Osteoporosis, the most common bone disease in the United States, is when bones aren’t as strong as they used to be. Generally, people don’t think about their bone health until they are middle-aged or older. To put this into better perspective, osteoporosis is regarded as a silent disease. This means someone may not even know they have it until there’s a broken bone.

Half of all American adults age 50 or older are at risk of breaking a bone. In fact, 50% of women and 25% of men will break a bone in their lifetime. This is often due to osteoporosis. If you are getting older or have older family members, bone health is very important. Thankfully, there are some common sense options to support your bones naturally.

Why Worry About Bone Health?

Bone is constantly being destroyed and rebuilt by the body throughout life. On average, bone is fully replaced in 8 to 10 years. The majority of people have their highest bone density during their 20s. Peak bone mass is generally reached by age 30. After this age, bone building slows down, and in late middle age, bone breakdown is often higher than bone building, making weaker bones.

Typically in osteoporosis, the bone itself is weakened by structural changes. The average adult may not think anything of this, but these changes can lead to broken bones. Hip fractures especially in older adults can be very serious, sometimes leading to chronic illness and even death. Experts estimate up to 33% of all older adults (over age 65) will die within a year of suffering a hip fracture. A broken hip leads to less physical activity, and they might be unable to do daily tasks such as bathing or dressing themselves.

How to Know if You Have Osteoporosis

The United States Preventive Services Task Force (USPSTF) recommends screening for women over the age of 65 and women of any age at increased risk of developing osteoporosis. There is not enough research at this time to have a recommendation for men. Factors that raise the risk of having weak bones include:

• Being of white or Asian descent
• Age
• Small body frame
• History of fractures
• Overall lifestyle habits including exercise, diet, smoking/alcohol use
• Any diagnosis or medications that may contribute to low bone mass
• Family history of osteoporosis
• Hormone status

Osteoporosis is also more likely to occur if there has ever been an eating disorder involved. Gastrointestinal surgery and a low dietary mineral intake can also increase risk.

Generally, doctors will do physical exams checking on muscle strength, posture, balance, and how someone walks to screen for osteoporosis and other potential health concerns. During a physical exam, they will also measure height and weight to make sure those are in a normal range. Next, a bone mineral density (BMD) test may be in order. The most common type of BMD test is a dual-energy x-ray absorptiometry (DXA) scan. This measures bone density mainly in the hip and spine using low-dose x-rays.

DXA results are compared to the average bone density of healthy young people with normal bone health. A T-score is used in people over 50. A score from 0 to -1 means bone density is normal and -1 to -2.5 means osteopenia or low bone density is present. A score of -2.5 or lower usually means osteoporosis is the diagnosis.

Being aware of bone health before age 50 can help build healthy lifestyle changes that will support lifelong health. There are many ways you can grow and maintain healthy bones. Below are several suggestions you can consider.

Using Nature for Prevention

Diet – Eating more vegetables and fruits daily has been associated with a higher BMD. Fruits and veggies have vitamin C, carotenoids, vitamin K, and potassium, all of which have a positive association with better bone health.

Consider eating foods with supportive minerals such as milk, cheese, broccoli, cabbage, okra, soybeans, tofu, nuts (especially almonds), and fish containing bones (such as sardines). One study found drinking milk once a day lowered osteoporosis risk by 39% or more. Finally, consuming recommended amounts of protein can also be helpful.

Supplements – The recommended dietary intake (RDA) for calcium is 1000 mg for adults and 1200 mg for women over age 50. Men aged 70 or older should also get 1200 mg of calcium a day. Supplementation of no more than half calcium RDA (500 mg - 600 mg) is recommended with the remainder coming from dietary sources. There are a lot of calcium supplements to choose from.

Calcium carbonate has the highest amount of elemental calcium and is inexpensive, but it can be constipating and hard to absorb if you have stomach trouble. Calcium phosphate can be better tolerated, but it’s more expensive. Another form, calcium citrate is very easily absorbed, but it doesn’t contain as high a percentage of elemental calcium. Talk to your doctor to find your best option. Other minerals to consider supplementing include magnesium, strontium, and boron.

