HOUSE CALL: Bone power: It's the key to staying young


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One of the most important things to keeping "youth" and independence is healthy, strong bones

Healthy bones support muscles and protect vital organs, enabling us to perform everyday tasks and enjoy other activities.

Vitamin D and calcium are crucial to good bone health. Women lose the most bone mass in the first five years after menopause due to estrogen loss. Men have less bone loss due to later age-related testosterone decline.

Nutrition throughout life is key to building (until about age 30) and maintaining a strong skeleton.

So many people are undernourished today when it comes to calcium and vitamin D, the two most important nutrients our bodies need to develop and maintain bone density.

To absorb calcium into our bones, we need vitamin D.

The average woman should intake about 1,200 to 1,500 mg of calcium daily and between 400 and 1,000 units of vitamin D, depending on one's current bone health. The average man should take in 1,000 mg calcium daily and the same vitamin D.

I've seen women with low bone density make major improvements by increasing their intake of vitamin D and calcium, along with exercise, avoiding the need to take medication.

While women need more calcium than men, men also should consider the adequacy of their diet and risk factors for early bone loss.

Spread the intake of supplements out over the course of the day, and drink lots of water.

Before adding supplements, you should discuss what and how much with your personal physician.

Beyond good nutrition, there are other ways to improve bone health. Cigarette smoking, caffeine and excessive alcohol use worsen bone health. Interestingly, more and more medications are being studied for their secondary effects on our bones.

Of note, thyroid overmedication, certain anti-seizure medications, chemotherapy, steroids, lithium and even the diuretic lasix can contribute to bone loss for a variety of reasons. Some preliminary evidence indicates that statins used for cholesterol may aid in bone strength.

Weight-bearing and weight resistance exercise is a major plus to enhance bone health.

Osteoporosis is a 'silent disease,' because no symptoms are evident until the bones have already become weakened. It is often not diagnosed until someone has experienced an unusual or non-traumatic fracture.

Who should get tested for low bone density? All women within one year of menopause, regardless of age, should have a baseline bone density test. Younger women with poor calcium intake, anorexia or a history of hyperthyroidism should be considered for testing. Men and women with other less common endocrine disorders such as hyperparathyroidism, or malabsorption syndromes such as celiac disease should also be tested.

For those who have been diagnosed with osteopenia (lower than normal bone density) or osteoporosis, there is nothing as good as the opportunity to build bones like we can before the age of 30, but there are increasing options for medication and supplement treatments, to prevent fracture risk, which should be discussed with your physician.

Dr. Judith Nations Dibble is a board-certified internal medicine physician on staff at Missouri Baptist Medical Center. For a physician referral call 314-996-LIFE.

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