Why Does Bone Health Matter?

Our bones support us and allow us to move. They protect our brain, heart, and other organs from injury. Our bones also store minerals such as calcium and phosphorous, which help keep our bones strong, and release them into the body when we need them for other uses.

There are many things we can do to keep our bones healthy and strong. Eating foods rich in calcium and vitamin D, getting plenty of exercise, and having good health habits help keep our bones healthy.

But if we don’t eat right and don’t get enough of the right kinds of exercise, our bones can become weak and even break. Broken bones (called fractures) can be painful and sometimes need surgery to heal. They can also cause long-lasting health problems.

But the good news is that it is never too late to take care of your bones.

• What Is Osteoporosis?
• Who Gets Osteoporosis?
• Am I Really at Risk?
• How Do I Know if I Have Osteoporosis?
• What Can I Do to Make My Bones Healthier?
• Will I Need to Take Medicine for My Bones?
• How Can I Join a Research Study?
• Where Else Can I Go for Help?

Information Boxes

• Sources of Calcium
• Calcium Chart
• Vitamin D Chart

What Is Osteoporosis?

There are many kinds of bone diseases. The most common one is osteoporosis (AH-stee-oh-por-OH-sis). With osteoporosis, our bones become weak and are more likely to break. People with osteoporosis most often break bones in the wrist, spine, and hip.

Our bones are alive. Every day, our body breaks down old bone and puts new bone in its place. As we get older, our bones break down more bone than they put back. It is normal to lose some bone as we age. But, if we do not take steps to keep our bones healthy, we can lose too much bone and get osteoporosis.

Many people have weak bones and don’t even know it. That’s because bone loss often happens over a long period of time and doesn’t hurt. For many people, a broken bone is the first sign that they have osteoporosis.

People with osteoporosis most often break bones in the wrist, spine, and hip.

Who Gets Osteoporosis?

There are many things that can increase your chances of getting osteoporosis. These things are called “risk factors.” Some risk factors are things you can control, and some things are outside of your control.

Risk factors you can control

• Diet. Getting too little calcium can increase your chances of getting osteoporosis. Not getting enough vitamin D can also increase your risk for the disease. Vitamin D is important because it helps the body use the calcium in your diet.
• Physical activity. Not exercising and not being active for long periods of time can increase your chances of getting osteoporosis. Like muscles, bones become stronger–and stay stronger–with regular exercise.
• Body weight. Being too thin makes you more likely to get osteoporosis.
• Smoking. Smoking cigarettes can keep your body from using the calcium in your diet. Also, women who smoke go through menopause earlier than those who don’t smoke. These things can increase your risk for osteoporosis.
• Alcohol. People who drink a lot are more likely to get osteoporosis.
• Medicines. Certain medicines can cause bone loss. These include a type of medicine called glucocorticoids (gloo-ko-KOR-ti-koids). Glucocortiocoids are given to people who have arthritis, asthma, and many other diseases. Some other medicines that prevent seizures and that treat endometriosis (en-do-me-tree-O-sis), a disease of the uterus, and cancer can cause bone loss, too.

Risk factors you cannot control

• Age. Your chances of getting osteoporosis increase as you get older.
• Gender. You have a greater chance of getting osteoporosis if you are a woman. Women have smaller bones than men and lose bone faster than men do because of hormone changes that happen after menopause.
• Ethnicity. White women and Asian women are most likely to get osteoporosis. Hispanic women and African American women are also at risk, but less so.
• Family history. Having a close family member who has osteoporosis or has broken a bone may also increase your risk.

Am I Really at Risk?

Because more women get osteoporosis than men, many men think they are not at risk for the disease. Many Hispanic and African American women are not concerned about their bones either. They believe that osteoporosis is only a problem for white women. However, it is a real risk for older men and women from all backgrounds.

Also, people from certain ethnic backgrounds may be more likely to have other health problems that increase their risk for bone loss. If you have one of the following health problems, talk to your doctor about your bone health:

• Alcoholism
• Anorexia nervosa
• Asthma/allergies
• Cancer
• Cushing’s disease
• Diabetes
• Hyperparathyroidism
• Hyperthyroidism
• Inflammatory bowel disease
• Lactose intolerance
• Lupus
• Liver or kidney disease
• Lung disease
• Multiple sclerosis
• Rheumatoid arthritis

How Do I Know if I Have Osteoporosis?

Since osteoporosis does not have any symptoms until a bone breaks, it is important to talk to your doctor about your bone health. If your doctor feels that you are at risk for osteoporosis, he or she may order a bone density test. A bone density test measures how strong–or dense–your bones are and whether you have osteoporosis. It can also tell you what your chances are of breaking a bone. Bone density tests are quick, safe, and painless.

What Can I Do to Make My Bones Healthier?

It is never too early or too late to take care of your bones. The following steps can help you improve your bone health:

• Eat a well-balanced diet rich in calcium and vitamin D. Good sources of calcium include low-fat dairy products, and foods and drinks with added calcium. Good sources of vitamin D include egg yolks, saltwater fish, liver, and milk with vitamin D. Vitamin D is also made by the skin when people are in the sun, but not all people can get enough vitamin D this way. Some people may need to take nutritional supplements in order to get enough calcium and vitamin D. The charts below show how much calcium and vitamin D you need each day. Fruits and vegetables also contribute other nutrients that are important for bone health.

