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Protect your skeleton's health

January 25, 2017

Our bones’ functions are to protect organs, to provide structure and act as the body's framework, to anchor muscles, and to store calcium. The optimal bone-building years are childhood and young adulthood. As children grow and mature, their bone mass increases until it reaches peak mass. About 90 percent of peak bone mass is acquired by age 18 in girls and age 20 in boys, according to the National Osteoporosis Foundation.

Bones are constantly changing, with new bone being formed and old bone being broken down. When one is young, the body makes new bone more quickly than it breaks down old bone, which is called remodeling. After peak bone mass is acquired, bone remodeling continues, but most adults lose more bone mass than they gain. Achieving high peak bone mass means a person has a reduced risk of developing osteoporosis.

Decreasing bone density, or bone loss is part of the aging process. Osteoporosis affects the spongy interior of bones, known as trabecular bone, and the outer bone layer, called cortical bone. Osteoporosis or brittle bone disease is often not diagnosed until a bone is broken. Risk factors contributing to the development of osteoporosis include:

• Gender - Women are at greater risk than men of developing osteoporosis due to their smaller bone mass.

• Size - Those with small body frames or a body mass index of 19 or less may have less bone mass to draw from as they age.

• Family history and race - Having a parent or sibling who has osteoporosis, or being white or of Asian descent.

• Hormone levels - Bone loss increases with high thyroid hormone levels. As we age, men experience declining testosterone levels and women experience lower estrogen levels, both of which contribute to bone loss.

• Health conditions. Those with anorexia or bulimia are at an increased risk for bone loss. Conditions which affect your body's ability to absorb calcium increase the risk of bone loss. These include Crohn's disease, celiac disease, Cushing's disease, and stomach and weight loss surgery.

• Medications. Bone health is at risk with long-term use of corticosteroid medications (prednisone, cortisone, prednisolone and dexamethasone); aromatase inhibitors; some anti-seizure medications; proton pump inhibitors; and selective serotonin reuptake inhibitors. Discuss your bone health with your primary healthcare provider if prescribed any of these medications.

• Tobacco and alcohol use. Research suggests tobacco use contributes to weakening bones. Consuming more than two alcoholic drinks a day decreases the body's ability to absorb calcium, increasing the chances of developing osteoporosis.

Youth is the optimal time to build strong bones, but adults can also take steps to protect their bone health. Low-impact, weight-bearing cardiovascular exercises that require you to stand and support your body weight aid in keeping bones strong and help decrease bone loss. Examples are fast walking outdoors, treadmill walking, low-impact aerobics, tai chi, dancing, and using a stair machine or elliptical. Muscle-strengthening activities such as weight lifting, use of elastic exercise bands, yoga, Pilates or weight machines help build bones, strengthen muscles and improve balance. Adopt fall-prevention strategies such as removing throw rugs, using night lights and shower mats, and installing bathroom grab bars and raised toilet seats.

The most common cause of osteoporosis is having a genetic predisposition; next is inadequate nutrition. Choosing healthy foods can aid in preventing bone loss. Two of the most important nutrients for bone health are calcium and vitamin D. The Institute of Medicine recommends adults consume 1,000 to 1,200 milligrams per day with the upper limit being 2,500 mg. per day. Good calcium food sources are fat-free yogurt, skim milk, soy milk, tofu enriched with calcium, edamame, white beans, bok choy, kale, collard greens, broccoli and almonds.

Vitamin D is essential for the development and maintenance of bone, and aids with calcium absorption. Vitamin D is made in the skin when it is exposed to ultraviolet B rays, which could contribute to skin damage, premature aging and skin cancer. Food sources and supplements as discussed with your physician are the best ways to obtain Vitamin D. The IOM recommends 800 to 1,000 IU for fracture prevention.

Research finds overweight and underweight individuals have a higher fracture risk. Staying at a healthy weight and engaging in regular physical activity helps increase or at least aid in maintaining bone density. According to the American Academy of Orthopedic Surgeons, preventing falls is vital to aid in preserving bones, since half of all fractures are due to falls. A healthy eating plan, fall-prevention strategies, physical activity and maintaining a healthy weight are all important for the health of your skeleton.

Always consult with your physician or healthcare provider before making any dietary/nutrition changes, or commencing or changing your physical activity.

Debra Dobies, MA, RD, LDN, is Beebe Healthcare's Ornish Lifestyle Medicine registered dietitian and medical nutrition therapist. Beebe Healthcare's Ornish program is in the Beebe Medical Arts Building at the Rehoboth Beach Health Campus. It is a part of Cardiac Rehab, and Beebe's Cardiac and Vascular Services. For more information, call 302-645-3514 or go to www.beebehealthcare.org/ornish.

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