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Reducing the Risk of Osteoporosis: What You May Not Know

I worked in healthcare for 25 years and spent nearly 8 years as my mother's caregiver. I hope to share tips that can help others.

What is Osteoporosis?

Osteoporosis is a condition in which the bones become more porous, brittle, and fragile. The result is that an individual's bones will break more easily, their mobility can become more limited, and they can lose height as well.

It's common knowledge that women, especially smaller women, are prone to this condition as they age. We know that after menopause, the risk of developing osteoporosis is much greater. However, because of what we already know about this condition, we sometimes make wrong assumptions, which can lead us to avoid making good choices when it comes to assuring good bone health and assessing our risk.

My mother and father both had severe osteoporosis, and I know that I have low bone mass (osteopenia). Therefore, I have spent some time discussing this topic with my physician and reading up on the facts that will allow me to do what I can to maintain my bone health. I would like to share a few bits of information that may be useful to others and may clear up some dangerous misconceptions or significant gaps in knowledge.

My Diagnosis with Osteopenia

Around the age of 40, I began taking a 600mg calcium supplement each morning, although I already consumed plenty of dairy products in my diet. I knew that my mother had been diagnosed with osteoporosis and it just seemed prudent to begin taking precautions. My friends told me I was being paranoid. After all, I was probably a decade away from menopause, and that's when they said I should begin to worry.

When I turned 50, I dutifully had a bone mineral density scan done as recommended by my physician—just a routine scan done for women at that age. The results showed that I had low bone mass (osteopenia) but not osteoporosis. I had not yet gone through menopause, but the signs that this was something that needed to be addressed were clearly there.

My physician ordered me to begin taking 1200mg of calcium supplements daily. I researched things a bit and then had a discussion with my doctor. Here is what I learned that I feel more people need to understand.

The Truth About Osteoporosis

Small, white and Asian women aren't the only ones who develop osteoporosis.

According to the National Osteoporosis Foundation, nearly 52 million people in the US have low bone mass or osteoporosis. That is 35 million women and over 17 million men. Studies show that African-American women experience osteoporosis at half the rate of Caucasian women, but that number is still significant. Certainly, osteoporosis in children is rare, but it can be caused by certain medical disorders and medications. For instance, people of any age group who are treated with corticosteroids run the risk of developing it.

Osteoporosis does not begin at menopause.

The process often begins during childhood when your bones are forming. Building good bones should begin in childhood and continue throughout your life. We reach peak bone mass in our 20's or 30's. Waiting until you are 40 or 50 years old is really too late to lay the foundation for good bone health. While it's true that the hormonal changes which occur at menopause are a factor in bone loss, waiting until that point to consider bone health would be unwise.

Osteoporosis can mean more than broken bones.

While most of us know that weakened bones due to osteoporosis can break more easily and that over time people can get shorter due to this process, there is more to the picture.

In severe cases, compression fractures can occur very easily in the spine. When not repaired, these fractures heal spontaneously but are collapsed. While height decreases, so does the space in the cavity where the lungs, stomach, and other organs reside. This means that over time it is possible for osteoporosis to have a negative effect on breathing, eating, and perhaps even bowel and bladder functions.

As we become older, balance and strength can decline, and falls are more likely to occur. With a bone-weakening disease like osteoporosis, a broken bone due to a fall is not uncommon. This can result in reduced mobility, disability, loss of quality of life, depression, and significant costs as well.

Your body needs more than calcium for strong bones.

Although taking calcium supplements is important for those who have been diagnosed with osteoporosis or are at risk, it's not enough. There is the question of how well your body absorbs the calcium that you get from supplements. Obviously, ingesting calcium and having your bones absorb it can be two different things.

There are different types of calcium supplements such as citrate, carbonate, and so forth. A discussion with a physician should help in choosing which is best for you as an individual. However, it is also important to assure your body will be able to absorb the supplement. To be absorbed, some types of supplements need to be taken on an empty stomach while others require they be taken with a meal, so that stomach acid is generated to help with absorption. If you want your treatment to be successful, it's important to know the specific instructions for your supplement. In general, calcium carbonate needs to be taken with food and calcium citrate does not.

The dosage of the supplement is also important. For instance, 1200mg is a common daily dosage but taking that entire quantity at one time isn't beneficial. Instead, breaking it into two or three doses over the course of a day is better as your 500–600mg is about all your body can make use of immediately. If it isn't absorbed, your body will merely excrete it. There are more recent studies which seem to indicate that including collagen chelate as a supplement can improve results over taking calcium alone.

Other nutrients matter too. Calcium is better used by the body when accompanied by vitamin D. Like calcium, our body's ability to absorb Vitamin D is reduced as we age. Thus, a good calcium supplement provides Vitamin D as well. Certainly, changes to our diet to increase calcium and vitamin D intake are also important. Other nutrients known to promote calcium absorption and better bone health are Vitamins E, C, K, magnesium, and boron.

There are things you do and things you consume that can block calcium absorption.

There are many things that can block the absorption of calcium. This is important to understand not only when taking supplements, but even in general as it blocks calcium consumed in your diet. Certainly, tobacco use, excessive caffeine, and alcohol consumption are known to block calcium uptake. If your risk of osteoporosis is high, it might be good to avoid these things as much as possible.

