7 Tips for Healthy Bones

Take these steps to halt the thinning of your bones as you age.

As we age, our bones become thinner and lose their density. But there are steps we can take to halt the “thinning” of our bones, called osteopenia, and prevent osteoporosis. Follow these tips from Cleveland Clinic experts:

1. Eat calcium-rich foods. Besides dairy products, choose fish with bones (such as salmon, sardines or whitebait), and serve them with a side of dark leafy green vegetables or broccoli. Fortified tofu and soy milk are other calcium-rich choices, says registered dietitian Laura Jeffers, MEd, RD, LD. For a calcium boost, snack on almonds or dried figs.
2. Take calcium supplements. The U.S. recommended daily allowance for calcium is 1,000 mg a day during our 20s, 30s and 40s. But our need for calcium rises as we age. Check with your doctor before starting supplements about the amount that’s right for you. After menopause, women need 1,000 to 1,500 mg a day unless they take hormone therapy. Your body only absorbs 500 mg of calcium at a time, notes Ms. Jeffers. So spread the calcium you consume over the course of the day for the greatest benefit, and take calcium with meals to maximize absorption. You can also check an online calcium calculator to see how much calcium you are already getting in your diet. “This will help guide how much you should take in supplements,” says Andrea Sikon, MD, Chair of Internal Medicine and on staff in the Center for Specialized Women’s Health. “Remember, many other vitamins, including multivitamins, also have calcium already in them.”
3. Add some D to your day. To help absorb calcium, most adults need 1,000 to 2,000 IU of vitamin D daily, says Dr. Sikon. Combined calcium-vitamin D pills usually do not contain enough D to meet this requirement. “Vitamin D deficiency is far more common than previously thought, and affects everyone, young and old,” she notes. This is especially true in any region north of Atlanta. Due to the risks of skin cancer and the difficulty in getting vitamin D from the sun, it is best to take a vitamin D supplement to ensure you are meeting your daily needs.
4. Start weight-bearing exercises. For bone strength and new bone cell formation, try strength training plus exercises that “load” or compress your bones, says exercise physiologist Heather Nettle, MA. “Running, jogging, high-impact aerobics, repetitive stair climbing, dancing, tennis and basketball are best for building bones. But if you have osteopenia, osteoporosis or arthritis, try walking or using an elliptical trainer or stair stepper,” she says. (Clear any exercise plans with your doctor first.)
5. Avoid smoking and drinking to excess. Loss of bone mineral density is associated with tobacco use and excessive alcohol intake, says Dr. Sikon. If you smoke, look into a smoking cessation program, and if you drink, stick to no more than one mojito or glass of wine or beer a day, she advises.
6. Get your bone mineral density tested. Doctors can get a quick and painless “snapshot” of bone health using a simple X-ray test called DXA. This test measures bone mineral density (BMD) and helps determine risks of osteoporosis and fracture. “Most women lose bone at an accelerated rate for four to seven years after menopause, so they may wish to start BMD testing within two years of menopause,” says Dr. Sikon. Younger women who skip periods or suffer unexplained broken bones/fractures should start testing sooner. Earlier BMD tests are recommended for men and women with certain diseases and for those taking medications that increase risk, such as long-term steroid therapy. Anyone who has broken a bone from a fall from a standing height should be evaluated for osteoporosis. “This is not normal — if you fall, you should not break anything,” she adds.
7. If necessary, consider medication. Perimenopausal women at high risk of osteoporosis may consider hormone therapy to boost the waning estrogen levels linked to bone loss. Women and men diagnosed with osteopenia or osteoporosis can take various medications to prevent dangerous hip and spine fractures. Bisphosphonates prevent further bone loss and are taken by mouth once a week or once a month or, if side effects occur, once a year by IV infusion. Teriparatide, a medication similar to a natural human hormone, rebuilds bone when given by daily injection but can be taken safely for just two years. The newest medication for osteoporosis is called denusomab. It is given via a shot every six months. “None of these medications works without calcium and vitamin D as building blocks,” cautions Dr. Sikon.

To see Dr. Sikon or other physicians in Cleveland Clinic’s Center for Specialized Women’s Health, call 216.444.4HER.

For more information on osteoporosis, download the Free Osteoporosis Treatment Guide.