Vitamin D is another great supplement for bone health as it helps regulate bone metabolism. This means it helps make sure bone is built and broken down appropriately. It’s recommended that taking at least 800-1,000 IU of Vitamin D daily can support healthy bone status. Vitamin K2 is also helpful with a recommendation of 45 mg a day if you aren’t getting adequate amounts from your diet. Getting out in the sun is also a great way to get some natural vitamin D.

Get Moving

Getting enough daily movement is critical to having strong, healthy bones. If you don’t move, your bones aren’t getting enough stress throughout the day. Without some stress, bones will slowly get weaker over time since they aren’t getting challenged enough. Movement such as walking and going up and down the stairs are some basic weight-bearing exercises. As gravity pulls more weight onto the bones, the bones are forced to get stronger.

Research shows walking alone doesn’t necessarily rebuild bone, but it does seem to stop deterioration. To make walking a more effective exercise, bring along a backpack with a water bottle or two. Something as simple as lifting a heavy soup can help build bone since it is under added stress. Swimming and cycling can also help with strengthening muscles and bones. Activities such as dancing, balancing, tai chi, etc., seem to help elderly patients the most. They may have a hard time remembering more complicated exercises depending on mental health.

What to Do if You Have Osteopenia/Osteoporosis

Most importantly, osteoporosis is something that can be prevented OR supported through lifestyle changes and working closely with your holistic healthcare practitioner. It’s important to note certain lifestyle choices such as smoking and drinking too much can negatively impact bone health. Be sure to talk with your doctor to find out what health recommendations are best for you and your wellness goals. Your doctor may offer medications, minerals or other supplements, an exercise routine, etc.

Remember to advocate for yourself and your health goals to get the best possible care, especially if you are aware of a family history of disease. As always, be sure to have a conversation with your doctor before changing your lifestyle habits or adding any supplements.

Resources:

1. Benedetti, Maria Grazia, et al. 2018. "The Effectiveness of Physical Exercise on Bone Density in Osteoporotic Patients." BioMed Research International; 2018: 4840531. doi:10.1155/2018/4840531
2. Bone and Health Osteoporosis Foundation. N.D. "Osteoporosis Fast Facts." https://www.bonehealthandosteoporosis.org/wp-content/uploads/Osteoporosis-Fast-Facts-2.pdf
3. Health in Aging. 2019. "How Do Older Adults Fare After Hip Fracture?" https://www.healthinaging.org/blog/how-do-older-adults-fare-after-hip-fracture
4. Kostecka, Małgorzata. 2014. "The Role of Healthy Diet in the Prevention of Osteoporosis in Perimenopausal Period." Pakistan Journal of Medical Sciences; 30(4): 763-8. doi:10.12669/pjms.304.4577
5. Laird, Eamon, et al. 2010. "Vitamin D and Bone Health: Potential Mechanisms." Nutrients; 2(7): 693-724. doi:10.3390/nu2070693
6. Mayo Clinic. 2024. "Osteoporosis." https://www.mayoclinic.org/diseases-conditions/osteoporosis/symptoms-causes/syc-20351968
7. Muñoz-Garach, Araceli, et al. 2020. "Nutrients and Dietary Patterns Related to Osteoporosis." Nutrients; 12(7): 1986. doi:10.3390/nu12071986
8. National Institute of Arthritis and Musculoskeletal and Skin Diseases. N.D. "Bone Mineral Density Tests: What the Numbers Mean." https://www.niams.nih.gov/health-topics/bone-mineral-density-tests-what-numbers-mean
9. National Health Service (NHS). 2024. "Food for Healthy Bones." https://www.nhs.uk/live-well/bone-health/food-for-strong-bones
10. National Institute of Arthritis and Musculoskeletal and Skin Diseases. "Overview of Osteoporosis." https://www.niams.nih.gov/health-topics/osteoporosis/more-info
11. Price, Charles T., et al. 2012. "Essential Nutrients for Bone Health and a Review of Their Availability in the Average North American Diet." The Open Orthopaedics Journal; 6: 143-9. doi:10.2174/1874325001206010143
12. Sahni, Shivani, et al. 2015. "Dietary Approaches for Bone Health: Lessons from the Framingham Osteoporosis Study." Current Osteoporosis Reports; 13(4): 245-55. doi:10.1007/s11914-015-0272-1
13. Saljoughian, Manouchehr. 2015. "Pros and Cons of Calcium Supplements." https://www.uspharmacist.com/article/pros-and-cons-of-calcium-supplements

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