Osteoporosis and Bone Health

Osteoporosis is a major cause of broken bones in the elderly. But the broken bone is merely the final evidence of a process that may have begun as early as age 35 and progressed silently over the years. Throughout life, minerals - calcium, in particular - constantly move in and out of bone. At about age 35, peak amounts of minerals are in the bones. After that time, more calcium leaves bone than is absorbed into it, at a rate that varies from person to person. This results in loss of bone mass. Bones become porous or brittle and susceptible to fracture - the condition of osteoporosis. You can do much to slow or even prevent osteoporosis. Essentially, it amounts to living the "good life." Maintain an active lifestyle, eat well - which includes sufficient calcium intake and avoid tobacco and excessive use of alcohol. Known risk factors for osteoporosis include:

Calcium

The amount of calcium needed to slow or prevent osteoporosis is estimated to be 1,000 mg/day for men and premenopausal women, and 1,500 mg/day for postmenopausal women. Unless you drink large quantities of milk, you probably don't get that much. Most Americans don't. The average diet probably contains only 400-500 mg/day of calcium. If you like milk, ice cream, cheese, and yogurt, increase the amounts you normally eat - preferably low-fat varieties to reduce the amount of cholesterol and saturated fats in your diet. Each 8-oz glass of milk - whole or skim - supplies about 300 mg of calcium. Calcium is also plentiful in green, leafy vegetables, such as kale, mustard greens, and spinach, and in sardines. Sesame seeds and almonds also are good sources. If you don't like these foods or can't tolerate them, or if you don't want the calories, you can take a calcium supplement. Os-Cal 500 consists of 1.25 grams of calcium carbonate, which gives you 500 mg of elemental calcium. Each regular Tums anatacid pill (500 mg) contains 200 mg of elemental calcium. The new Tums 500 contains 500 mg of elemental calcium. Look for generic versions of these medicines, as they will usually be cheaper and just as good. Make sure you're taking the right amount of "elemental" calcium. That's the amount of actual calcium contained in the calcium lactate, calcium gluconate, or calcium carbonate tablets.

Vitamin D

Vitamin D is necessary for your body to absorb the calcium you eat. People living in southern climates generally get enough vitamin D from sunshine. However, a number of studies have found Bostonians sadly lacking in vitamin D. Hence, I suggest getting 400 IU of vitamin D from a multivitamin for those under age 60. For older people, I suggest getting a total of 800 IU of vitamin D per day. A simple way to do this is to take a multivitamin (which should have 400 IU of D) PLUS a calcium/vitamin D pill (often sold as 600 mg of calcium with 200 IU of vitamin D) TWICE a day (with breakfast and with supper - easier to remember that way). DO NOT take more than 800 IU of vitamin D unless told to by a doctor - too much vitamin D can be harmful.

Exercise

If you are now swimming, playing tennis, or jogging regularly, keep it up. But swimming, yoga, and some forms of aerobic dancing - while excellent activities to keep you limber, to keep your heart in shape, to strengthen your muscles, and to keep your joints flexible - do not seem to keep the calcium in your bones. For that you need "weight-bearing activities." Tennis, jogging, and other such sports are fine. But so is walking. If you now live an essentially sedentary life, begin to take short walks on a regular basis, building up to 1 to 1.5 miles a day or 1 to 1.5 hours about three times a week.



FoodServingCaloriesCalcium (mg)Phosphorus (mg)
Chedder cheese1 oz115200145
Cottage cheese (4% fat)1/2 cup12080150
Cream cheese1 oz1002330
Ice cream1 cup270175135
Milk, skim8 oz100300225
Milk, whole8 oz150300225
Parmesan cheese1 oz130390230
Yogurt, plain1 cup140275210
Green beans1 cup306045
Broccoli1 cup4013595
Collards, cooked1 cup65355100
Spinach1 cup4016565
Summer squash1 cup305555
Winter squash1 cup13055100
Sesame seeds1/2 cup280580300