Beyond
Walking

By Ronda Gates, MS

Ronda Gates, MS, is a pharmacy grad who traded her white coat for a pair of athletic shoes and never looked back. Her health promotion business, LIFESTYLES, provides motivational speaking, program development, and fitness assessment services to support people making a lifestyle change. She has developed health promotion programs for many organizations nationwide.
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An early-morning walk is a blessing for the whole day.

— Henry David
Thoreau

Boning Up for Good Health

“Describe a person with osteoporosis,” I ask my clients. The most frequent response is, “A stooped over old man,” or, “An old woman with a dowager’s hump.” It’s not that simple. Osteoporosis can occur at any age.

What is osteoporosis?
A doctor will tell you that osteoporosis is “an insidious metabolic bone disease that results in a loss of bone at an accelerated rate.” Simply put, the process of bone building and bone breakdown is seriously out of balance: Your bones are at risk for fracture.

Bone is alive.
Throughout your lifetime, new bone is added, and old bone is dissolved. During childhood and teenage years, if we eat healthfully and exercise, new bone is added faster than old bone is removed. This makes bones larger, heavier, and denser. This faster pace of bone growth continues until about age 30. After that, bone loss slowly begins to exceed bone formation, until menopause, when bone loss can be dramatic. Sadly, this occurs without our knowledge, so most people don’t know they have osteoporosis until they break a bone. If you have ever had a fracture and thought, “I’m surprised that bone broke,” it’s possible your bones are weak.

It’s projected that 50% of all post-menopausal women — many of whom don’t know they have weak bones — will have an osteoporosis-based fracture before they die. In this age group, 20% of women who break a hip die within one year of that fracture.

Men, who typically have stronger bones, have only a 25% risk of osteoporosis-related fractures. However, because men get osteoporosis later in life, when their health may already be compromised, the consequences are often grave.

Are you at risk for osteoporosis?
Understanding what causes osteoporosis is critical to taking a proactive approach to bone health. There are well known risk factors for osteoporosis:

• Risks that are uncontrollable, like age, gender, genetic predisposition, or the need to be treated with medicines that interfere with bone health.

• Risks that are dependent on your lifestyle, like exercise and eating habits.

Do you have weak bones?
A bone density test can confirm bone weakness or, more importantly, detect low bone density before a fracture occurs. Although the heel bone scans you see at health fairs and grocery stores are a good screening method, the most reliable test — called a DEXA scan — can measure fracture-prone spots, including your hip, wrist, or shoulder, without a need to change clothes. Don’t be intimidated by the big DEXA bone-scanning machine. The scan is painless and the amount of x-ray used is less than you are exposed to on an airplane trip.

Your DEXA scan will give one of three results. The best news is, “Your bones are strong — keep up the good work.” If you have had some bone loss but not enough to render a diagnosis of osteoporosis, you will be told you have osteopenia. That’s a signal to make lifestyle changes that can slow bone loss. The news, “You have osteoporosis,” is a trigger for a prescription that can slow or stop bone loss and decrease fracture risk.

Can osteoporosis be treated?
There are several therapeutic medications approved for preventing and treating osteoporosis. The most popular is a class of drugs called bisphosphonates. Other treatments include sex hormone–related medications, and, for serious disease, injections of a human parathyroid hormone. Although osteoporosis itself is painless, once a bone breaks the pain can be debilitating — especially if the fracture occurs in the spine. Happily, there are now minimally-invasive orthopedic treatments that can stabilize spinal fractures and reduce pain. Regardless, a comprehensive program to treat osteoporosis also includes a significant focus on proper nutrition, exercise, and safety to help prevent the falls that can result in fractures.

How can I keep my bones strong?
If you are serious about your bone health, you’ll get the most bang for your buck with an exercise and strength-building program that triggers changes in your bones. Impact exercises — especially walking, hiking, jogging, stair climbing, and dancing, work best. Add strength-building weight training and you’ll increase bone mass faster. That’s because the tension that hard-working muscles put on bones can prevent bone loss and, in some cases, increase bone density. Beyond that, it’s essential to eat calcium-rich foods, including low-fat dairy products, dark green leafy vegetables, and foods fortified with calcium, like orange juice, cereals, and whole grain breads. Additionally, a twice-a-day calcium supplement that includes vitamin D is critical to bone health. Since calcium needs increase with age, ask your doctor about the right dose for you.

Last but not least, remember that cigarettes and alcohol are devastating to your bones. The only thing that’s better than less of these is none at all.

Smart men and women can have strong bones. But there is no magic. Outwitting osteoporosis requires well-informed and well-executed health and lifestyle choices. The effort is well worth it.

It’s a lesson I learned well: Osteoporosis stole my mother’s life. I’m in my mid-60s now, and wise choices have rendered strong bones for me. They can for you too.

Know the Score

There are two ways of scoring a bone scan. A Z-score compares your bones to other people your age and is not the best indicator of bone health for active people. Instead, learn your T-score, which compares your bones to that of a person with healthy bone.

Men and women of all ages need to be concerned about osteoporosis:

• Young teens who use asthma inhalers.
  
• Twenty-somethings who exercise too much or diet excessively to stay thin.
  
• Thirty-somethings who are treated for breast cancer or have had a hysterectomy.
  
• Forty-somethings who take thyroid replacement or drink too much coffee.
  
• Fifty-somethings who believe a daily vitamin pill and calcium supplement alone keep bones strong.
  
• Sixty-somethings who don’t do weight bearing exercise.
  
• Seventy-somethings who think it’s too late to prevent the diseases of aging.