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Why is bone health
important?
Your bones are continuously changing
- new bone is made and old bone is
broken down. When you’re young, your
body makes new bone faster than it
breaks down old bone and your bone
mass increases. Most people reach
their peak bone mass around age 30.
After that, bone remodeling continues,
but you lose slightly more than you
gain. How likely you are to develop
osteoporosis - a condition that causes
bones to become weak and brittle -
depends on how much bone mass you
attain by the time you reach age 30 and
how rapidly you lose it later. The higher
your peak bone mass, the more bone you
have “in the bank” and the less likely you
are to develop osteoporosis as you age.
What affects bone
health?
A number of factors can affect bone
health - some modifable and some not.
For example:
The amount of calcium in your diet. A
diet low in calcium contributes to
diminished bone density, early bone
loss and an increased risk of fractures.
Physical activity level. People who are
physically inactive have a higher risk
of osteoporosis than do their more-
active counterparts.
Tobacco use and excessive alcohol
consumption. Research suggests
that tobacco use contributes to weak
bones. Similarly, regularly having
more than two alcoholic drinks a day
increases the risk of osteoporosis,
possibly because alcohol can interfere
with the body’s ability to absorb
calcium.
Being a woman. Women have less
bone tissue than do men.
Getting older. Your bones become
thinner and weaker as you age.
Race, frame size and family
history. You’re at greatest risk of
osteoporosis if you’re white or of
Asian descent. You’re also at greater
risk if you’re extremely thin (with a
body mass index of 19 or less) or have
a small body frame because you may
have less bone mass to draw from as
you age. In addition, having a parent
or sibling who has osteoporosis puts
you at greater risk - especially if you
also have a family history of fractures.
Hormone levels. Too much thyroid
hormone can cause bone loss.
In women, bone loss increases
dramatically at menopause due to
dropping estrogen levels. Prolonged
periods of amenorrhea, the absence
of menstruation, before menopause
also increases the risk of osteoporosis.
In men, low testosterone levels can
cause a loss of bone mass.
Eating disorders and other conditions
and procedures that affect bone
health. People who have anorexia
or bulimia are at risk of bone loss.
In addition, stomach surgery
(gastrectomy), weight-loss surgery
and conditions such as Crohn’s
disease, celiac disease and Cushing’s
disease can affect your body’s ability
to absorb calcium.
and soy products, such as tofu. If you
fnd it diffcult to get enough calcium
from your diet, ask your doctor about
calcium supplements.
Pay attention to vitamin D. For
adults ages 19 to 70, the Institute
of Medicine recommends 600
international units (IUs) of vitamin D
a day. The recommendation increases
to 800 IUs a day for adults age 71
and older. Although many people
get adequate amounts of vitamin D
from sunlight, this may not be a good
source for everyone. Other sources of
vitamin D include oily fsh, such as
tuna and sardines, egg yolks, fortifed
milk, and vitamin D supplements.
Include physical activity in your daily
routine. Weight-bearing exercises,
such as walking, jogging, tennis and
climbing stairs, can help you build
Use of certain medications. Long-term
use of corticosteroid medications,
such as prednisone, cortisone,
prednisolone and dexamethasone,
is damaging to bone. Other drugs
associated with an increased risk
of osteoporosis include long-term
use of aromatase inhibitors to treat
breast cancer, the antidepressant
medications called selective serotonin
reuptake inhibitors (SSRIs), the cancer
treatment drug methotrexate, some
anti-seizure medications, the acid-
blocking drugs called proton pump
inhibitors and aluminum-containing
antacids.
What can I do to keep
my bones healthy?
You can take steps to prevent or slow
bone loss. For example:
Include plenty of calcium in your
diet. For adults ages 19 to 50 and
men ages 51 to 70, the Institute
of Medicine recommends 1,000
milligrams (mg) of calcium a day. The
recommendation increases to 1,200
mg a day for women age 51 and older
and men age 71 and older. Dietary
sources of calcium include diary
products, almonds, broccoli, kale,
canned salmon with bones, sardines
strong bones and slow bone loss.
Avoid substance abuse. Avoid
smoking and don’t drink more than
two alcoholic drinks a day.
Consider bone-boosting
medications. A number of
medications are available to help
slow bone loss and maintain bone
mass, including bisphosphonates
(Fosamax, Actonel, and Boniva) and
raloxifene (Evista). If you’re taking
a medication that affects your bone
health, talk to your doctor. He or she
will monitor your bone density and
may recommend other drugs to help
prevent bone loss.
For women, consider hormone
therapy. Estrogen, especially when
started soon after menopause, can
help maintain bone density. However,
the use of hormone therapy can
increase the risk of blood clots,
endometrial cancer and, possibly,
breast cancer.
Ask your doctor whether hormone
therapy is right for you. If you’re
concerned about your bone health or
your risk factors for osteoporosis, consult
your doctor. He or she may recommend
a bone density test. The results will help
your doctor gauge your bone density
and determine your rate of bone loss.
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