Osteoporosis Prevention: What to Know So You Don’t Get It

Osteoporosis occurs when there is an imbalance in bone breaking down and new bone formation. You may be wondering why bones break down, only to form again. Simply put, normal bone is in a constant process of breaking down and re-forming, called bone remodeling. Typically, there is an even balance, but when there is more breaking down than re-forming, osteoporosis may occur. Its exact cause remains unknown.

What does osteoporosis mean?

The word osteoporosis means porous bone. Derived from the Greek word “osteo” for “bones” and “poros” for “passage, pore, or voyage,” the name stems from its microscopic characteristics. When viewed under a microscope, bones with osteoporosis have a more porous look than normal bones, meaning there is more open space than usual.

You may have heard the term osteopenia, a precursor of osteoporosis since it’s a milder form.

Symptoms

The most obvious finding in advanced osteoporosis is a stooped or hunched-over position. Other signs consist of a loss of height and low back pain. However, most cases of osteoporosis don’t present with any specific symptoms. Many people are unaware they have the disease until a fracture, or break, of a bone, occurs more easily than expected from the level of trauma. The fractured bone can be anywhere, but it most commonly occurs at the wrists, hips, or spine.

How is osteoporosis diagnosed?

The best way to diagnose osteoporosis is with a test that measures bone mineral density through a dual-energy x-ray absorptiometry test. Density specifically refers to the thickness of the bone. Osteoporotic bone has a decreased density.

There are two different kinds of machines:

• A peripheral, or smaller machine, checks the density (thickness) of a peripheral bone, such as a finger, heel, or wrist.
• Central DEXA machines are much larger and measure the density of the bone at the hip or spine.

The machines give different scores, which compare the person’s score to other standard scores.

Prevention #1: Adequate calcium intake

Calcium is an important mineral needed to prevent osteoporosis. The body needs 1000 mg to 1200 mg per day, depending on gender and age. You can get calcium from dietary products such as dairy products like milk, yogurt, and cheese; however, there are also non-dairy products that contain large amounts of calcium.

Good non-dairy sources of calcium include:

• Beans and lentils
• Nuts, like almonds
• Kale
• Certain fish, like sardines and canned salmon
• Rhubarb
• Leafy green vegetables
• Whey protein
• Tofu
• Edamame
• Foods fortified with calcium, such as some orange juices and cereal

We recommend you check the nutrition labels on the foods for exact information.

Prevention #2: Healthy vitamin D levels

Vitamin D is an important vitamin needed to prevent osteoporosis. Without vitamin D, we can't properly absorb calcium in our intestines.

You’ve probably heard about the recent trends to soak up the sun to get vitamin D. Most people need approximately 15 minutes of sunlight per day to obtain the required amount of vitamin D. It is even longer for those with darker skin. However, be cautious of skin cancers. For those spending a lot of time in the sun, see your dermatologist for yearly skin checks.

If you live in Arizona or California, getting enough sun to meet vitamin D needs is fine. But what if you live in a part of the country, or world, that doesn’t receive much sunlight? No need to worry. You can take supplements to obtain adequate vitamin D in your system.

Vitamin D supplements consist of two main types: vitamin D2 and vitamin D3. For supplementation, they are pretty much the same. The dosage of the supplements is in terms of international units (IUs). For people at or under 70 years of age, taking 600 IU of vitamin D each day is recommended. After 70, the recommended dose increases to 800 IU each day. It is important to note that vitamin D is fat-soluble, and can be toxic if taken in too large of a dose. For that reason, the upper limit is 4000 IU per day.

Certain foods contain high vitamin D levels, such as egg yolks, saltwater fish, canned tuna, liver, enriched orange juice, and fortified milk.

Prevention #3: Active lifestyle

Exercise helps with the prevention of osteoporosis. The contraction and relaxation of muscles around the bones will strengthen the bones; thus, resistance or weight training exercise is ideal for preventing osteoporosis.

You can combine weight training with cardiovascular exercises, such as biking, walking, treadmill, and elliptical. For those who have difficulty tolerating those exercises, pool activities can be helpful, given the water's low impact.

Other tips

• Limit alcohol use: Having more than two alcoholic beverages per day increases the risk of osteoporosis, so avoid excessive alcohol use.
• Limit alcohol use: Having more than two alcoholic beverages per day increases the risk of osteoporosis, so avoid excessive alcohol use.Avoid cigarette smoking: Researchers aren't entirely sure how cigarette smoking can lead to osteoporosis, but it has been shown to correlate with the development of the disease.
• Medications to help prevent osteoporosis: Most medications for osteoporosis exist for use after the diagnosis. An exception exists for postmenopausal women when doctors prescribe estrogen replacement hormones since they help decrease the risk of osteoporosis. Breast cancer can be a side effect of these hormones, so proceed with caution.
• Medications that cause osteoporosis: Certain medications can cause osteoporosis, such as corticosteroids and several anti-seizure medications. Please check with your physician or pharmacist.

Osteoporosis: Final thoughts

• Osteoporosis occurs when there is an imbalance in bone breaking down and new bone formation.
• Most cases of osteoporosis don’t present with any specific symptoms. There can be physical findings in advanced osteoporosis, with the most obvious being a stooped or hunched-over position, loss of height, and low back pain.
• The exact cause of why osteoporosis develops remains unknown.
• The best way to diagnose osteoporosis is a test that measures bone mineral density.
• Adequate intake of calcium, maintaining healthy levels of vitamin D, and an active lifestyle help much with osteoporosis prevention.