Steps to Prevent Osteoporosis and Osteopenia


For those who live in cold climates for a good portion of the year, the vitamin can be found in fortified milk, fish, eggs and supplements. People up to 70 years of age should aim for 600 IU per day, and anyone older should up their intake to 800 IU per day. About 3½ ounces of salmon will get you 360 IU, and a cup of vitamin D-fortified milk clocks in at 98 IU.

And, along with receiving adequate calcium and vitamin D, Mishori said it's important to maintain an active lifestyle throughout life.

"Exercise, exercise, exercise to enhance bone strength, particularly weight bearing, but also jumping in place, [and] running if you can," Mishori said. "Tai chi has been shown to be very beneficial in maintaining balance and gait to prevent falls, which could be disastrous if you have weak bones."

Don't Smoke: 'Quit Now'

And, in case people need yet another, kick the smoking habit, Mishori said.

"Smoking is a risk factor for osteoporosis," she said. "Quit now. Don't start."

Smoking decreases estrogen, a hormone that helps to slow bone loss, production in the body. Heavy drinking has a similar outcome: Too much alcohol can slow and prevent calcium absorption in the body.

Next Steps

The National Osteoporosis Foundation recommends that doctors administer a bone-density test to female patients older than 65 and male patients older than 70.

Postmenopausal women with at least one risk factor, people older than 50 with a history of a broken bone, and those taking medications such as prednisone and anti-seizure should receive a bone-density test.

"Once osteoporosis is identified with a DEXA [bone] scan, you do not need to have [the scan] every year," Mishori said. "This is a total waste of money.

"While there are no robust guidelines, the recommendation is that it be done two to three years after the initiation of treatment."

The goal in treating osteoporosis is to prevent bone fractures by reducing bone loss. While the lifestyle changes mentioned above do help with treatment, medications such as Fosamax, Actonel, Evista and Boniva promote bone strength in people who suffer from the condition.

And, despite all the chatter on bone health, Dr. Steve Cummings, professor of medicine and epidemiology at the University of California at San Francisco, said some doctors are moving away from the terms "osteoporosis" and its predecessor, "osteopenia."

"Many experts are moving away from using the words, 'osteoporosis' and 'osteopenia' because we believe that the most important thing is a person's risk of fracture," Cummings said. "Some without osteoporosis have a high risk and some, mainly relatively young women, with osteoporosis or osteopenia have a relatively low risk of fracture."

And, to go along with that, Favus said: "More fractures occur among the population with osteopenia because there are more people in the category; however, the fracture rate is higher in those in the osteoporosis range."

Pursue a Treatment Plan

If you are at risk of weakened bones and osteoporosis, Favus said, be sure to talk with your doctor about the best way to prevent adverse outcomes of the condition.

"For those with weak bones, [or] increased fracture risk with susceptibility to fracture with little or no trauma," Favus said, "a treatment plan to strengthen bone and prevent further bone loss should be undertaken and followed with good adherence."

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