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Guide Health: How to help prevent osteoporosis

Men can be impacted as well, and are more likely to end up in a nursing home

Osteoporosis is linked to low bone density, a decrease in bone strength and deterioration of bone structure. And, with this loss of bone integrity comes an increased risk for fractures, most notably hip and wrist fractures.

Unfortunately, by the time you realize your have osteoporosis, it may be too late to build healthy bone.

Bone mass increases during teenage years, peaking sometime in the late 20s and early 30s. These are the years when you should have been eating a calcium-rich diet to maximize your bone mass

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After this, you start losing bone at about 0.3-0.5 per cent per year, which is why it follows that if you have higher bone mass when young, the loss has less of an impact.

According to Osteoporosis Canada, about 1.5 million Canadians have osteoporosis, with one in four women over 50 years of age affected. With their larger bones, men are less often affected, but with age the risk does increase and when men break a bone, hospitalization and admission to nursing homes occur more often.

Calcium is the basis for healthy bone. Health Canada recommends that everyone aim for 1,000 mg daily, with women over 50 and anyone over 70 aiming for 1,200 mg.

Ironically, teenagers should try to consume even more, with a target of 1,300 mg in order to build good bone mass.

While there are many supplements, calcium in your diet is better absorbed. Milk and milk products are excellent sources.

Keep track of what you eat for a couple of days or use an online “calcium calculator” to determine if you are getting sufficient calcium. Changing your morning beverage to a glass of low fat milk or adding a low fat yoghurt to your lunch may be all that you need.

Vitamin D is the other key ingredient in bone building. Your skin does manufacture it with sun exposure; about 20 minutes three to four times a week is needed. But, at Canada’s latitude and during short winter days your skin may not have the sun exposure needed. Supplements and fortified foods are alternatives.

Your bones do need other minerals, for example fluoride, magnesium and phosphate, but only in trace amounts found in an average diet.

Bisphosphonates (for example alendronate, etidronate, risedronate) promote bone growth by reducing the rate at which bone breaks down. These are the drugs of choice for osteoporosis. The drawback, though, is that any food or beverage interferes with their absorption. You need to take them by themselves, first thing in the morning and wait for at least 30 minutes before eating or drinking anything else.

You also want to avoid having the tablets “stick” in your throat where they can cause ulceration. Remaining upright after taking them means gravity will help move them through your esophagus, as will taking them with a full glass of water. Once-weekly formulations are available and more convenient.

For people who have difficulty with bisphosphonate tablets, zoledronic acid is a once-yearly bisphosphonate infusion. And, if you can’t take bisphosphonates —for example, if you have low kidney function — denosumab injections given every six months may be an alternative.

Regardless of which drug you take for osteoporosis, a break in therapy after three to five years may be recommended depending on your age and on your risk for fractures.

Regardless of what you may take for osteoporosis, you want to make sure your lifestyle is conducive for healthy bones. Quit smoking, drink alcohol only in moderation, minimize your caffeine intake, take measures to prevent falls and regularly do weight-bearing exercises.

And, make sure your diet contains sufficient calcium.

About the author

Contributor

Marie Berry is a lawyer/pharmacist interested in health and education.

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