Q. As I get older, I’m increasingly worried about osteoporosis. Are there any steps I can take to prevent it? If I do get osteoporosis, what is the best way to keep it under control and still live a life?—a reader in Minocqua

A. Osteoporosis is a huge health concern for people of all ages. Starting from young ages we are encouraged to consume large amounts of calcium to “bulk up” our bones for later in life. As far as prevention goes however, there is a lot more to it than just taking a supplement.

You may be surprised to learn that the #1 key to preventing osteoporosis at any age is exercise! As always, the earlier in your life you start the better, but just because you’re not 20 anymore doesn’t mean that exercise won’t go a long way to helping you prevent osteoporosis.

Calcium uptake

As far as calcium is concerned, it is very important for bone growth. However, you can take twice the recommended amount of calcium and not have it make any difference at all. Why? Unless your body is engaging with the calcium (here comes the exercise part!), the calcium you intake is expelled as waste.

Exercise causes muscles to pull on bones as you move. This pulling is what leads to bone growth, and as bones want to grow, they need calcium to do it. It is out of this need that your body takes up the calcium you eat and uses it, rather than expelling it.

Another factor in calcium function is vitamin D. It is recommended that you get 10 to 15 minutes of direct sunlight (sun block blocks that production of vitamin D almost completely) per day, between the hours of 8 a.m, and 4 p.m.

Exercise

As far as the preventative exercise goes, you should do resistance (weight) exercises 2 to 3 times per week. Also important is jumping: 50 jumps 3 times per week. As your jumping skill level and height increase, you can progress to more difficult jumping exercises like plyometric exercises (squat jumps, box jumps, stair exercises, hop progressions and side cone hops to name a few).

When using exercise as an osteoporosis prevention you are better off using high weight and low reps rather than low weight and lots of reps. Bone is built by using heavy weight, but be sure to lift and exercise within your limits and build up gradually.

If you suffer from arthritis, jumping is not a good idea, and you are better off sticking with the weight training and avoiding the jumping aspect. At any age, exercise and calcium from food paired with vitamin D are your best preventative measures.

Lifestyle choices: avoid smoking, alcohol, soda, red meat

Unfortunately, there is a lot more to the disease than just prevention. There are lifestyle choices that play key roles in the development of osteoporosis.

Major things to avoid are smoking and drinking alcohol. Smoking increases bone reabsorption—which means, that in order to get the calcium it needs for daily function, the body thins out the bones. Alcohol decreases bone formation, so while it doesn’t eat away at bones, it prevents them from getting any larger.

Caffeine is also not something you want in excessive amounts, but when compared to smoking and alcohol, it’s more of an acceptable vise, osteoporosis-wise.

Soda is terrible for you. There are no redeeming factors to soda, but on top of the widely-known issues with the sweet drink, there are also very high levels of dietary phosphorous which is bad for bone health.

Red meat also contains dietary phosphorous in high levels, so limit yourself to the 2 to 3 four-ounce servings per week recommended.  

The problem of medications

There are also common medications that decrease bone density, such as corticosteroids (commonly used for the treatment of arthritis and asthma), anti-convulsants, chemotherapy agents, prescription allergy medications, and COPD (chronic obstructive pulmonary disease) medications.

Although it’s scary to think that you have to chose between one health disorder or another (asthma vs. osteoporosis...etc.) it’s important to remember that all side-effects of any drug you take are minimized by following the instructions given to you by the doctor.

Also, work with your doctor to make sure you are on the lowest effective dose possible. As always with any medication, see the prescription through till the end of the run—don’t self-regulate!

Antacids also reduce calcium absorption, but if you need to take an antacid avoid any that include aluminum, as they increase calcium excretion.

Feeding the bones

Now that you know things you should avoid, here are things that will help your bone health. Everyone knows that low-fat dairy products are a great source of calcium, but did you know that broccoli has more calcium per calorie than any other food?

Other food sources are spinach, seaweed, tahini (used in humus), almonds, tofu and sunflower seeds.

The hip, wrist and upper back

There are three sites in the body that are most commonly hit with osteoporosis. The hip, wrist and upper back. Even if you already have osteoporosis, exercise can still help to build bone and stop loss. You have an increased chance of injury if you are unable to hold up your own body weight.

To begin a strength training series I recommend focusing on exercises that utilize your own body weight (wall push-ups, knee push-ups, toe push-ups, back extensions, leg lifts...etc.), rather than external weight sources (dumbbells, ankle weights, etc.).

Do NOT do sit-ups, crunches and forward-bending exercises—these exercises round your back while you perform them, which puts pressure on your fragile vertebrae, which can increase the chance of wedge and compression fracturing. Despite this precaution, there are still numerous abdominal exercises available that do not include forward bending (plank, knee-ups, side plank... etc.)

Also, avoid exercises that involve forceful and abrupt trunk rotation and large compressive forces on the spine (overhead presses, upright rows, lateral raise...etc.)

When you reach the point of adding external weight into your fitness routine, a weighted vest or weighted belt is the best option. It places the weight snug on your trunk avoiding any possible torque problems, as well as offering versatility in weight amount. You can add or remove weight as you see fit, rather than needing to purchase new weights each time you progress.

An inexpensive version is a fishing vest. The only thing you need to consider with a fishing vest is that you add weight evenly in the pockets around your body, don’t only front or back load the vest, and always be sure to know how much weight you are adding.

Body in balance

In addition to the weight aspect of your fitness routine, you also need to include some balance work. Osteoporosis disrupts your body's normal posture, which leads to balance issues. Good balance exercises include: getting up off the floor, eventually progressing to getting up off the floor without using your hands; bouncing and catching a ball, progressing to bouncing and catching a ball on one leg; squats and lunges.

Osteoporosis is a terrible disease but it doesn’t have to be life-debilitating. Starting prevention at any age can go a long way to minimizing or eliminating your risk for the disease. Once you’ve already got it, it doesn’t have to be the end of everything you love to do; you just have to take the initiative to do everything you can to prevent further bone loss.

There still is a lot of unknowns about osteoporosis, and new discoveries are being made every day. The above represents some of the best information out there right now. Regular exercise and nourishing foods not only prevent and halt osteoporosis but also lead to healthy lives for men and women of all ages.

(Email your health and fitness questions to cihla@newsofthenorth.net.)