By Eric Lagoy, PT, DPT, OCS, and Kelley Breyer, RD, CDN, CSOWM
According to the Oxford Dictionary, osteoporosis is “a medical condition in which the bones become brittle and fragile from loss of tissue, typically as a result of hormonal changes, or deficiency of calcium or Vitamin D.”
This information accurately describes osteoporosis but is missing one crucial piece of information – osteoporosis also increases the risk of sustaining a fracture.
This additional fact is why we’re talking about osteoporosis today. By focusing on increasing bone density and decreasing the controllable risk factors for osteoporosis, we are doing our best to decrease our risk of fracture due to osteoporosis.
So, what’s the plan?
You’ve heard that exercise and nutrition are the most important considerations when managing or controlling most health issues and concerns. You may not know that the exercise recommendations for preventing osteoporosis have changed – for the better.
At Gaylord Specialty Healthcare, we work hard to ensure patients don’t experience the standard “one-size-fits-all” program of treadmill walking, stretching exercises, calf raises, mini lunges, etc. Studies in patients who have followed this program have not shown an improvement in bone mineral density, and at best only small changes were found in strength or general mobility.
The good news is the current recommendations – and the standard of care we provide – are very safe and have shown small improvement in bone mineral density and significant improvement in strength and mobility.
Now that we have your attention, here’s our best recommendations for using exercise and diet to decrease your risk of osteoporosis and a possible fracture:
1. Supervised High-Intensity Resistance Training
This training includes deadlifts, squats, overhead presses, and jumping that is done in a controlled environment and is individualized for the patient. How or why does this work? Bones adapt and increase in density in response to heavier mechanical loading. The opposite is also true. Check out Wolff’s Law for more information about this concept.
Important! If high-intensity resistance training is new to you, don’t walk into a gym tomorrow and start doing deadlifts. The “supervised” part of this training is not optional. Also, be sure your physical therapist follows three important steps to your training 1) a familiarization period, 2) a training period, and 3) a transitional period.
“Drink your milk!” Did anyone else’s mom always tell you that? It turns out she’s not wrong. But she also forgot to say, “Get some sunshine, increase your potassium and magnesium, and try some protein and Vitamin C too!”
Calcium is indeed essential for bone health. It’s also true that calcium isn’t the only thing we should be focused on. Check out this site for more information on increasing your calcium intake.
Vitamin D: people as young as three years old need the “sunshine vitamin” to help stay healthy. Ages 3-17 require 200 international units (UI) per day, ages 18-70 require 400 IUs/day, and ages 70+ need 600 IUs/day, at a minimum!
Potassium: is found mainly in fruits and vegetables. Potassium can increase the accumulation of calcium in the kidneys, and it has an important role in maintaining an alkaline state in the body.
Magnesium: is found in most whole foods (green leafy vegetables, legumes, and nuts). Magnesium helps the body metabolize calcium and is the second most abundant intracellular cation (second to potassium).
Protein: approximately 50% of bone volume and 1/3 of bone mass is composed of protein, which is why recent meta-analyses have reported a higher protein intake (>0.8g/kg body weight/day) is associated with a higher body mass index, reduced risk of hip fracture, and a slower rate of bone loss.
Vitamin C: is a marker of a healthy dietary pattern rich in fruits and vegetables and has been shown to improve bone health because of their antioxidant properties.
Now that we know what we should be eating, let’s look at what we shouldn’t be eating, or more accurately, what nutrients may impair bone health:
Salt: according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, overconsumption of salt can cause the kidneys to excrete calcium.
Alcohol: compared with drinking no alcohol, 1-2 drinks/day has not been shown to significantly impact bone markers, but heavy drinking can lead to bone loss.
And consumption of soda and phosphorous, an additive found in fast food, canned or bottled drinks, spreadable cheese, and processed foods, should be limited or avoided.
Here’s a 1-day sample menu to help get you started:
- 8 ounces of orange juice with calcium and vitamin D
- 1 cup of ready-to-eat cereal fortified with vitamin D
- 4 ounces of skim milk
- 2 ounces of extra-lean ground beef on a bun with one slice of non-fat American cheese, one lettuce leaf, two slices of tomato
- One green salad with one hard-boiled egg with 2 tablespoons of low-calorie dressing, eight baby carrots
- 8 ounces of skim milk
- 2.5 oz chicken breast with ½ cup broccoli and ¾ cup rice
- Two slices of French bread with 1 teaspoon of margarine
- 1 cup strawberries with 2 tablespoons of lite whipped topping
Don’t forget! Pair good nutrition with your supervised high-intensity resistance training for your best defense against osteoporosis and possible fractures.