Awareness Comes First


Meet the “Silent Thief”

There are no obvious symptoms of osteoporosis. In fact, many people do not know they have it until after a fracture, usually of the wrist, spine, or hip. And we’re not talking about any old bone break. After an break due to osteoporosis, a person can experience chronic pain, loss of mobility, disability, and even loss of independence according to Women On the Go. Right after a hip fracture, 40% of patients can walk by themselves, but a year later, 60% need help walking. Osteoporosis fractures can also be fatal.

If you have or are at risk for osteoporosis with low bone density, it’s important to understand your treatment options and work out a plan with your doctor to maintain bone density. This will almost always include weight-bearing exercise, calcium, vitamin D, and avoidance of alcohol and smoking. Depending on your condition, medications and other medical treatments may be available to you. On the Go Women has a great personalized conversation guide that you fill out to help know what you and your doctor will talk about when discussing other treatment options.

As with many chronic conditions, osteoporosis can be difficult to deal with. It’s important to keep a social network and stay positive. Taking steps to take care of yourself physically can go a long way to improving your condition, but also taking care of yourself mentally, emotionally, and socially will definitely improve your quality of life. The National Osteoporosis Foundation has an a page called Thinking and Feeling Good about Yourself with a list of affirming thoughts and ideas.

Remember, there is much you can do to build or maintain bone health through good lifestyle habits. Make others aware of what they can do to lower their risk of osteoporosis as well. Let’s build strong bones together!

Drink and smoke less for healthy bones

In the last post I mentioned that alcohol and tobacco use increase risk of osteoporosis and fractures, but I wanted to find out more why that was. An article I read called Drink Less for Strong Bones says heavy drinking, especially when teenagers, greatly increases the risk of osteoporosis in the future. And there are a ton of reasons why.

When you drink a lot, your pancreas and liver cannot absorb calcium and vitamin D the way they are supposed to. Also, drinking has shown to lower levels of estrogen, which leads to bone loss. The hormone cortisol is seen in high levels of heavy drinkers, leading to slowed bone production and bone breakdown. Parathyroid hormone can increase too, which takes calcium from bones. Osteoblasts, the cells that build bone, are destroyed with excessive drinking, as well as nerve cells in the hands and feet because of nutritional deficiencies. You are more likely to fall and sustain a fracture if you abuse alcohol, and healing will take longer than normal.

According to the National Institutes of Health evidence linking prolonged and smoking to low bone mass for more than 2o years. Like with drinking, the younger you start smoking, the longer you do it, and the amount you smoke all impact your future risk of fractures. If all that isn’t bad enough, being a heavy smoker and drinker makes matters worse. If you are have osteoporosis and are seeking treatment, it will not work unless you quit both habits. But there is good news! Once you quit, there is a significant reduction in your risk for osteoporosis and fractures.

Most people know about the cardiovascular, lung, and liver risks of drinking and smoking, but how many know about the bone risks? Until I wrote this post, I didn’t realize how detrimental they are to your bone health.

Here is a short video about the way heavy drinking affects bone health.

Guys, this one’s for you

So I realize that this is blog about women and their bone health, but men need to know that they are not exempt from osteoporosis. According to an article I read called Q&A: Osteoporosis, not just a threat for woman, osteoporosis affects 2 million American men and 12 million more are at risk with low bone density. One in four men over 50 will at some point have a fracture due to osteoporosis. Men don’t lose bone as fast or as young as women do, but when they do get osteoporosis they are more prone to death following a fracture than women.

In a news video about men and osteoporosis I watched, it mentioned a healthy 58-year-old man who stayed fit by bicycling and swimming, but had noticed a decrease in his physical ability. The man was screened and found to have severe osteoporosis. Though he was exercising, he was not participating in weight-bearing exercises that force you to work against gravity, like jogging, weight-training, tennis, etc. These are the types of exercise that strengthen bone. He also was found to have low levels of testosterone. This is similar to women who lose bone mass when their hormone levels drop after menopause. Because he was younger than 70, his condition is called secondary osteoporosis. Other reasons men find themselves with this debilitating disease when younger are excessive alcohol use,  smoking, gastrointestinal disease, certain medications, and other conditions.

