Throughout life, we can reduce our risk of developing osteoporosis. It takes a combination of diet, exercise, appropriate treatments ... and commitment.

Nutritional Needs – Calcium and Vitamin D

Kids aren't the only ones who need calcium. At every age, our body needs calcium to keep bones strong. The preferred source of calcium is food. Most American women, however, have a calcium-deficient diet (averaging only 600 - 800 mg of calcium daily), making a change in diet or calcium supplement advisable.

There are three common forms of calcium supplements: calcium citrate, calcium carbonate and calcium lactate. Calcium carbonate and calcium citrate are absorbed most readily by our body. Calcium citrate doesn't need stomach acid to be absorbed. Calcium supplements are better absorbed with meals. Calcium supplements are especially helpful to women who cannot tolerate dairy products. But, taking more calcium than we need (more than 2,500 mg daily) can be harmful.

Our body also needs Vitamin D to help absorb calcium and, thereby, make the calcium more beneficial to our bones. Too much supplemental Vitamin D, however, can be harmful. Vitamin D is a fat soluble vitamin which gets stored in body fat. We should not exceed recommended daily levels.

Treatments

Estrogen replacement therapy (ERT) replaces or supplements our body's falling level of estrogen. ERT (pill or patch) is shown to reduce bone loss, increase bone density in both the spine and hip and reduce the risk of hip and spinal fractures. Recent studies show that estrogen can reduce the risk of fractures by about 50%. It can even help prevent fractures in women with established osteoporosis. There are several kinds and doses of ERT that are FDA-approved specifically for osteoporosis prevention and treatment. To get the full benefits of estrogen for our bones, experts recommend it be taken continually. Even if we're taking estrogen, we still need to get our appropriate amount of calcium.

It is important to remember that estrogen is associated with certain potential health risks, and there are medical reasons why some women should not take it. The decision to start any therapy should be made after discussing the risks and benefits with your physician, taking into account your medical history, current health and future risks and concerns.

Bisphosphonates work by slowing down the activity of cells that remove old bone, thus allowing the cells that build bone to dominate the "old bone loss/new bone growth" process that constantly goes on inside our body. Bisphosphonates increase bone density and decrease the risk of fracture at both the hip and spine.

Selective Estrogen Receptor Modulators (SERMS) are compounds which have estrogen-like effects on some parts of the body. SERMS can slow bone loss, increase bone density and decrease the risk of fracture at the spine.

Calcitonin is a drug delivered by nasal spray or injection. A few studies show that in women who are at least five years postmenopausal, it can slow bone loss, increase spinal bone density and may relieve the pain of bone fractures.

Weight-bearing exercise (walking, jogging, lifting weights) can help maintain bone mass. It is never too late to start.

Weight-Bearing Exercise

Like muscle, bone is living tissue and responds to exercise by becoming stronger. Inactivity makes bones lose strength and become more fragile, increasing the risk of fracture. Thirty to 60 minutes of weight-bearing exercise three times a week can help maintain bone and prevent loss. Weight-bearing exercise means forcing our bones and muscles to work against gravity. Examples include walking, jogging, playing tennis, climbing steps, dancing, taking aerobics classes, gardening and lifting weights. Swimming and bicycling are not weight-bearing but are nevertheless helpful because of their positive effects on fitness. Recent studies indicate that women who walk as little as one mile a day show significantly less bone loss than non-walkers, especially in their legs and torso. The best advice is to make weight-bearing exercise part of our everyday life. Start a walking club and make exercise a time to socialize. Purchase a pair of hand weights and do simple exercises at home while watching TV. Once we start an exercise program, however, we should stick with it to maximize the effects on our bones. Check with your doctor before starting any exercise program.

Note: If you're lactose intolerant, try to get your daily intake of calcium from soybeans, tofu, broccoli, turnips, spinach, almonds, lactose-free/calcium- fortified foods and juices. Use calcium supplements if you cannot get enough calcium from food.

*Calcium levels may vary depending on brand and size.

VITAMIN D

• Milk (fortified in the U. S. with Vitamin D)
• Egg Yolks
• Saltwater Fish
• Liver
• Sunshine (about 15 minutes/daily)