Maintaining strong bones as you age can reduce the risk for osteoporosis and related complications, such as painful vertebral compression fractures in the spine. Try these some tips to improve your bone health and protect your body.
Bone conditions, such as osteopenia and osteoporosis, affect the health of your bones by making them weaker.
How often do you think about bone health? It can be easy to forget about keeping your bones healthy, but good bone health contributes to good overall health. Fortunately, it’s easy to keep your bones healthy, and there are several things you can do to improve your bone health. Here are a few things that you can start doing to improve your bone health today.
Bone mineral density is a measure of how dense your bones are. Bone density tells us how strong your bones are. Osteopenia is a condition in which your bone mineral density is lower than normal. Some people with osteopenia can protect their bone health by changing their lifestyle habits, following a healthy diet, and sometimes taking medications, if needed. Having osteopenia can sometimes lead to osteoporosis. Osteoporosis is a disease in which your bones become weak and more likely to fracture (break).
How to Improve Your Bone Health
Go For A Walk Or Jog
The pace and frequency of your walks or jogs are up to you. Your doctor or certified personal trainer can help you decide what is appropriate. Typically, 20 to 30 minutes, 3 to 4 times a week is recommended.
Lifestyle Changes
You can make changes in your lifestyle in order to reduce your risk of osteoporosis and its effects.
- If you smoke or use tobacco products, try to quit. If you need help quitting, contact the Memorial Sloan Kettering (MSK) Tobacco Treatment Program at 212-610-0507.
- Limit your intake of alcohol. Don’t have more than 2 drinks a day if you’re a woman and 3 drinks a day if you’re a man.
- Exercise regularly. For more information, read the “Exercise for Strong Bones” section in this resource.
- Your doctor may recommend exercises to strengthen your bones and muscles. These may be weight-bearing exercises that help increase bone density, such as walking, jogging, running.
- Strengthening exercises such as lifting small weights, or strengthening the muscles in your lower back and abdomen (belly) can also be helpful.
- Balance exercises, such as yoga or Pilates, can also improve your strength and flexibility.
- Always talk with your doctor before starting a new exercise routine. If you have trouble establishing an exercise routine, talk with your doctor about whether physical therapy (PT) is right for you.
- Make sure you have enough calcium and vitamin D in your diet.
- Most adults need 1,300 milligrams (mg) of calcium every day. Your doctor or clinical dietitian nutritionist can tell you how much calcium is right for you. The best way to get calcium is through food (see the table “Foods Rich in Calcium”).
- If you don’t get enough calcium from your diet, you may need to take a calcium supplement. Calcium supplements come in different forms, including calcium carbonate and calcium citrate.
- Your body also needs vitamin D to absorb and use calcium. Most adults with osteopenia or osteoporosis need at least 800 international units (IU) of vitamin D daily, but how much vitamin D you need may be different. Your doctor or clinical dietitian nutritionist can tell you how much vitamin D is right for you. Although the main source of vitamin D is the sun, you can also get it from food (see the table “Foods Containing Vitamin D”). Your healthcare provider can check your vitamin D levels with a simple blood test.
- If you’re not getting enough vitamin D, you may need to take a vitamin D supplement. You can buy vitamin D supplements at your pharmacy without a prescription.
- If you have low levels of vitamin D, your doctor may recommend that you take prescription supplements with higher amounts of vitamin D. This can bring your levels up to normal.
- Most adults need 1,300 milligrams (mg) of calcium every day. Your doctor or clinical dietitian nutritionist can tell you how much calcium is right for you. The best way to get calcium is through food (see the table “Foods Rich in Calcium”).
- Talk with your doctor about medications and hormone therapy treatments.
- There are prescription medications available to help prevent and treat osteoporosis. Your doctor will discuss your options with you and prescribe the one that best meets your needs. They will go over any specific instructions for taking your medication.
- Medications and hormones that treat osteoporosis include:
- Oral medications, such as risedronate (Actonel®) and alendronate (Fosamax®), that you take by mouth.
- Injectable medications, such as denosumab (Prolia®) or romozusomab (Evenity™), that you get as a shot.
- Intravenous (IV) medication, such as zoledronic acid (Reclast®), that you get into your vein in your arm.
- Hormone therapies, including calcitonin, parathyroid hormone type injections (such as Forteo® and Tymlos®), and estrogen replacement therapy.
- Prevent falls.
- Make your home safe to prevent falls. Here are some things you can do:
- Remove throw rugs or attach them to the floor.
- Install safety rails on stairs and grab bars in your shower or tub.
