For those of us over 50, now is the time to step up our knowledge of bone health if we want to continue living active lifestyles and prevent osteoporosis. That truth bomb struck me like a sledgehammer when a routine bone density test came back with a diagnosis of osteopenia, or below-normal bone density.
I’ve been athletic nearly all my life and have incorporated resistance training for years. I was shocked my numbers weren’t stellar, until my physician reminded me that I’m a post-menopausal woman over 50 and that I shouldn’t expect to have the bone density of a 20-year-old. That’s normal aging. My grandmother had osteoporosis, which is also a risk factor.
Silent & Stealthy
According to the National Osteoporosis Foundation (NOF), about 10 million Americans have osteoporosis, often called the silent disease, and 44 million have low bone density. It’s “silent” because you really don’t know you have it until you break a bone. There are no other symptoms.
Perhaps more startling is that half of all adults in the U.S. age 50 and older are at risk of breaking a bone or should be concerned about bone health. In fact, 50 percent of all women and 25 percent of all men will break a bone in their lifetimes due to osteoporosis.
Susan Randall, RN, MSN, FNP-BC and NOF Senior Clinical Advisor, explains it this way: “Osteoporosis is silent because the damage from the disease is inside the bone, and you don’t feel anything changing or happening until a fracture occurs. We want people to be aware of these early signs, so that we can get them identified and started on a treatment program.”
Take Proactive Steps
Randall, a fellow Baby Boomer, understands better than most the importance of taking proactive steps now to minimize the impact osteoporosis may have on healthcare in the future. It’s estimated that 40 million new Medicare-age patients will flood the healthcare system by 2050, largely due to aging Boomers. This surge is often referred to as the ‘silver tsunami.’
“The silver tsunami is really worrisome for the NOF because we know the Baby Boom generation is going to have a huge impact on the healthcare system, yet people don’t want to think about their bone health.” For those 50 and older, osteoporosis is the underlying cause of fractures for the majority of people, Randall says.
When it comes to bone density, it’s important to understand the nuances of a fracture risk. Randall draws an analogy between a cow bone and a chicken bone. Cow bones are much denser and tough to break with your hands; whereas, chicken bones can be snapped without much effort. “We’re trying to prevent fractures and keep the bones strong to be able to resist fractures,” she explains.
Women at Higher Risk
Post-menopausal women are among the highest at-risk groups for osteoporosis because hormones play a supporting role when it comes to bone density.
“Not all these mechanisms are completely understood, but what we do know is that that in the first several years after the onset of menopause, a healthy woman can lose 5% to 20% of bone mass – just because of the decline in estrogen,” Randall says. If you go into menopause with a history of health issues, the risk for osteoporosis is even higher.
Randall paints a picture of an active 50+ woman rollerblading who falls and breaks her wrist. When she recovers from the fracture, she quickly resumes her active lifestyle. Months or years later, the same woman experiences back pain from working the garden and thinks she just overdid it. Then comes the pooch in the tummy that she attributes to aging. And when the kids come to visit, they say mom looks like she’s getting shorter.
“The reason for the back pain, the tummy and loss of height is that she has had some broken bones in her spine,” Randall says. “For some people, it can cause very acute pain; but for others, it can be silent.”
She tells this story to advocate for monitoring yearly changes in height. If you experience 1.5 inches or more in height loss, osteoporosis may be the culprit. “The bones in the spine start to crumble with osteoporosis and causes forward flexing and bending, which affects your height and posture,” Randall says
So what should 50+ people to do to prevent osteoporosis? Here are 5 ways to reduce your risk.
1. Eat a healthy diet and exercise regularly.
This helps slow or stop bone loss and minimize fracture risk. Just like muscles, bones become more strong and healthy with exercise and proper diet.
“We know that not moving, being inactive, is a serious risk factor,” Randall emphasizes. “Everyone needs to exercise for everything that goes on in life and to retain mobility.
Weight-bearing exercise can help prevent osteoporosis because it stimulates the bone cells to function. Combining weight-bearing exercise with flexibility and balance exercise is also important. “If you’re lifting weights, you can add muscle. But you can’t grow new bone,” Randall says. “The goal of exercise is to maintain function and improve balance and flexibility so we can protect from fractures.”
Weight-bearing exercise can be fun and includes everything from running to dancing and aerobics to HIIT training. Randall points out that walking, while good, is not strenuous enough to stimulate bone cells.
2. Supplement with calcium and vitamin D, if necessary.
Getting enough vitamin D and calcium from sunlight and food can be a challenge, so a lot of people supplement to reach the recommended daily allowance.
“Everyone needs calcium and vitamin D in their diets,” Randall says. Vitamin D comes primarily from exposure to sun, but sunscreens (which are recommended for skin cancer prevention) block Vitamin D absorption. It’s also difficult to get enough vitamin D from diet, unless you consume large amounts of fatty fish, sardines and egg yolks, to name a few sources.
With calcium supplementation, Randall recommends getting it through diet first, and then supplementing. “You can definitely get enough calcium from your diet if you eat dairy foods,” Randall says. “For non-dairy eaters, they may have issues getting enough from nutrition and need to supplement.”
The NOF recommends 1,000 mg of calcium and 400-800 IU of vitamin D for women under 50. For women 50 and older, get 1,200 mg of calcium and 800-1,000 IU of vitamin D. For men under 50, 1,000 mg of calcium and 400-800 IU of vitamin D. Men 50-70 should get 1,000 mg of calcium and 800-1,000 IU of vitamin D. And men 71+ should get 1,200 mg of calcium and 800-1,000 IU of vitamin D.
3. Don’t smoke.
“Smoking kills all kinds of cells in your body, including bone cells. No matter how old you are or what stage of life, smoking is bad,” Randall says.
4. Ask your doctor about a bone density test if you’re in one of the at-risk groups.
“If you’re age 50 or older and you get a fracture, insist on a bone density test to determine if you have osteoporosis,” Randall recommends.
- Women 65+
- Men 70+
- You break a bone after 50
- Menopausal/post-menopausal women under 65 with risk factors
- Men 50-69 with risk factors
5. Consider osteoporosis medication when it’s right for you.
This is a discussion you should have with your physician if have been diagnosed with osteoporosis.
Randall set me straight on my osteopenia diagnosis and assured there are proactive steps to minimize my risk of developing full-blown osteoporosis.
“Osteopenia is not a disease, but rather a risk factor for osteoporosis and fractures. I look at osteopenia as a wake-up call.” Armed with test results and this knowledge, I’m confident my continuing commitment to fitness and nutrition will keep me on the right path.
For more information about osteoporosis, osteopenia and related risks, visit the NOF website at www.nof.org.