Building Strong Bones: Tips for Preventing Osteoporosis and Increasing Bone Density

By Ingrid Snellings, BA, Certified Health Coach

Osteoporosis is a chronic condition in which bone mass is lost faster than rebuilding. "…[B]one is a living tissue made of cells. Old cells break down and die and are replaced by new ones. Osteoporosis happens when new bone cells are not created fast enough to keep up with natural bone loss." (Orthopedic Specialists of SW Florida) Osteopenia is an earlier stage of bone loss, but not to the point of being diagnosed with osteoporosis. As bones become less dense, they become more brittle and easier to break if we experience falls or accidents.

Factors contributing to bone loss are age, gender, race, hormone levels, family history, and menopausal stage, and affect women more than men. Other factors include medical issues, such as autoimmune conditions, hematologic issues, cancer, and more. Lifestyle choices also influence bone loss, such as diet, exercise, smoking, and alcohol consumption. As we age or have risk factors that may contribute to loss of bone density, it is important to understand the changes our body goes through and to provide it with the resources it needs to be as healthy and strong as we can manage.

According to Medical News Today, "In some cases, a person may be able to reverse osteoporosis…Some lifestyle strategies can prevent future bone loss and reduce the risk of fractures. Additionally, certain medications may help a person rebuild bone mass, essentially reversing osteoporosis." While in some cases, osteoporosis is reversible, sources agree that in most cases further bone loss can be prevented and rebuild bones, but not be reversed.

According to the Bone Health and Osteoporosis Foundation, the following list is the recommendations for when someone should get a bone scan:

• Women age 65 years and older

• Men age 70 years and older

• Anyone who has broken a bone after age 50 years

• Women age 50-64 years with risk factors*

• Men age 50-69 years with risk factors*

*Examples of risk factors for osteoporosis and fractures include family history of osteoporosis and/or fracture, frequent falling, vitamin D deficiency, smoking, excessive alcohol intake, malabsorption, and some medications, such as prednisone.

While some contributing factors can only be addressed with the support of medical providers, other contributing factors can be ameliorated through lifestyle changes, such as our food choices, the level of physical activity we participate in, the rate of alcohol consumption, and whether we smoke or not.

Nutrition

It is important to eat a diet rich in calcium and vitamin D. A few foods rich in calcium are dairy products, dark green leafy vegetables, salmon, sardines, beans, tofu, and almonds. Several foods rich in vitamin D are mushrooms, salmon, sardines, cod liver oil, mackerel, tuna, dairy products, and eggs. Also, spending time outside each day can provide some vitamin D.

An overall healthful diet, according to Dietary Guidelines for Americans, should be met through eating a variety of nutrient-dense foods from all the basic food groups which include:

• Vegetables of all types—dark green; red and orange; beans, peas, and lentils; starchy; and other vegetables

• Fruits, especially whole fruit

• Grains, at least half of which are whole-grain

• Dairy, including fat-free or low-fat milk, yogurt, and cheese, and/or lactose-free versions and fortified soy beverages and yogurt as alternatives

• Protein foods, including lean meats, poultry, and eggs; seafood; beans, peas, and lentils; and nuts, seeds, and soy products

• Oils, including vegetable oils and oils in food, such as seafood and nuts

For more information on the nutritional needs of each age group, activity level and gender, and other important information, visit: www.health.gov/dietaryguidelines

Reducing or eliminating processed foods and foods with added sugar is helpful. According to Dietary Guidelines for Americans, we should not consume more than 10% of our calories as added sugars per day.

Reducing salty foods is also important. According to Medical News Today and their research, "[t]he Bone Health & Osteoporosis Foundation (BHOF) notes that eating foods high in salt causes the body to lose calcium and can lead to bone loss. The organization advises people to look at nutrition labels and avoid foods that contain 20% or more of the Daily Value of salt." (Feller et al, 1) The Dietary Guidelines for Americans recommend consuming 2,300 mg of sodium or less per day.

Supplements

It is preferred that dietary needs are met through a varied diet rich in nutrients, however, if this is difficult to do, then it is recommended to take supplements.