Phosphoric acid, sodium, and sugar are other reported problems. This is one reason why drinking a lot of soda and even fruit juice is discouraged. Some elements that block calcium are found in healthy foods and are even essential for overall health. Foods high in phytic acids (high-fiber whole grains such as wheat and bran, beans, nuts, seeds, spinach, celery, and so forth) or oxalic acid (spinach, collard greens, sweet potatoes, rhubarb, beans, etc.) shouldn't be consumed at the same time as a calcium supplement.

Iron and protein are other examples of calcium blockers. Clearly, eating foods that provide iron and protein are critical to bone and overall health but excess should be avoided and they might best be consumed separately from any calcium supplement. A balanced diet is critical, but timing can improve the chance that your body can better use the nutrients consumed.

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These Healthy Foods Block Calcium Absorption

Eat these foods in moderation and at separate times from taking calcium supplements.

Calcium Blocking ElementFound in:

phytic acid

high-fiber whole grains such as wheat and bran, beans, nuts, seeds, celery

oxalic acid

spinach, collard greens, sweet potatoes, rhubarb, beans

Much more than your diet can affect your bone health.

While your diet and any supplements you consume can affect your bone health, there are other critical things to consider. A sedentary lifestyle can be dangerous for those at risk for osteoporosis. Exercise is important but not just any exercise. While swimming is great for your cardiovascular system and perfect for those with arthritis, it isn't optimal for those with low bone mass or osteoporosis. These individuals need weight-bearing exercise and muscle strengthening exercise. These types of activities help limit both muscle and bone loss. Ideally, people should engage in such exercise for at least 30 minutes a day.

Exercise ideas for osteoporosis:

  • walking
  • dancing
  • weight lifting
  • resistance exercises
  • low impact aerobics
  • bicycling

Non-dietary risk factors of osteoporosis:

  • smoking
  • excessive alcohol or caffeine consumption
  • use of many antacids, GERD medications, or antidepressants
  • extreme or frequent dieting and eating disorders
  • chemotherapy, radiation therapy, and the use of corticosteroids

While some of these may be necessary in the face of other health challenges, a conversation with your physician to determine how to reduce the negative effects is warranted.

Increasing calcium intake through diet changes and oral supplements isn't the only treatment option.

If osteoporosis is diagnosed, there are other treatment options as detailed on the Mayo Clinic site. Certainly, there are patches that can be used as well as annual infusions such as Reclast. Hormone replacement therapy is sometimes useful too.

Compression fractures are a common result of severe osteoporosis and treatment via procedures such as balloon kyphoplasty can effectively reduce or eliminate pain and prevent collapse of the spine. (It's not within the scope of this article to discuss treatment options, but these links should help.)

Remember These Take Aways

Bone health is something that needs to be considered beginning in childhood.

Kids need to be active and eating a balanced diet, including plenty of calcium and Vitamin D. Sugary drinks should be avoided. This healthy lifestyle needs to follow a person throughout their life. The time to focus on bone health is before you are diagnosed with a problem.

Know your risk factors.

Know your family history and what other things contribute to this condition. Get tested if you find significant risk factors. Age is also a risk factor, so screening at 50 or older is certainly recommended. It is advisable that anyone who finds they have low bone mass or osteoporosis should research thoroughly what they can do to help improve their bone health. Many physicians will provide the diagnosis and perhaps prescribe a calcium supplement. Figuring out how to help assure that your supplement works well and that your bones benefit from it may be up to you or at least prompts you to question your physician further.

You can't change your DNA, but many other factors are under your control and should help in lessening the overall risks.

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2018 Ruth Coffee


Miebakagh Fiberesima from Port Harcourt, Rivers State, NIGERIA. on May 11, 2018:

@Pamela999: do you think only women have bones? Inactive young men can develop such problems. What about old persons? These are equally more prone to bone diseases.

The challenge is that we all should lead a very active lifestyle.

Stretching, exercise, jogging with good balance meal can help prevent or minimize osteoporosis and other bone diseases.

You are welcomed.

Pamela999 on May 11, 2018:

I am glad you wrote this article, so women will take this problem more seriously at a younger age. The suggestions you made were exactly what I have been taught. I have serious osteoporosis due to long term Prednisone use for treatment of lupus. I have been on a large number so treatments for this problem, and after two back surgeries that didn't heal very well, I concur that this is a serious problem.

My bone density showed osteopenia for a long time, when it should have shown osteoporosis.I could have been treated more aggressively sooner. Thanks for addressing this important topic.

Miebakagh Fiberesima from Port Harcourt, Rivers State, NIGERIA. on March 22, 2018:

Hi Ruth Coffee,

This is a very serious topic. I hope many will pay attention to it, and carry out the suggestions and exercises.

Not only so, but things will be increasely easy if parents, teachers, health authorities began to teach such subject to tenegers.

As you said, bone mass began to decrease as one ages. But it all begins from any bad chop plate. So, improving the nutrition content of a meal helps much.

Thank you fo rsharing.

Mary Wickison from USA on March 20, 2018:

This is something I am concerned with as my mother had it. I do think that it was partly due to lifestyle choices she made.

I don't take supplements but will ask my doctor about doing so.

Thanks for the information.

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