Developing a Plan of Action

While the basics of protecting your bones — such as getting enough calcium and engaging in weight-bearing exercises — remain the same throughout your life, there are different factors to consider as you age. The following tips can help you put together a plan to boost your bone strength, no matter what your age.

An early start

If you're a man under age 65 or a premenopausal woman, the best approach is to concentrate on attaining and maintaining a high peak bone mass. The good news is that many of the factors that reduce the risk for osteoporosis also limit your chances of developing cancer, heart disease, and adult-onset diabetes.

Age and bone health No matter what your age, there's plenty you can do to improve your bone health.

Monitor your diet. Get the recommended amounts of vitamin D (see "Vitamin D") and calcium (see "Calcium") each day. Read food labels for calcium content. Although dairy products may be the richest sources, a growing number of foods, such as orange juice, are calcium-fortified. Fruits, vegetables, and grains are also important, because the plant kingdom is a good provider of other minerals that contribute to bone, such as magnesium and phosphorus. While the Nurses' Health Study found that consuming 95 grams or more of animal protein a day may increase the risk for osteoporosis, some protein is essential for maintaining muscle mass.

Maintain a reasonable weight. A body mass that is too low to support menstruation — because of anorexia or excessive exercise — is usually a sign that estrogen levels are too low to promote bone growth.

Avoid cigarettes and too much alcohol. Both decrease bone mass, and heavy alcohol use can also make you more apt to fall.

Perform weight-bearing exercises regularly. Just 30 minutes of weight-bearing exercise each day can protect your bones. Exercise offers a wide array of health benefits, including reducing your risk of developing heart disease, lowering blood pressure, boosting your energy level and your mood, and decreasing your chances of developing colon cancer and diabetes.

Review your health status. If you have conditions or take medications that reduce bone mass (see "Possible causes of secondary osteoporosis"), ask your doctor what you can do to counteract these effects.

Early postmenopause

If you are a woman in the early years of menopause, you are probably in the period of your greatest bone loss. All of the suggestions for younger women still apply, and you should do the following as well.

Assess your risk. If you have reason to believe you're at greater risk for osteoporosis (see "Who gets osteoporosis?"), talk to your clinician about having a bone density evaluation — preferably a DXA test (see "Dual energy x-ray absorptiometry").

Discuss preventive medications with your doctor. Consider talking to your doctor about medications — such as alendronate, risedronate, raloxifene, or hormone therapy — that can help prevent osteoporosis. Each medication has its own benefits and risks, and your doctor can help you determine which one may be best suited for you.

Check your calcium and vitamin D. Get at least 1,000–1,200 mg of calcium a day. Also, be sure that you are getting the vitamin D you need (see "Vitamin D").

Re-evaluate your exercise regimen. Exercise not only builds bone, it also increases strength, flexibility, and balance. As you age, it becomes more difficult to maintain muscle mass, so you may need to add more exercise to keep from losing ground. Now may be a good time to incorporate weights into your routine, if you haven't already been using them (see "The importance of exercise"). The poster "Osteoporosis Workout" offers a simple exercise routine to strengthen your bones; for ordering information, see "Help with your exercise routine."

If you are 65 or older

At this point, bone loss has tapered off for women. Estrogen deficiency is no longer the primary thief of bone; decreased absorption of minerals plays a significant role. But for men, bone loss has speeded up. Regardless of your sex, you are still losing bone as you age. All of the previous suggestions for bone maintenance still apply, and you should be vigilant in following them. In addition, consider these suggestions.

Increase your calcium intake and get plenty of vitamin D. The recommended intake of calcium is 1,200 mg for everyone. Make sure that you accompany it with 400–600 IU of vitamin D to enhance absorption.

Keep up your exercise routine. It's necessary not only to preserve bone, but also to maintain muscle mass, which helps protect bones should you fall. Exercise also helps improve balance and lessens the likelihood of falling. Consider learning tai chi or other types of exercises that improve balance and coordination. Also, perform the exercises in "Two exercises that can improve your balance."

Consider medication. Now you have more choices than ever before. Alendronate, risedronate, raloxifene, and hormone therapy have all been shown to reduce bone loss, and are approved for the prevention and treatment of osteoporosis. Parathyroid hormone and calcitonin are approved for treatment. Each has its own benefits, risks, and side effects. You may want to talk to your doctor about whether you should take a preventive medication and, if so, which one may be best for you.

Diet and osteoporosis prevention and treatment Exercise and osteoporosis prevention and treatment Diet and exercise are important components in an osteoporosis prevention or treatment plan.

Source: from Harvard Health Publications, Copyright © 2008 Harvard University. All rights reserved. Harvard Medical School does not endorse products.
Used with permission of StayWell.
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