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Reducing Your Risk of Osteoporosis
Your bones grow and strengthen during childhood, but bone accumulation is not completed until you are in your twenties. The bone mass you attain before age 30 is perhaps the most important determinant of life-long skeletal health. Genetic factors exert a strong influence on your peak bone mass, but physiologic, environmental, and modifiable lifestyle factors can also play a significant role. Among these are adequate nutrition and body weight, exposure to sex hormones at puberty, and physical activity.
Maximizing bone mass early in life is the most crucial way to reduce the impact of bone loss related to aging. Childhood is also a critical time for the development of lifestyle habits conducive to maintaining good bone health throughout life. For example, exercising promotes strong bones. Cigarette smoking, which usually starts in adolescence, may negatively affect your ability to achieve peak bone mass.
Here are some tips on reducing your risk of osteoporosis:
- Eat a healthful diet.
- Exercise regularly.
- Do not smoke.
- Avoid excessive alcohol and caffeine.
- Talk to your doctor about preventive medications.
- Have a bone mineral density test.
- Talk to your doctor about your medications.
Eat a Healthful Diet
Good nutrition is essential for normal growth. A balanced diet, adequate calories, and appropriate nutrients are the foundation for development of all your tissues, including bone. Inadequate intake of calcium and vitamin D is thought to contribute to the development of osteoporosis.
Calcium is the nutrient most important for attaining peak bone mass and for preventing and treating osteoporosis. Depending on your age, recommended calcium intakes for adults fall between 1,000 and 1,200 mg per day, according to the National Academy of Sciences. A study published in Archives of Internal Medicine reported that taking 1,200 mg a day of calcium helped to increase bone mineral density in men.
You can increase your calcium intake by eating more calcium-rich foods such as low-fat milk, yogurt, cheese, sardines, soy foods, and collard greens. Many foods such as orange juice, breakfast bars, and cereals are now fortified with calcium. You can increase the calcium content of home-baked goods by adding non-fat powered dry milk to them. If you are unable to get adequate calcium in your diet, talk to your healthcare provider or a registered dietitian (RD) about a supplement.
High dietary protein, caffeine, phosphorus, and sodium can adversely affect calcium balance, but the effects may not be as important in individuals with adequate calcium intakes.
Vitamin D is required for optimal calcium absorption and thus is also important for your bone health. Your skin manufactures vitamin D in response to direct exposure to sunlight. How much sunlight you need depends on where you live, the time of day, and the color of your skin.
Older adults and people who are exposed to little sunlight may have difficulty meeting vitamin D requirements. Most infants and young children in the US have adequate vitamin D intake because of supplementation and fortification of milk. During adolescence, when consumption of dairy products decreases, vitamin D intake may be inadequate, and this may negatively affect calcium absorption.
Experts recommend a daily intake of between 600 and 1,000 international units (IU) of vitamin D.
There is strong evidence that regular physical activity in childhood and adolescence contributes to higher peak bone mass. Exercise during later years, combined with adequate calcium and vitamin D intake, may help slow the decline in bone density associated with aging. Some evidence indicates that weight-bearing and resistance exercises are most likely to be beneficial.
To help reduce bone loss, engage in regular weight-bearing exercise. Examples include walking, running, tennis, dancing, hiking, and racquetball. Strength training can also help increase your bone density and keep your muscles strong, so that you are less likely to fall.
Do Not Smoke
Smoking puts people at higher risk for developing osteoporosis. A study reported in the Journal of the American Academy of Orthopedics suggests that smoking puts you at higher risk for developing osteoporosis.
Avoid Excessive Alcohol and Caffeine
Alcohol has several negative effects on bones. Alcohol can interfere with vitamin D metabolism, which results in impaired calcium absorption. It also increases magnesium excretion. In addition, heavy drinkers tend to have diets that are lacking in many key nutrients, including calcium and vitamin D.
Heavy drinking can affect hormone production in both women and men. In premenopausal women, chronic alcohol use can result in irregular menstrual cycles. This increases the risk of osteoporosis. Testosterone production may be affected in alcoholic men. Low testosterone levels have been linked to a decrease in bone formation.
Heavy alcohol consumption is associated with an increased risk of fracture. Alcohol affects your balance and gait making you more prone to stumble, trip, or run into objects.
The relationship between caffeine use and bone health is not as clear-cut. Studies on the effect of caffeine on the bones have yielded mixed results. On the basis of the studies to date, current recommendations are for moderate caffeine consumption, which equals two or less cups of coffee per day.
Talk to Your Doctor About Preventive Medications
Some medications, such as estrogens, bisphosphonates, and raloxifene have been approved by the US Food and Drug Administration for the prevention of osteoporosis in postmenopausal women. These medications slow or stop bone breakdown. If you are at high risk for osteoporosis, discuss the potential benefits of taking these medications with your doctor.
Have a Bone Mineral Density Test
Osteoporosis often has no symptoms and can go undetected for years. For that reason, early diagnosis is important. A bone mineral density test (BMD) can diagnose osteoporosis and determine your fracture risk. BMD is a painless and noninvasive test that measures the density (mass) of your bones. Talk to your healthcare provider about whether you are a candidate for a BMD test.
Talk to Your Doctor About Your Medications
Some medications that you are taking may contribute to osteoporosis. Examples of these medications include:
- Medications to suppress the immune system
- Gonadotropin releasing hormone
- Antiseizure medications
- Medications containing aluminum, such as some antacids
- Proton pump inhibitors
- Long-term heparin therapy
- Glitazones, medications to treat diabetes
Osteoporosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 29, 2016. Accessed May 19, 2016.
Osteoporosis overview. NIH Osteoporosis and Related Bone Diseases National Resource Center website. Available at: http://www.niams.nih.gov/Health%5FInfo/Bone/Osteoporosis/overview.asp. Updated June 2015. Accessed May 19, 2016.
What women need to know. National Osteoporosis Foundation website. Available at: https://www.nof.org/prevention/general-facts/what-women-need-to-know. Accessed May 19, 2016.
DynaMed's Systematic Literature Surveillance http://www.dynamicmedical.com: Cockayne S, Adamson J, Lanham-New S, Shearer MJ, Gilbody S, Torgerson DJ. Vitamin K and the prevention of fractures: systematic review and meta-analysis of randomized controlled trials. Arch Intern Med. 2006;166(12):1256-1261.
DynaMed's Systematic Literature Surveillance http://www.dynamicmedical.com: Lyles KW, Colón-Emeric CS, Magaziner JS, et al. Zoledronic acid and clinical fractures and mortality after hip fracture. N Engl J Med. 2007;357(18):1799-1809.
DynaMed's Systematic Literature Surveillance http://www.dynamicmedical.com: Reid IR, Ames R, Mason B, et al. Randomized controlled trial of calcium supplementation in healthy, nonosteoporotic, older men. Arch Intern Med. 2008;168(20):2276-2282.
DynaMed's Systematic Literature Surveillance http://www.dynamicmedical.com: Carbone LD, Johnson KC, Bush AJ, et al. Loop diuretic use and fracture in postmenopausal women: findings from the Women's Health Initiative. Arch Intern Med. 2009;169(2):132-140.
3/12/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Alekel DL, Van Loan MD, Koehler KJ, et al. The soy isoflavones for reducing bone loss (SIRBL) study: a 3-y randomized controlled trial in postmenopausal women. Am J Clin Nutr. 2010;91(1):218-230.
- Reviewer: Michael Woods, MD
- Review Date: 05/2016
- Update Date: 05/20/2015