Osteoporosis is a silent disease, so most men will not realize their problem until a fracture occurs, usually of the hip, spine, or wrist. So how can men prevent and treat osteoporosis? Getting screened with a bone mineral density test is the first step. According to the National Institutes of Health, a doctor may design a  plan to treat an underlying cause or prescribe medication, but otherwise treatment and prevention are similar. Both require weight-bearing exercise, adequate calcium, adequate vitamin D, and reducing alcohol intake and smoking.

So don’t think because you are a guy you don’t have to look after your bone health! Do you know a man with osteoporosis? If so, what were the causes?

The Sunshine Vitamin

Did you know that your bones and muscles need vitamin D to absorb calcium? According to Science Daily, vitamin D can help prevent falls, cancer, cardiovascular disease, chronic pain, and autoimmune diseases. Also, you can’t get that much vitamin D from food, even if it is vitamin D-rich fish or fortified milk and cereal. Your main source comes from your own skin. That’s right! Skin produces vitamin D when exposed to good old sunlight.

Everyone needs at least 1000 IU (International Units) of vitamin D everyday to maintain good health. According to the American Academy of Orthopedic Surgeons, you can get 1000 IU just by exposing your face, hands, arms, or legs for 5-30 minutes depending on the quality of sunlight. Seems easy enough. A lot of people do get enough vitamin D through daily activity, but a whopping 50% of Americans don’t.  Why might that be? UV exposure may be compromised depending on the time of day, the season, how far up north you are, or the amount of smog in the air. Clothing and sunscreen will block access to sunlight. And if your skin is darker, it will need more sunshine to get the right amount of vitamin D.

Kids are especially susceptible when it comes to lack of sunlight. When families first worked in factories rather than fields, a disease called rickets increased among children causing bone weakness, bowed legs, stooped posture, and other skeletal deformities. Today, rickets is again gaining attention. Kids spend less time outdoors and more time inside in front of a screen, few regularly walk to school, popular sports are often played inside, milk is replaced with soda and juice, and sunscreen use prevents the skin from soaking in rays.

You may be thinking, “Hold on, I thought I was supposed to avoid UV rays to protect my skin from cancer!” Unfortunately, there is not really a clear line between when and when not put on sunscreen. Perhaps there is a balance depending on your area, how long you plan to be outside, and your outdoor habits. Any thoughts?

Next time you catch yourself cooped up inside on a nice day, go outside for a just a few minutes and enjoy the sunshine. It’s good for you!

Got Milk?

Yes, you’ve seen the slogan in commercials, magazines, billboards, etc.  But why does milk matter? With protein, potassium, phosphorus, and fortified vitamin D (which helps the body absorb calcium), milk is a major source of calcium and other nutrients for the bones and body. It’s not the only way to get these nutrients, but it’s one of the easiest ways.

How much milk kids drink makes a difference. According to, regular milk drinking while young translates to being taller and having more bone, while skipping out on milk means reduced height and more fractures. To answer a question I posed in the last post, research shows that moms who drink milk are more likely to have daughters who drink it too. Availability of milk and beverage habits in the home before adolescence impact a child’s future bone health greatly.

So we know milk is great for the growing kids, but what about everyone else? has a Milk for All Ages chart that outlines milk intake needs for every age.  Other tools and calculators are also available, like the beverage analyzer, as well as other helpful information. Did you know that you can drink chocolate milk to recover after exercise?  It’s a fluid with lots of protein and nutrients, plus research shows milk can help build overall lean muscle.

At this point you may be nodding your head but clutching your tummy if you are lactose intolerant. According to the National Institutes of Health website called Milk Matters, people have varying degrees of lactose intolerance. Even with a higher degree,  kids and teens can still consume 8-12 oz of milk a day without any symptoms. You can also come up with other calcium strategies according to your needs.