Sources of Calcium:

• Tofu (calcium fortified)
• Soy milk (calcium fortified)
• Green leafy vegetables (e.g., broccoli, brussels sprouts, mustard greens, kale)
• Chinese cabbage or bok choy
• Beans/legumes
• Tortillas
• Sardines/salmon with edible bones
• Shrimp
• Orange juice (calcium fortified)
• Pizza
• Bread
• Nuts/almonds
• Dairy products (e.g., milk, cheese, yogurt)

Calcium Chart

Your Age	How Much Calcium You Need Each Day
0 to 6 months	210 mg
7 to 12 months	270 mg
1 to 3 years	500 mg
4 to 8 years	800 mg
9 to 18 years	1,300 mg
19 to 50 years	1,000 mg
Over 50 years	1,200 mg

Vitamin D Chart

Your Age	How Much Vitamin D You Need Each Day
0 to 50 years	200 IU
51 to 70 years	400 IU
Over 70 years	600 IU

• Get plenty of physical activity. Like muscles, bones become stronger with exercise. The best exercises for healthy bones are strength-building and weight-bearing, like walking, climbing stairs, lifting weights, and dancing. Try to get 30 minutes of exercise each day.
• Live a healthy lifestyle. Don’t smoke, and, if you choose to drink alcohol, don’t drink too much.
• Talk to your doctor about your bone health. Go over your risk factors with your doctor and ask if you should get a bone density test. If you need it, your doctor can order medicine to help prevent bone loss and reduce your chances of breaking a bone.
• Prevent falls. Falling down can cause a bone to break, especially in someone with osteoporosis. But most falls can be prevented. Check your home for dangers like loose rugs and poor lighting. Have your vision checked. Increase your balance and strength by walking every day and taking classes like Tai Chi, yoga, or dancing.

Will I Need to Take Medicine for My Bones?

There are medicines to help prevent and treat osteoporosis. Your doctor may want you to take medicine if your bone density test shows that your bones are weak and that you have a good chance of breaking a bone in the future. Your doctor is more likely to order medicine if you have other health concerns that increase your risk for breaking a bone, such as a tendency to fall or a low body weight.

How Can I Join a Research Study?

The National Institutes of Health (NIH) conducts research studies all over the country in which people take part as volunteers. These studies help uncover new risk factors and treatments for osteoporosis and other diseases.

There are many benefits to being part of a research study, such as getting related medical care at no charge and, in some cases, help with travel and other costs. Also, study volunteers are seen by a team of experts and are often among the first to receive new treatments ahead of the general public. Many volunteers take part in the research simply because they want to help others with the same disease, both today and in the future.

You can learn more about joining an osteoporosis research study by going to the Web site www.ClinicalTrials.gov.

12 Steps to Boost Your Health for Life

1. Drink more water: There is no right amount of water to drink, but generally the bigger and more active you are, the more you should drink. By increasing the amount of water you drink you can significantly reduce cravings, aches and pains and increase your energy.

2. Practice cooking: You might hate me for saying this, but cooking is a fundamental step to healthier living. By making your own meals you know what's going into them. Meals don't need to take hours to prepare and involve multiple ingredients. Here are some simple recipes to get you started.

3. Increase whole grains: Trust me it's not these types of carbohydrates that have led to the obesity epidemic, but rather the processed goods like doughnuts. Whole grains are some of the best sources of nutritional support and provide long-lasting energy.

4. Increase sweet vegetables: People forget that these exist and they are the perfect medicine for the sweet tooth. Instead of depending on processed sugar, you can add more naturally sweet flavors to your diet and dramatically reduce sweet cravings. This is a great sweet vegetable recipe.

5. Increase leafy green vegetables: These are seriously lacking in the American diet and they are most essential for creating long lasting health. More specifically they help eliminate depression, improve liver, gallbladder and kidney function.

6. Experiment with protein: The majority of Americans eat way too much protein and mostly in the form of animal meat. Try other forms like beans or soy.

7. Eat less meat, dairy, sugar and processed foods: consume less coffee, alcohol and tobacco: Did you notice how I said eat less instead of don't eat? If I told you not to drink coffee or chocolate you would want it all the more. By increasing your whole grains, vegetables and water you will naturally crowd out the more processed items.

8. Develop easy self-care habits: People get so wrapped up in their busy lives that they forget to take care of themselves. This can be something as simple as a relaxing bath and as nice as a day at the spa.

9. Have healthy relationships: I call love the ultimate superfood. A loving, supportive relationship can nourish your soul. What's more is when you feel love and happiness you are more likely to eat better. Reach out to that one person who makes you feel loved and nourished.

10. Find physical activity: You don't need to spend hours at the gym. What gets you moving?

11. Find work you love or a way to love the work you have: So many of us spend 8 hours a day in a job that is unfulfilling and end up stressed out which leads to a slew of health problems. Ask yourself if your job is aligned with your values.

12. Develop a spiritual practice: Some people freak out when I tell them this, but it's really about connecting with yourself. You don't need to start going to church or praying every day. Maybe being spiritual means taking a walk in nature. Finding a spiritual practice can help you slow down and appreciate the non-material things in life.