By Alia Tuqan, M.D.
May is designated “National Osteoporosis Awareness and Prevention Month” to highlight the importance of maintaining strong, healthy bones. But any month is a good time to think about bone health and osteoporosis.
Bone is a dynamic, vital organ composed of the minerals calcium and phosphorus, collagen, other proteins and two types of cells: ones that build bone and others that break it down.
In children and young adults until their mid-20s, the bone-creating cells build it faster than the other cells destroy it. In adults, there is a balance between bone created and bone destroyed. As adults age, however, they can develop an imbalance when some cells break down bone faster than others build it, leading to thinning, porous bones.
Osteoporosis is a disorder caused by abnormal thinning of bone. People with osteoporosis are at increased risk of fractures. Compression fractures – small breaks in the vertebrae – and hip fractures after falls are unfortunate consequences.
The most common screening for osteoporosis is called a DEXA scan. All guidelines recommend screening post-menopausal women age 65 or older because they are at highest risk for osteoporosis and fractures.
Although there are no universally accepted screening guidelines for men in this age group, they also may be screened for osteoporosis, as well as younger women with certain risk factors.
There are several types of medications used to treat osteoporosis and reduce the risk of fractures. The most common class of medications is called bisphosphonates, such as alendronate (Fosamax), ibandronate (Boniva), and risedronate (Actonel).
For those who cannot tolerate these types of medications, there are other treatment options.
Reducing Fall Risk
If you have osteoporosis, here are practical ways to reduce your risk of falls:
• Stay physically (and mentally) strong with regular exercise. Always talk to your doctor about exercise routines.
• Reduce clutter and keep walkways clear.
• Walk in well-lit areas.
• Avoid rugs or, if you do use them, make sure they have non-slip backings or pads.
• Wear comfortable, well-fitting shoes.
• Use assistive devices, such as canes and walkers, if recommended by your doctor or physical therapist.
• Review medications with your doctor and pharmacist to see if any of them can cause dizziness that leads to falls.
• Watch your alcohol consumption. Intoxication can affect walking and cause falling.
These tips can help maintain strong, healthy bones and prevent osteoporosis:
• Eat a diet rich in calcium. Foods high in calcium include milk, yogurt and other dairy products; spinach, kale and other green vegetables; almonds, other nuts and sunflower and sesame seeds; and soy milk, tofu and other calcium-fortified products.
• Load up on vitamin D. Sunlight is a good source of vitamin D, but increases skin-cancer risk. Vitamin D-rich foods include oily fish, such as salmon, mackerel, herring and sardines; mushrooms; and vitamin D-fortified milk and juice.
• Talk to your doctor about supplements if your diet is deficient in calcium and vitamin D.
• Exercise regularly, after checking with your doctor about safe, age-appropriate exercise regimens.
• Get regular check-ups. Your doctor will monitor for conditions that increase your osteoporosis risk and recommend screening, if appropriate.
• Stop smoking.
• Avoid excessive alcohol consumption.
• Review medications with your doctor to determine if any increase your osteoporosis risk.
Follow these simple steps for healthy bones – and a healthier you!
Dr. Alia Tuqan is a board-certified geriatrician with the highly regarded UCLA Geriatrics Program in Santa Monica and Westwood. For more information, call 310.319.4371 or visit www.uclahealth.org.