Some teens and others avoid milk because they perceive it as fattening.  Heard of low-fat or fat-free milk?  It’s a healthy choice that is not high in fat or calories. And some kids plain don’t like milk.  To keep up the calcium, you can try the chocolate, vanilla, or strawberry varieties, yogurt smoothies, orange juice, and other fortified drinks to name a few.  Even ice cream and frozen yogurt have calcium.

Lastly, here are some hilarious Japanese ads from a milk campaign for teens. Enjoy!

What teen bones are lacking

Calcium?  It’s a mineral necessary for healthy bones, teeth, and good heart, muscle, and nerve function.  Your body can’t make it, so you’ve got to eat it. Calcium is needed to maintain good health at every age, but not everyone needs the same amount.  Here is a chart of recommended calcium intake by age from the U.S. Center for Disease Control:

Ages Amount mg/day
Birth–6 months 210
6 months–1 year 270
1–3 500
4–8 800
9–13 1300
14–18 1300
19–30 1000
31–50 1000
51–70 1200
70 or older 1200

So apparently, the need for calcium intake peaks at ages 9-18, with 1300 milligrams per day.  But did you know that only 12% of teen girls get enough calcium in their diet? If you are not feeding your body enough, it will take calcium right from your bones. Your bones will weaken, which will put you at greater risk for fractures and later, osteoporosis.

Soda doesn’t help! According to, studies show that teen girls who drink a lot of soda, especially colas, have more fractures.  This is because they are less likely to be drinking milk, which provides necessary vitamin D and calcium.  Also, a lot of colas contain phosphoric acid, which may weaken the bones by causing them to lose calcium.

Best Bones Forever!, a site targeting teen girls and their bone health, provides a calcium calculator which tells you the amount of calcium according to portion in everyday foods. These include dairy products, dark green leafy veggies, nuts, and calcium fortified foods like orange juice, cereal, bread, and tofu.

What reasons do you think the overwhelming majority of teen girls are not getting enough calcium? Could parents play a role in this statistic?

While we’re at it, here are some other some factors that can put a young girl at risk for osteoporosis by the Center for Young Women’s Health:

  • Being white
  • Having irregular periods
  • Doing little or no exercise
  • Being below a normal weight
  • Having a family history of osteoporosis
  • Smoking
  • Drinking large amounts of alcohol

Wait, what does exercise have to do with my bones?

So everyone knows that calcium and vitamin D are good for bone health. But what about exercise? According to the U.S. National Institutes of Health exercise is vital to bone health at every age. Bone, like muscle, is living tissue that strengthens with exercise. Because bone reaches peak mass by the twenties, young people who exercise regularly build up to a higher peak bones mass than those who do not exercise regularly. Exercising later will slow the loss of bone and strengthen them against osteoporosis.

But not every type of exercise is equal in regards to bone health.  Weight-bearing exercises, like weight training, walking, hiking, jogging, climbing stairs, tennis, and dancing are the best because they force you to work against gravity. Examples of non weight-bearing exercises are swimming and bicycling. Exercise also improves cardiovascular health, builds muscle, balance, and coordination.  Balance and coordination are especially important to older people trying to avoid falls that lead to fractures.

However, there is a catch for women athletes.  In an article I read called Too much exercise? What every woman athlete should know about osteoporosis, it mentions that a strict exercise regime and diet can actually lead to premature bone loss and early osteoporosis. This may happen if a girl does not supply her body with enough food to compensate for the amount of energy she is putting out during exercise. Her body no longer has enough resources to make estrogen, a hormone necessary for menstruation and bone growth. During a time she should be gaining 40% of her bone mass, a teenage runner may be weakening her bones. Some experts recommend extra calcium and vitamin D intake in such cases.

That being said, for the rest of us here are some examples of weight-bearing exercises you can do at home.  America Bone Health has some diagrams of exercises you can do without any equipment.  The video below demonstrates ways to maintain your bone mass with weights, a ball, and resistance bands.  Happy bone building!