Osteoporosis and Exercise: 6 Things You Should Know

Nearly 200 million people around the world have osteoporosis, making it the most prevalent metabolic bone disease. The disease involves compromised bone strength, both in loss of bone mass due to low bone density, and in declining bone quality manifested by deterioration of bone microarchitecture.
 
Here are six things you should know about osteoporosis and the role exercise plays in preventing the disease and reducing its impact on those who have it.
 
1. Fragility fractures are much more likely. People with osteoporosis have a much greater risk of suffering a fragility fracture — a fracture that occurs spontaneously or from relatively minor trauma (e.g. from a fall at or below standing height, or at walking speed or below). The areas most prone to fragility fractures include the spine, hips and wrists.
 
2. Aging and gender affect risk. Aging is a primary risk factor, with most cases of osteoporosis occurring after age 50. Women are roughly four times more likely than men to be diagnosed with osteoporosis, owing largely to women’s smaller, thinner bones as well as the impact of declining levels of the hormone estrogen after menopause, which can lead to bone loss.
 
3. The consequences are serious. Patients who suffer a fragility fracture may experience chronic pain, immobility, lower quality of life, a loss of independence, and higher overall mortality. The first fragility fracture puts the patient at an increased risk of additional fractures.
 
4. Exercise, calcium and vitamin D are must-haves. Exercise, calcium and vitamin D are the critical components of life-long bone health — to prevent osteoporosis in the future, and to slow the rate of bone loss and rebuild bone strength in osteoporosis patients.
 

• Exercise: The best evidence we have supports multi-component exercise programs that combine strength, balance and aerobic training. In fact, programs which included only walking were not as effective in preventing falls, and did not have affect hip bone mineral density. You can strengthen your bones by doing weight-bearing exercises such as running, weight-lifting, tennis and stair climbing. Older adults should aim for at least 30 minutes each day of moderate-to-vigorous-intensity aerobic physical activity.

 
If you have a previous spine fracture or other physical limitations, consider low-impact alternatives including and Pilates. These improve strength and balance, enabling your body to have the proper reflexes to react nimbly before suffering a fall and avoid the subsequent bone fracture or breakage that may occur.
 

• Calcium: Aim for a total daily intake of 1,200 milligrams (mg) of calcium through diet and supplements.

 

• Vitamin D: A daily intake of 400 to 1,000 IU is recommended for adults under age 50 without osteoporosis or other conditions affecting vitamin D absorption. A daily intake of 800 to 2,000 IU is recommended for adults aged 50 and older.

 
5. Medication can boost bone strength. Medication may be prescribed for men and women who have a high fracture risk, such as those who have already had a fragility fracture of the hips or the spine, and those who have had two or more fractures not involving the spine or hips. Medication can stabilize or improve bone density and has been shown to reduce fracture risk by approximately 50%, with the greatest benefits seen in patients judged to be at high risk.
 
6. FRAX can estimate your future fracture risk. FRAX is an online tool doctors use to compute a patient’s 10-year absolute risk for a hip fracture or a major osteoporotic fracture. The FRAX algorithm computes the risk using the patient’s individual attributes including: gender; age; bone density of the femoral neck bone; fragility fracture history; glucocorticoid usage history; low weight (BMI); smoking; high alcohol consumption; parents’ hip fracture history; and rheumatoid arthritis prior diagnosis history.
 
Whether you are a young adult or have reached an age when osteoporosis becomes a significant threat, protecting your bone health should be a continuing priority. And if you have not been tested for osteoporosis, ask your doctor about osteoporosis testing options.