Osteoporosis: A fanged dog without a bark

Our bones are a dynamic organ, like a house that’s constantly been remodeled.

Bone loss is natural aging. But when the demolition crew far outpaces the construction crew, bones thin critically, liable to fracture with minor injuries – it’s osteoporotic.   

Osteoporosis is diagnosed based on a bone density study (DXA). The U.S. Preventive Services Task Force recommends screening women once at age 65. Earlier if they have additional risk factors: parents with hip fractures, smoking, weight less than 127 pounds, excessive drinking, among others.

Osteoporosis is more common in women, affecting 15 percent of women and 4.7 percent of men over 50. The benefit of screening men is less clear, mostly because we don’t know (yet) if the treatments that work well for women also work for men.

While osteoporosis hits all joints, doctors are most concerned with two fracture sites – hips and spine.

Hip fracture is the worst. Due to prolonged immobilization, many require assistance living and suffer chronic pain. Up to 30 percent of women with hip fractures die within a year. The rate is higher for men.

From 2007 to 2016, “the number of U.S. older adults who die as the result of a fall has increased by 31 percent,” according to the Centers for Disease Control and Prevention.

So, what can you, starting today, do to keep your bones healthy?

First, exercise.

Like muscles, bone grows in areas of stress. For example, tennis players have stronger bones in their racket arm.

My exercise mantra usually goes something like this, “Any exercise is better than no exercise.”

You may be thinking, “What? That’s the best you can do?”

If you really want to make your femurs and spine happy, consider a combination of endurance (jogging, tennis), resistance (weights, elastic bands) and balance (Tai Chi) exercises. You don’t have to go long or hard – 20-30 minutes most days of the week will do. A potpourri of strength and coordination activities is your best bet for slowing down bone loss and reducing your chance of falling.

Second, diet.

Calcium is the bricks and mortar of bones; vitamin D helps guts absorb calcium. Doctors recommend a diet rich in vitamin D (egg yolks, fortified dairy and grains) and calcium (dairy and green leafy vegetables, like kale). But for independently living, healthy adults, taking vitamin D and/or calcium pills, has no added benefits in reducing fall or fracture risks.

Third, smoking/drinking.

Women’s bone density peaks around 30 then begins to decrease. The rate of loss accelerates the first few years after menopause, then slows. Osteoporosis is a fanged dog without a bark. It gives no warning, like pain, until the first surprise fracture. Smoking and excessive drinking aggravate the problem – earlier and faster. How much bone you have after menopause very much depends on how much bone you have before menopause.

What’s “excessive” drinking?

For bone health, three or more drinks per day is considered “excessive.” One drink is a 10 ounce glass of beer or a 4 ounce glass of wine.  

What’s “moderate” drinking?

That, my friend, depends on where you live. For example, the Australians have one of the most generous drinking guidelines in the world. So if you really like your craft beer, I say – go with the Aussies.