• Men 50 – 70 years old should consume 1,000 mg/day of calcium

• Women 51 years and older and men 71 years and older should consume 1,200 mg/day of calcium

• Both men and women over 50 should consume 800 to 1,000 IU/day of vitamin D (Brehm et al, 431)

Exercise

It is important to discuss with your medical provider plans to begin or increase a current exercise program to determine if there are any guidelines that you may need to follow to stay safe from injury or to prevent further damage that you may already be experiencing. For example, you might be advised to avoid certain types of movement that can twist or compress the spine or movements that are quick and jarring. You may be advised to work with an exercise trainer who with your healthcare provider can design a program that is safe and efficient in meeting your goals.

Exercise is important for two reasons for people diagnosed with osteoporosis: increasing bone mass and improving strength and balance to prevent falls. Exercise causes "bone loading [which] stimulates bone deposition and associated gains in bone mass and strength." (Brehm et al, 432) Participate in a variety of activities to build up strength, agility, and balance. Such activities should include weight-bearing exercises, resistance training, and activities that promote balance.

• Weight-bearing exercises include aerobic exercises such as walking, jogging, playing tennis, and resistance training. Individuals should work up to 150 minutes (or more) per week of aerobic exercises, which breaks down to five 30-minute workouts per week. Benefits are gained whether workouts are for 30 minutes, or broken into three 10-minute workouts in a day.

• Resistance training includes using bands or weights with exercise. It is recommended that each major muscle group be worked 2 – 3 times per week.

• Balance exercises, aka neuromotor exercises, include such activities as balancing on one foot, yoga, or tai chi combined with flexibility work. This should be practiced for 20 – 30 minutes at least 2 or 3 times per week.

Other important considerations are to make sure that you are participating in activities in areas that are safe, such as non-slippery surfaces, and that are free from tripping hazards.

Other Health Considerations

It is not only important to include good nutrition and exercise but also to reduce and eliminate certain behaviors. Smoking and heavy drinking should be eliminated as both behaviors lead to bone loss. It is recommended that women should limit alcohol consumption to one serving per day and men to two servings per day or less.

Medical Interventions

As mentioned earlier, there are medical issues that can lead to bone loss, such as autoimmune conditions, hematologic issues, and cancer. Other factors may include age, hormone levels, and family history. While nutrition and exercise are helpful in bone health, you may need additional pharmacological support which can be determined by your medical care provider. There are a variety of pharmacological choices that may help increase bone density.

Summary

As we age, it is important to do what we can to prevent bone loss. Eating more healthfully, increasing exercise, not smoking, and limiting alcohol consumption will maintain and increase bone density. Working towards more healthful living will also have the added benefits of improving the clarity of mind, mental well-being, stress reduction, strength, endurance, agility, balance, and our ability to participate in more activities. As the saying goes, as we age, "if we don't use it, we will lose it"!

References:

(2022, December 6). Can You Reverse Osteoporosis? Here Are the Facts. Orthopedic Specialists of SW Florida. Retrieved January 29, 2024, from https://www.osswf.com/blog/can-you-reverse-osteoporosis-here-are-the-facts

Carteron, N., M.D., FACR, & Geng, C. (2023, February 28). What to know about reversing osteoporosis. Medical News Today. Retrieved January 29, 2024, from https://www.medicalnewstoday.com/articles/is-osteoporosis-reversible#lifestyle-factors

Brehm, B. A., Colberg, S. R., Fassbender, J. E., Finn, L., Fogg-Phillips, L., Franklin, B. A., Jo, S., Matthews, J. A., Muth, N. D., Pagoto, S., Pettitt, C. D., Read, B., Skinner, J. S., Zize, M. (2019). The Professional's Guide to Health and Wellness Coaching. American Council on Exercise.

Feller, M., MS, RD, CDN, Nutrition, & L. R. (2022, May 25). What foods should a person with osteoporosis avoid? Medical News Today. Retrieved January 29, 2024, from https://www.medicalnewstoday.com/articles/osteoporosis-foods-to-avoid