture of the hip, wrist, or spine. Although the risk of osteoporosis in men is lower, men over age 70 have about as much osteoporosis as women over 50.
Broken hips in older women are a serious problem. About 25% of older people who break their hip die within a year of the fracture. Only 25% recover enough to return to their previous level of activity. Many need to move to long-term nursing facilities. Those who do recover from a broken hip have an increased risk of breaking a hip again in the future.
Fractures in the spine due to osteoporosis are called compression fractures. The spinal bones break and collapse on themselves. These fractures can cause severe pain, difficulty in bending and twisting, and loss of height. In severe cases, curving of the back occurs (sometimes called Dowager’s Hump) and can result in hip pain, stomach problems, and difficulty breathing.
What Can You Do to Prevent Osteoporosis?
Prevention of osteoporosis begins when you are young. All bones lose strength as they age. If the bones are strong and healthy when they are young, loss of a little strength will not weaken the bones significantly. However, if the bones are not really strong when younger, as they age, they are more likely to become osteoporotic. If bones are treated right, they will continue to get stronger throughout childhood, puberty, and early adulthood.
There are 2 important things to do to create and keep strong bones:
- Exercise your bones – Muscles get stronger when you exercise them. In the same way, bone gets stronger when you use it. When you put weight on bones, you are exercising them and they get stronger. Any weight-bearing exercise is good for bones. Walking is an excellent exercise for all ages and helps keep your bones healthy.
- Feed your bones – Bones need calcium to build strong bones. Calcium is important to the function of many other parts of your body as well, including your heart. If you are not getting enough calcium in your diet, your body will steal the calcium it needs out of your bones in order to keep other important body parts functioning correctly. The current recommended levels of Calcium are:
- For ages 9 to 18 – 1300 mg per day
- For ages 19 to 50 – 1000 mg per day
- For ages 51 to 70 – 1200 mg per day for women, 1000 mg per day for men
- For ages 71 and up – 1200 mg per day for men and women
It can be a challenge to get this much calcium in your diet just from food, especially if you avoid dairy products. An 8-ounce glass of milk has between 276 and 299 mg of calcium (depending if whole or nonfat). Other good sources of calcium are yogurt, cheese, tofu, dark green vegetables, and calcium-fortified items like orange juice and breakfast cereal.
If it is difficult to get enough calcium in your diet from food, it is important to add a supplement to your diet. If you are getting a moderate amount of calcium from food, a multivitamin may have a sufficient amount of additional calcium. If your diet is lacking in calcium, then adding a calcium supplement is recommended. Calcium supplements come in two forms – calcium carbonate and calcium citrate. When choosing a supplement look on the label for how much elemental calcium is in each pill, not the size of the pill. Calcium carbonate has more calcium in a pill so you take fewer or smaller pills to get the same dose of elemental calcium. Calcium citrate dissolves better in acid environments, so it may dissolve better in the stomach than calcium carbonate. There are also chewable versions of calcium that may dissolve better. Some people who have used calcium complain that it causes constipation. If you experience problems with constipation you can try several things. First, drink more water when you take the pills. You can also try splitting the dose and take one pill in the morning and one in the evening. Some people feel they have fewer problems with calcium citrate than with calcium carbonate. Or you can try the chewable pills.
Vitamin D - In order to process and use calcium your body also needs to have sufficient levels of vitamin D. Your body can get vitamin D in two ways, either through diet or through sun exposure. The recommended amount of vitamin D is 600 IU a day for people ages 70 and under and 800 IU a day for people ages 71 and up. Your body can produce its own vitamin D is exposed to the sun’s UV-B rays. However, the northern 2/3 of the US is too far north to get these rays during the winter months. A fair-skinned person who spends 10 minutes in the sun during the summer without sunscreen and dressed in shorts and a tank top can produce 10,000 IU of vitamin D. Darker-skinned people will produce significantly less vitamin D. Sunscreen blocks the UV-B rays from penetrating the skin and no vitamin D will be produced. Dietary sources of vitamin D are fatty fish like salmon, catfish, and tuna; egg yolks, beef liver, and fortified milk. Vegans do not have a good source of dietary vitamin D.
