Let’s talk about osteoporosis: 

Osteoporosis is a medical condition characterized by weakened bones that become more brittle and prone to fractures. It occurs when the body loses too much bone mass or does not produce enough new bone tissue. This imbalance leads to weakened bones that are more susceptible to breaking with simple movements such as bending, coughing or minor falls.  

 

What are the risk factors? 

Aging, hormonal changes in both men and women, inadequate calcium and Vitamin D intake, sedentary lifestyle and certain medical conditions or medications such as steroids.  

 

What can you do to help prevent osteoporosis? 

The most impactful is proper diet. Eating foods high in calcium including dairy products, leafy greens, almonds, and fortified foods helps maintain bone density and reduce fracture risk particularly when combined with vitamin supplementation. There is a growing amount of evidence pointing to the gut biome as being an integral factor in preventing or helping treat osteoporosis. Something as simple as taking a probiotic can help stave off osteoporosis.  

Some other dietary considerations and their impacts are:  

  • Vitamin D: Vitamin D enhances calcium absorption in the gut and supports bone remodeling. Foods such as fatty fish and fortified milk are good sources of vitamin D. Vitamin D is a fat-soluble vitamin, so you’ll want to get a blood level prior to starting supplementation so you don’t take too much.  
  • Protein: adequate protein intake supports bone matrix formation. Too much protein intake may increase calcium excretion so balance is key.  
  • Magnesium and phosphorus support bone structure and strength.  
  • Vitamin K helps bind calcium to the bone matrix. 
  • Omega -3 Fatty acids may help reduce bone loss and inflammation.  

 Exercise: 

Weight bearing exercise stimulates bone formation and bone mineral density. Resistance training supports and strengthens bones. Proper strength also helps with balance decreasing fall risk. Flexibility and balance exercises such as tai chi and yoga help reduce fall risk by improving balance and coordination. This is where physical therapy can help by learning proper exercises to strengthen your muscles and bone while avoiding vulnerable bone positions. Physical therapy can also teach you how to perform lifting maneuvers and ADL with minimal risk to your bone health.  

 Lifestyle choices: 

  • Avoid smoking! Smoking impairs calcium absorption and decrease estrogen levels in women, which accelerates bone loss. Research shows smokers have a significantly lower BMD (bone mineral density).  
  • Moderate alcohol consumption. For woman 1 drink/day, men 2 drinks/day. Research shows decreased BMD with an increase in alcohol consumption.  
  • High sodium increases calcium loss through the urine so try to limit processed foods 
  • Caffeine (high amounts>3 cups of coffee/day may interfere with calcium absorption.  

Long Term Impact: 

While lifestyle interventions may not entirely prevent osteoporosis in individuals with genetic predispositions or severe risk factors, they significantly delay its onset and reduce fracture risk, improving overall quality of life.  

Does having a normal BMD mean I should not be concerned? The downside of the test.  

  • Not necessarily. BMD doesn’t assess bone quality such as microdamage accumulation, bone architecture, bone turnover rates. Bottom line, a bone may have a high BMD but poor quality so could still be fragile.  
  • Limited ability to predict fracture risk. Other factors influence fracture risk including age, falls and balance issues, muscle strength.  
  • Does not provide information about dynamic bone processes such as bone formation and resorption rates.  
  • Generally, only 1 or 2 areas are screened. Osteoporosis may affect certain areas more severely than others, leading to under or over estimation of patient’s condition or severity of condition.  
  • Factors such as degenerative changes or vascular calcifications can artificially elevate BMD measurements. 

Additional tools for evaluation:  

Frax Score: estimates 10-year fracture risk. Looks at age, family history, smoking and prior fractures in addition to BMD. 

Blood and urine tests that measure turnover rate of bones. Examples of blood markers are C-telopeptide (CTX) and procollagen type 1 N-propeptide (P1NP). These generally are not ordered routinely and are performed in specialty centers, generally not by the PCP.  They can be used to determine how successful treatment is. An example of urine test markers is NTX.  

The take home message:

  • You can significantly help your bone health with diet and exercise, and we are here to help!

If you have osteoporosis or osteopenia, we have a comprehensive osteoporosis class, led by our very own Michele Morris PT. She will guide you in safe ways to work on your strength and bone health.  Follow the link to reserve your spot, your bones will thank you!: osteoporosis-class-signup 

 

 

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