Osteoporosis and osteopenia, both conditions characterized by loss of bone mass, are major health concerns in the United States. Throughout our lifespan, bone is constantly broken down and rebuilt, usually in a balanced way that results in bone growth and mineral accumulation in bones (bone mineral density) that supports a strong skeleton.
As we age, this accumulation reaches its highest point (peak bone mineral density) and gradually shifts towards bone loss. Osteopenia occurs when bone mineral density declines below a healthy value; osteoporosis is its more severe manifestation, and both increase the risk of bone fractures.
The most recent national survey estimates that 9 percent of people over age 50 have osteoporosis, while 49 percent have osteopenia. In other words, more than half of the aging U.S. population has a chronic bone disease that puts them at risk for injury. When bone fractures occur in older people with osteopenia or osteoporosis, patients often require surgery, usually followed by a prolonged recovery period, often in a nursing facility. They may still experience significant pain and/or a permanent decline in function, or even death — an estimated 20 percent of those who suffer osteoporosis-related fractures die within a year.
Reduce your risk
There are many lifestyle changes that everyone at any age can make to help reduce their risk of osteopenia, osteoporosis and bone fractures:
• Get an adequate amount of vitamin D and calcium from your diet.
• Engage in consistent weight-bearing and muscle-strengthening physical activity.
• Avoid tobacco and excess alcohol consumption.
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Vitamin D and calcium are the superstars of bone health. Most of the body’s calcium is stored in the bones, and adequate calcium intake is essential for healthy bone formation. Vitamin D is important for calcium absorption from the gastrointestinal tract and helps maintain the balance between calcium deposited in the bones and the calcium in body fluids. Adequate dietary intake of both nutrients is important for achieving peak bone mineral density in early life (for most people by age 30, with adolescence being the most important time for building strong bones) and maintaining bone mineral density in later years.
The recommended daily intake of calcium is 1,000 mg for women age 19-50 and men age 19-70, and 1,200 mg for women 51 years and older and men 71 years and older.
Consuming a healthy, well-balanced diet generally provides adequate amounts of calcium from food sources. About three daily servings of low- or nonfat dairy products (1 serving=8 oz. of milk or 6 oz. of yogurt or 1o oz. of cheese) can provide the majority of daily needs. For people who do not consume dairy products, there is a wide variety of good nondairy food sources, including dark green leafy vegetables, the soft bones of fatty fish, such as salmon and sardines, and calcium-fortified foods.
If adequate calcium intake still cannot be obtained from diet alone, a calcium supplement with vitamin D may be considered. These should be taken with food and in quantities of less than 500 mg of calcium per dose, to optimize absorption.
The recommended daily intake for vitamin D is 600 IU (15 mcg) for adults age 19-70, and 800 IU (20 mcg) for adults 71 years and older.
Vitamin D is found in various food sources, including liver, egg yolks, fatty fish such as salmon, herring and sardines, and fortified foods, such as fluid milk (cow, soy, almond, rice, etc.), yogurt and breakfast cereals.
The human body can produce its own vitamin D through sun exposure, and this contributes to a person’s vitamin D status. Unfortunately, there are currently no guidelines as to an appropriate amount of sun exposure for this purpose.
Individuals at risk for vitamin D deficiency, including the elderly, individuals with limited sun exposure, obese individuals and people with dark skin, may benefit from vitamin D supplements.
For more information, check out the websites for the National Osteoporosis Foundation and the NIH Osteoporosis and Related Bone Diseases National Resource Center.
To find a doctor near you, contact the Physician Referral Service at 866.804.1007. Information provided by Simone Walters, clinical nutritionist at Beth Israel Medical Center.