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  • Writer's pictureDr. Jesse Ropat

Bone Health In Aging: Preventing Osteoporosis And Fractures

As we age, the risk of fractures increases. Our muscles lose their strength, our bones become weaker, and we’re less coordinated. We’re also at greater risk of osteoporosis.


Osteoporosis is defined as low bone mineral density due to altered elements in our bone structure, which can put us at risk of low-impact, fragility fractures. Osteoporotic fractures can significantly decrease your quality of life.


In postmenopausal women, more than 50 percent will have an osteoporotic-related fracture, and only 33 percent of senior women who have a hip fracture will be able to go back to living independently again.


We have a large aging American population, and this is expected to triple the number of osteoporotic fractures we see every year!


This combined means more of us are likely to fall and hurt ourselves. So what can we do to prevent it?


I want to tell you about my grandmother. She was the sweetest woman you would ever meet. She loved everyone deeply and honestly. She was beaming the moment you walked in the door, and was selfless, giving everything to help those around her.


As she got older, she needed her walker more and more and was increasingly unsteady. She went from being able to get in and out of the car on her own, to needing me to hold her hand, and eventually needed us to help steady her while she moved.


One day, she fell in the bathroom and fractured her hip. She went from moving freely and having great mobility for her age, to needing a wheelchair. At the time, I knew that this was a bad sign. 


Studies consistently show that fractures are a leading risk factor for early mortality. She passed away 3 years ago, and during this time she was largely immobile in bed, unable to move unassisted.


It was the most challenging time for our family. We lost the glue that held us together.


Sometimes, accidents do happen. There may be nothing anyone can do to prevent them. However, you can give yourself a fighting chance to protect yourself. We need strong bones to keep our bodies moving freely. Here are some tips you can use to improve the strength of your bones, and the muscles that surround them.


1. Maintain a Balanced Diet:


We need a well-balanced diet with proper nutrient intake to keep our bones strong, especially in old age. I want to emphasize two key nutrients: calcium, and vitamin D. Both of these are essential for strong bones. Sources of these nutrients include dairy products (like milk, cheese), leafy green vegetables, and seafood.


I personally include these in my diet by using milk in my daily protein shakes and eating fish at least 3 times per week. I choose salmon, but your taste buds may vary!


I also take vitamin D regularly. This is even more important during the winter months when I am based in Toronto since the sun is hiding more often than not.


2. How much Calcium and Vitamin D should you be taking?


If you’re not getting enough of these nutrients through your diet, I would first try to include more foods that can get you closer to your goal. For Vitamin D, you can also seek out more sunlight during the day to allow your body to produce more naturally. However, be sure to keep your skin safe by wearing sunscreen if you’ll be in the sun for a prolonged period of time.


Once you’ve established a solid baseline in your diet and lifestyle, then, you can look into supplements.


There is some debate around this topic when it comes to Vitamin D. The range varies greatly, from 400 IU daily to 8000 IU daily. I recommend something in between. 1000 - 2000 IU of Vitamin D daily is a great starting point, and you can take it at any time of the day, with or without food.


As for calcium, generally, you don’t want to take more than 600mg at a time. That’s about all your body can absorb at one time. I recommend starting with 600mg once daily and increasing to up to 1200mg total daily (600mg with breakfast, and 600mg with dinner). 


These two additions are crucial for stronger bones. If you want to be playing with your grandkids in your older age, keeping your bones solid and fortified is essential.


3. Regular Weight-Bearing Exercise:


My mother recently began to worry about her bone health, because of a recent DEXA scan (we’ll get to that) showing that her bones were losing their strength.


I always tell her how important it is to make sure she keeps busy and focuses on weight-bearing exercises if she can. Things that put a strain on your bones and muscles in a safe and controlled manner will allow them to get stronger.


What does weight-bearing mean? Anything that adds weight to your body and puts a greater load on your bones. My personal favorites are squats, overhead shoulder presses, weighted lunges, and deadlifts. If you feel more comfortable with machines because you’re a bit less stable on your feet, there are machine alternatives to these at most gyms.


As well, cardiovascular exercise like jogging, dancing, and for seniors walking can be great to build strength and bone density. Something you could try is: walk like you’re in a hurry for 4 weeks.


4. Avoid Smoking and Excessive Alcohol:


People may think smoking only affects your lungs. However, study after study has shown that smoking is associated with lower bone mineral density, which means that smokers may have weaker bones compared to non-smokers. 


It may also reduce your blood circulation, which can reduce the delivery of essential nutrients, including calcium, to the bones. 


In women in particular, it has been shown to affect hormonal levels, including a decrease in estrogen, which can also increase your risk of osteoporosis.


In general, smoking is associated with an increased risk of fractures. 

The same can be said for alcohol as well!


Alcohol can reduce calcium absorption, and also impact our body’s ability to form new bone tissue. Just like smoking, it similarly reduces estrogen and testosterone, both of which are crucial for forming and maintaining new bone.


As we’re all probably aware, alcohol also increases your risk of falls and accidents, and can easily lead to fractures. This is especially true for people with already compromised bone density.


Finally, since chronic alcohol use can damage the liver (where our body activates vitamin D), this can throw of our nutrient balances.


Both smoking and alcohol can cause weaker bones over time, so if you indulge, do so in moderation.


5. Regular Bone Density Testing:


Now back to that DEXA scan my mom took a while back. Older adults, especially women after menopause, should undergo bone density testing (DEXA scans) to check their bone health. Early detection of osteoporosis or the signs of it can lead to better management and prevention of fractures.


If you’re in menopause, or near it (usually around the age of 52), I highly recommend you call your doctor and seek out this testing.


6. Fall Prevention:


There are a few key ways you can prevent falls, or at least be more aware of when and where they can occur.


Home Safety Assessment:


Look around your home to identify and remove potential hazards like loose rugs, cluttered pathways, poor lighting, and slippery floors.


You might even want to install handrails in hallways and staircases and use non-slip mats in the bathroom.


If you’re having more issues with mobility lately, consider using mobility aids like canes or walkers if needed.


Proper Footwear:


Wear well-fitting shoes with non-slip soles, and try not to walk in slippers. These are easy to trip over!


Stay Hydrated:


If you’re dehydrated, you might become dizzy and this easily leads to falls, especially in hot weather.


Fall Detection Devices:


The technology out there is great. Emergency fall devices wearables can automatically alert your loved ones or emergency services in case of a fall. LifeAlert is a common wearable, but you can certainly go with another company. 


7. Hormone Replacement Therapy (HRT) and other Medication Options:


There are some medications out there that can help slow osteoporosis, but these typically take a long time to take effect and can have some troublesome side effects, like stomach ulceration or esophagitis. The best way is to prevent it before you need these medications.


Hormone replacement therapy (HRT) can sometimes be considered for postmenopausal women to improve bone density, but it should be carefully evaluated with a healthcare provider due to potential risks, as should any medication change or supplement addition.


I hope this has given you some insight into how you can improve your bone health and keep yourself or your loved one safe.


Wishing you all the best on your journey to a more vibrant you.

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