- Apply nonskid tape or decals to your shower or tub floor.
- Make sure the rooms in your house or apartment are well lit.
- Wear sturdy shoes.
- Stand up slowly after sitting or lying down, so that your body can adjust to the new position.
- Use a cane or walker to improve your balance.
- When you bend over, bend at your knees, not at your waist.
- Make your home safe to prevent falls. Here are some things you can do:
Increase Calcium
One of the most critical minerals in your bones is calcium. Bone cells are constantly being broken down and replaced so it’s important to consume calcium in order to keep your bones strong. For adults between the age of 19 and 70, the (RDA) Recommended Dietary Allowance of calcium is 1,000 mg per day. If you’re a woman older than 50 or a male older than 70, this increases to 1,200 mg per day.
The best way to get calcium is through dairy products, vegetables such as broccoli and kale, salmon, soy products, and tofu. If you’re struggling to include enough calcium in your diet, speak with your doctor about dietary supplements.
Increase Vitamin D
Another important vitamin that your body uses for fuel is vitamin D. Calcium and vitamin D go hand-in-hand because your body uses vitamin D to absorb calcium. For all adults between the ages of 19 and 70, the RDA for vitamin D is 600 (IUs) international units per day. If you’re older than 70, this increases to 800 IUs per day.
The best way to include vitamin D into your diet is by eating salmon, whitefish, tuna, or trout. Also, cheese, eggs, mushrooms, milk, and certain cereals can be good sources of vitamin D. A great natural way to intake vitamin D is through sunlight.
According to studies done by the National Institutes of Health, children and adults with low vitamin D levels have lower bone density and are at a higher risk for bone loss. If you can’t find ways to get enough vitamin D into your diet, consult with your doctor for supplementary options.
So, you’ve incorporated the foods above into your diet to improve your bone density and health. That’s great! Unfortunately, without the proper amount of vitamin D, all of that calcium will be for naught. Your body needs vitamin D to absorb calcium.
Vitamin D can be found in three sources: sunlight, food and supplements. Depending on the time of year, where you live, other medical complications and skin cancer considerations, getting enough sunlight to meet your vitamin D needs may be difficult. And as vitamin D exists naturally in only a few foods, many people turn to supplements to maintain proper levels of vitamin D to maintain healthy bones.
When it comes to taking supplements, it’s always advisable to consult a healthcare provider before deciding on any specific vitamin D supplement or daily dose amount. Believe it or not, you can overdo it with vitamin D, and many providers may advise you to take K2 along with vitamin D, to help prevent arterial calcification
In addition to taking supplements for osteoporosis, women in menopause (especially the first 5 to 10 years) should consult a doctor about their hormone levels and possible hormone replacement therapy to help with both bone health, and with other menopause-related health issues.
Don’t Drink
Alcohol consumption increases your risk for developing osteoporosis.
Don’t Smoke
Smoking is detrimental to your health in many ways, and it can also prevent your body from properly using the calcium in your diet. Like drinking alcohol, smoking increases your risk for osteoporosis.
Watch Your Caffeine Intake
Just like alcohol, consuming a moderate amount of caffeine is perfectly safe for your bones. But excess amounts may interfere with calcium absorption.
Avoid Certain Medications
Steroids are miracle drugs in many ways, but long-term use of oral corticosteroids can have a negative effect on your body – including preventing your body from absorbing calcium. Some medications taken for chronic heartburn or acid reflux can also affect bone density when taken for long periods.
Know Your Risks
There are some risk indicators for osteoporosis that we can’t change. Women are more likely to be affected than men, as well as adults over 50, people of Caucasian or Asian descent, and people with relatives with osteoporosis. If you know you are more likely to have bone loss, you can make healthy choices in your life that may help balance the risk.
Do Weight-Bearing and Muscle-Strengthening Exercises
Weight-bearing and muscle-strengthening exercises are important for building and maintaining bone density.
- Take a brisk walk. Walking is good for bones.
- Include muscle-strengthening (resistance) exercises in your workout by using a pair of light dumbbells or resistance bands
- Join a gym or sign up for a group exercise class
- Go dancing
- Try a new sport or activity such as tennis or hiking
Dark Leafy Greens
Coming in at a whopping 358 mg of calcium per cooked cup, collard greens are the king of the dark leafy greens – and one of the best vegetables for osteoporosis. Other greens, such as kale, mustard greens, Brussel sprouts and turnip greens, are also great additions to your diet to improve bone health and density.
