Bone Up on Bone Health

Growing up, a broken bone—suffered during a sport or a daredevil act like jumping off a roof—was likely to produce bragging rights, along with a nice collection of autographs on the cast.

After age 60, fractures could mean hospitalization and a long recovery.  “A fracture can be a life altering event,” says Andrea Singer, MD, chief medical officer at the Bone Health and Osteoporosis Foundation (formerly the National Osteoporosis Foundation) and director of the division of women’s primary care at MedStar Georgetown University Hospital, Washington. “It can impair mobility and lead to a lack of independence.” Singer also directs MedStar’s bone densitometry and fracture liaison service, and often encounters myths and misconceptions from patients about bone health.

Bone Health Myths

• Myth: Women–but not men–get osteoporosis, the condition of thinning, brittle bones that ups the risk for fractures. “It’s more common in women,” Singer says. But men can, and do, get it, too. She finds men often lag behind women by about a decade in getting it. According to the CDC,1 in 5 women aged 50 and above and 1 in 20 men 50 and older in the U.S. have osteoporosis, and a fracture is often their first clue.
• Myth: It affects mostly white women. While white women and Asian women have higher risk than Black or Hispanic women, and white men are at higher risk than Black or Hispanic men, no one is  And thinking that way might result in skipping screenings or other measures to keep bones healthy, Singer warns.

Keeping Tabs on Bone Health

Numerous organizations have issued guidelines about screening bone density.  The U.S. Preventive Services Task Force guidelines recommend bone measurements in women at age 65 or under 65 if there is an increased risk for osteoporosis. It does not recommend screening men, citing insufficient evidence of benefit.

However, Singer says, many other organizations, including the Bone Health and Osteoporosis Foundation, recommend differently. It recommends women begin screening at age 65, men at age 70, but younger if risk factors (such as family history, fracture since age 50, smoking or vitamin D deficiency) are present.

The bone density test produces a score, and that guides the treatment plan, which might include dietary and lifestyle advice and medication.

If treatment with medication for osteoporosis (meant to build new bone or slow the breakdown of bone) is recommended, many people balk at the idea, frightened because they’re heard of a rare side effect with osteoporosis medicines known as bisphosphonates (usually the first choice of treatment) causing a break in the thighbone or bone death in the jaw. According to Mayo Clinic, those fractures, though rare, do occur; but many other medication options that work as well, or better, are available. The risk of developing these problems increase the longer bisphosphonates are taken, so your doctor might suggest a drug holiday—stopping the medication for a while.

Singer talks to patients about not only the benefits and risks of osteoporosis medication, but the risk of underlying disease and fracture risk and how the medication can help prevent those fractures.

A Bone Healthy Lifestyle

Paying attention to lifestyle helps bone health, too. “Calcium and vitamin D are important, they’re the building blocks for bones,” Singer says. According to the National Institutes of Health, adults age 19 to 50 need 1,000 milligrams a day of calcium (from food and supplements),  men 51 to 70, 1,000 mg, women 51-70 1,200, and men 71 and older 1,200.

Because some research has linked too much calcium intake with heart disease, the NIH recommends an upper limit of 2,500 milligrams for adults ages 19 to 50 and 2,000 for those 51 and older.  A cup of spinach has 245 mg of calcium; 8 ounces of nonfat Greek yogurt, 250 mg, 8 oz of plain nonfat yogurt, 488 mg.

The NIH recommends adults 19 to 70 years get 600 IUs of Vitamin D, while those 71 and older get 800 IUs; it says the upper limit is 4,000 IUs. However, not all agree on the daily recommendation. The Endocrine Society  suggests an intake of 1,500 to 2,000 IUs a day of Vitamin D for adults may be needed for those at risk for a vitamin D deficiency.

For bone health, weight training or resistance training help build muscles, which build strong bones.

Want to amp up your bone health?  Check out Senior Planet’s Health and Fitness classes (list is here) and get inspired by Senior Planet Sponsored Athletes like Tom  Simek.)

YOUR TURN

Do you take bone-strengthening medications? How are they working for you? Share your thoughts in the comments!

Kathleen Doheny is a Los Angeles-based independent journalist, specializing in health, behavior, fitness and lifestyle stories. Besides writing for Senior Planet, she reports for WebMD, Medscape, MedCentral and other sites.  She is a mom, mother-in-law and proud and happy Mimi who likes to hike, jog and shop.
Doheny photo: Shaun Newton

This article offered by Senior Planet and Older Adults Technology Services is for informational purposes only and is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding any medical condition. If you think you may have a medical emergency call 911 immediately.