Building Better Bones: Preventing Osteoporosis

By age seventy-five, 90 percent of us are expected to have some osteoporosis. Osteoporosis can turn a simple twist or fall into a fractured wrist, spine, or hip. Just lifting a bag of groceries can be enough to crack a bone!

Although we picture them as cold and hard, bones are actually made of living cells, continually wearing out and building up again. For most of us, our bones are at their strongest—what experts call peak density—around our mid-thirties.

From there, your bones gradually lose cells, picking up speed in the first years after menopause, because less estrogen means faster bone breakdown. This is when you can lose 1 percent or more of your bone each year. And each 10 percent lost doubles your fracture risk!

The good news is that with a little information and planning, you can really improve your odds. There are simple and inexpensive things you can do now to build and keep stronger bones. Think of it as another way to save for retirement: you're building a bone-saving account to avoid a frail and fearful later life.

• Eat calcium-rich foods. Your body needs calcium to build those bones. You need to have three or four servings a day of calcium-rich food. Dairy foods—milk, yogurt, and cheese—are the richest source of calcium; I recommend low-fat or nonfat dairy products.
  There's also calcium in canned salmon, with bones, and sardines; in dried beans and peas, including cooked lentils, navy beans, and white beans; and in oranges, broccoli, and dark green leafy vegetables like spinach, kale, and mustard greens.
• Take calcium supplements. Most of us don't get enough calcium, even with a healthy diet. Doctors suggest stocking up on calcium pills and taking 1,000 milligrams a day—more if you're pregnant or postmenopausal.
• Get enough exercise. "The things that are important for women specifically to do over time are weight-bearing exercise and resistance training," says Pat Manocchia. "It can be weight training or push-ups or classes where you're on your feet or running—but something where you're bearing your weight."
  If your bones are already on the fragile side, go for a low-impact weight-bearing workout. That might be a low-impact aerobics class, a walk in the woods, or stepping on a stair machine. Also get some balance and flexibility training, since it reduces your odds of falling.
  And never assume it's too late for exercise. No matter what your age, it can make a real difference. A 1994 study published in the Journal of the American Medical Association found that seventy-year-olds who lifted weights twice a week not only prevented bone loss but actually added a bit more bone density!
• Don't smoke, and drink only in moderation. Whenever I hear that statement, I think of Dr. Tim Johnson, who appeared on GMA many times to deliver this message. Each time, he looks me in the eye and says, "I know we've told them many times before, but maybe, just maybe, we'll save another life today." If you smoke, I'm sure you've heard a zillion reasons why you should quit. Here's reason one zillion and one: smoking decreases the estrogen circulating in your system and seems to make it harder to absorb calcium. Your bones don't need these problems. Having three or more drinks a day is also a bad idea, since alcohol interferes with the absorption of calcium and vitamin D.
• Cut down on caffeine and some medicines. Too much caffeine can cause problems with calcium. A 6-ounce cup of drip-brewed coffee has about 100 milligrams of caffeine; regular tea has about 50 mg; a 12-ounce glass of cola contains 36 mg.
  Two or three cups of coffee a day probably won't hurt you. A cup or two can boost energy, concentration, and mood for the sleep-deprived. But when you get to four cups or so, the amount of caffeine you are consuming will block your body's absorption of calcium. And if you drink upward of half a dozen cups of coffee a day, take note: it may raise your cholesterol level and your risk of heart attack.
  Bulk-forming laxatives like Metamucil also can interfere with calcium absorption; so can a diet very high in fiber (another plug for moderation in everything). Also watch out for medicines with hidden caffeine; there's a heaping helping of caffeine in some pain relievers, like Exedrin and Midol.
• Consider taking medications. Look at changing your health habits as your first line of defense, says Dr. Robert Recker, director of the Osteoporosis Research Center in Omaha. Then, if you need to, add medications to your bone-defense arsenal.
  In just the last year or two several new drugs have come out for women who already have weak bones. These include pills and nose sprays that can stop bone loss and cut your fracture risk by half. You can talk to a doctor about the pros and cons and about what your medical insurance will cover.
  Estrogen is most often the first-choice drug to control osteoporosis. Women who start estrogen treatments after menopause get fewer fractures. Even if you're five or six years out from menopause, estrogen seems to help, and it doesn't cost all that much.