Dairy
Decades of milk advertisements have lauded the beverage as the best – and healthiest – source of calcium for strong bones; yet, there are better sources of calcium in the dairy aisle…
Eat Right
Low weight and poor nutrition cause weak bones. It is important for children and teens with CF to gain and keep their weight up and eat healthy. Proteins, also known as amino acids, are the building blocks for all body tissues, even bones.
In addition to protein, the minerals calcium, zinc, magnesium, phosphorus and fluoride and vitamins A, D and K are essential to build and keep strong bones. Your CF care team may prescribe calcium or vitamin D supplements if you do not get enough through your diet and your levels are low.
People with CF should avoid alcohol and caffeine because they lower bone density.
Essential Bone Minerals
Calcium plays a big part in forming bones and keeping them strong. Children and teens need the most calcium because bones grow fast in those years. People with CF age 9 years and up should get 1,300-1,500 mg of calcium a day.
It is best to get your calcium from foods. Milk, milk products (cheese, yogurt, ice cream), and calcium-fortified plant-based milks are great sources of calcium and calories. Other good calcium sources are foods made with dairy products, such as macaroni and cheese, puddings and custards, and creamed soups. Dark green vegetables, almonds and calcium-fortified orange juice and cereals have some calcium. If you cannot get enough calcium from foods, ask your CF dietitian about calcium supplements. Your body can absorb only about 500 mg of calcium at a time, so spread your calcium sources throughout the day.
In addition to calcium, it is important to maintain the right levels of magnesium and zinc. Low magnesium blocks the body’s use of calcium, and low zinc levels can cause poor growth and slow puberty.
Most Important Vitamins
Vitamin D helps our bodies absorb calcium to make bone. Your body makes vitamin D from being in the sun. Being in the sun for 5-10 minutes, 2-3 times a week, can raise vitamin D levels. Be careful not to stay out in the sun too long to avoid sunburn.
Fortified milk and cereals, egg yolks and fatty fish are good food sources of vitamin D, but people with CF don’t easily absorb vitamin D from foods. They should take vitamins made just for people with CF like Vitamax™, AquADEKs® or MVW®. These vitamins have water-soluble vitamin D, which is easier to absorb.
Vitamin D levels in the blood should be checked once a year and after taking extra vitamin D as prescribed. If the amount of vitamin D in your blood is low, you may need to take more.
Vitamin K is a fat-soluble vitamin needed for bone density. You can get vitamin K in CF-specific vitamins. Vitamin K also is made in the intestines by bacteria. Good food sources include leafy greens such as cabbage, broccoli, kale and spinach.
Eat More Nuts, Beans, And Leafy Greens
Almonds, walnuts, and pistachios are all rich sources of calcium. Put a few handfuls in a small plastic bag and keep it nearby to snack on. Traditional baked beans and white beans also have a bunch of calcium. Eat them on their own, or add them to a low-sodium soup. Leafy greens also offer a lot of calcium. Collard greens, kale, and bok choy are all good options.
Exercise for Strong Bones
Exercise can help you maintain strong bones. It can also lower your risk of falls and fractures.
Talk with your healthcare provider before starting any exercise program.
High-impact weight-bearing exercises help build up your bones and keep them strong. Examples of high-impact weight-bearing exercises are:
- Fast dancing
- High-impact aerobics
- Hiking
- Jogging or running
- Jumping rope
- Climbing stairs
- Tennis
Low-impact weight-bearing exercises can also help keep bones strong. They’re also safer for people who can’t do high-impact exercises. Examples of low-impact weight-bearing exercises are:
- Using elliptical training machines
- Walking
- Using a climbing machine, such as a StairMaster®
- Riding a bicycle
- Rowing
- Tai chi
- Yoga
- Pilates
- Swimming
- Water aerobics
- Golf
- Cross-country skiing
- Ballroom dancing
Keep a Healthy Weight
Weight can play an important role in the health of your bones. Being too heavy or thin isn’t good for your bones and joints. Additionally, stomach and weight-loss surgeries can affect your body’s ability to absorb calcium. It’s important to consume a healthy diet of at least 1,200 calories per day to keep your bones healthy for a long time!
Having excess amounts of weight on your joints can be dangerous because your joints are built to sustain a certain amount of force and increasing that amount can be damaging in the long run. Depending on the activity you’re doing, your bones can feel immense amounts of pressure.
- The force on your knees at level ground is 1 1/2 times your body weight.
- if you’re going up and downstairs, that force is two to three times your body weight
- If you’re squatting to pick up an object, that force can be four to five times your body weight.
Maintaining a healthy weight will help your bones stay strong as you age. Excess stress on your joints can increase the likelihood of developing osteoarthritis.
