Calcium: An inadequate supply of calcium
over a lifetime contributes to the development of osteoporosis.
Many published studies show that low calcium intake appears to
be associated with low bone mass, rapid bone loss, and high
fracture rates. National nutrition surveys show that many people
consume less than half the amount of calcium recommended to
build and maintain healthy bones. Good sources of calcium
include low-fat dairy products, such as milk, yogurt, cheese,
and ice cream; dark green, leafy vegetables, such as broccoli,
collard greens, bok choy, and spinach; sardines and salmon with
bones; tofu; almonds; and foods fortified with calcium, such as
orange juice, cereals, and breads. Depending upon how much
calcium you get each day from food, you may need to take a
calcium supplement.
Calcium needs change during one's lifetime. The body's demand
for calcium is greater during childhood and adolescence, when
the skeleton is growing rapidly, and during pregnancy and
breastfeeding. Postmenopausal women and older men also need to
consume more calcium. Also, as you age, your body becomes less
efficient at absorbing calcium and other nutrients. Older adults
also are more likely to have chronic medical problems and to use
medications that may impair calcium absorption.
Vitamin D: Vitamin D plays an important role
in calcium absorption and in bone health. It is made in the skin
through exposure to sunlight. While many people are able to
obtain enough vitamin D naturally, studies show that vitamin D
production decreases in the elderly, in people who are
housebound, and for people in general during the winter.
Depending on your situation, you may need to take vitamin D
supplements to ensure a daily intake of between 600 to 1000 IU
of vitamin D. Massive doses are not recommended.
Exercise: Like muscle, bone is living tissue
that responds to exercise by becoming stronger. Weight-bearing
exercise is the best for your bones because it forces you to
work against gravity. Examples include walking, hiking, jogging,
stair climbing, weight training, tennis, and dancing.
Smoking: Smoking is bad for your bones as
well as for your heart and lungs. Women who smoke have lower
levels of estrogen compared to nonsmokers, and they often go
through menopause earlier. Smokers also may absorb less calcium
from their diets.
Alcohol: Regular consumption of 2 to 3
ounces a day of alcohol may be damaging to the skeleton, even in
young women and men. Those who drink heavily are more prone to
bone loss and fractures, because of both poor nutrition and
increased risk of falling.
Medications that cause bone loss: The
long-term use of glucocorticoids (medications prescribed for a
wide range of diseases, including arthritis, asthma, Crohn's
disease, lupus, and other diseases of the lungs, kidneys, and
liver) can lead to a loss of bone density and fractures. Bone
loss can also result from long-term treatment with certain
antiseizure drugs - such as phenytoin (Dilantin1)
and barbiturates; gonadotropin-releasing hormone (GnRH) drugs
used to treat endometriosis; excessive use of
aluminum-containing antacids; certain cancer treatments; and
excessive thyroid hormone. It is important to discuss the use of
these drugs with your physician and not to stop or change your
medication dose on your own.
Preventive medications: Various medications
are available for preventing and treating osteoporosis