Osteoporosis Prevention

By Laura Noyes, PA

It can be tempting to think of our bones as static support structures, like the wooden frame of a house, but bones are actually very dynamic. Our bones are constantly breaking down and being rebuilt in a process called remodeling. This helps to keep our bones strong over time and allows our body to regulate calcium. The two main players in bone remodeling are cells called osteoclasts and osteoblasts. Osteoclasts breakdown old bone and release calcium, while osteoblasts deposit calcium in the form of new bone. When these two processes are balanced, bone density remains relatively stable.
Generally, we reach peak bone mass in our 20s. Everyone’s bone mass slowly decreases after, but menopause can result in a steep decline putting people at increased risk for life-altering fractures. This is because estrogen plays a role in suppressing osteoclasts (the bone breakdown cells). When estrogen decreases in menopause, osteoclasts become more active and outpace their bone-building counterparts.
Osteoporosis is a diagnosis of low bone mass that can either come from a dual x-ray absorptiometry (DEXA) screening scan or from certain types of fractures.

Luckily, there are steps we can take to prevent loss of bone mass and identify problems early. Here is your checklist for osteoporosis prevention:

  1. Engage in weight bearing exercise- The Bone Health and Osteoporosis Foundation recommends 30 minutes of walking on most days of the week with 2-3 days of resistance/weight training.
  2. Limit alcohol intake- Low risk alcohol use is fewer than 2 drinks per day for men and 1 drink per day for women. Alcohol consumption in your teens can negatively impact peak bone mass.
  3. Tobacco Cessation-tobacco both directly and indirectly lowers bone density by impacting several of the hormones that control bone remodeling. Smoking can also slow healing after a fracture.
  4. Consume adequate calcium and vitamin D- The recommended daily intake is 1,200 mg CA and 600-800 IU of vitamin D. Calcium can be found in dark leafy greens, dairy, sardines, and several other foods. One serving of dairy is usually about 300 mg of CA.
  5. Get screened-The United States Preventative Task Force recommends all postmenopausal individuals over 65 years of age get regular screening with a DEXA scan.