It used to be that one of the first indications of osteoporosis, the gradual decrease in bone mass (and therefore bone strength), was a broken bone. Now time and research have done much to identify the risks and educate us about the importance of bone health. And while women are much more likely to develop osteoporosis, it's not just a woman's health issue. "Osteoporosis affects both men and women," says Dr. David Chamberland, Medford rheumatologist. "Over one million men in the U.S. are thought to suffer from osteoporosis."
Bone loss can begin as early as your 40s when the loss of vital bone nutrients begins to outpace the natural bone renewal process, and for women, menopause often marks a significant downturn in bone density.
The good news is that a bone density test, also called densitometry, is easy, painless and requires very little preparation. Using special low radiation X-rays, the amount of calcium and other bone minerals in the bone can be measured at the spots most typically prone to breaking — the lower spine, hip, wrist and forearm.
"Although there are many ways to measure bone mineral density, dual energy x-ray absorptiometry (DXA) is the most widely used standard method for measuring BMD [bone mineral density]," says Dr. David Chamberland, Medford rheumatologist and certified clinical densitometrist. The results are assessed in terms of a "T-score" that is used to determine whether you have, or are at risk of osteoporosis.
So who should be tested? The U.S. Preventive Services Task Force recommends a bone density test if you are a woman 65 or older, or if you are at increased risk of osteoporosis. These risks may include a previous fragility or low trauma fracture, long-term glucocorticoid therapy, low body weight (less than 127 pounds), a family history of hip fracture, cigarette smoking or excessive alcohol intake. If you think you may be at risk for osteoporosis, reminds Dr. Chamberland, talk to your health care provider.
For Mary Jean Sayre, 84, of Medford, the knowledge was gained firsthand. Diagnosed with osteoporosis, Mary Jean broke her hip after a fall and has had to work at her recovery. So when she and Bonnie Symmonds, 76, also of Medford, saw a notice for a class called "Strong Women, Strong Bones" at Avamere Health and Fitness Club in Medford, they were interested.
"Once osteoporosis has occurred, there are medications which can reduce the risk of fracture, [and] maintain or enhance bone mineral density. Some are taken daily, weekly or monthly. These are best discussed with a physician. And impact exercise in moderation is recommended for these patients, too" says Chamberland. "This type of exercise can enhance bone mineral density."
"Strength training is directly linked to halting or reversal of osteoporosis," says Bill Macy, director of Avamere and an American College of Sports Medicine-certified professional. Put simply, studies done over the last decade have discovered that in strength training, the pull of muscle contractions on the bone was found to strengthen the bone along with the muscle. And over time, bone loss was actually reduced or reversed.
"When I first started I thought this is so simple," recalls Mary Jean. "But that night my legs told me I had been working."
"It's not body building," says Macy." [And] cardio is great, and very important, but it complements — does not replace strength training for osteopenia [low bone density] and osteoporosis." Because of the injury risks inherent with osteoporosis or other chronic joint conditions, it is important to make strength training safe and appropriate, caution both Chamberland and Macy. "[A] critical [component] for beneficial exercise, is to be referred to a medical exercise professional for safe and proper guidance," says Macy.
Nutrition plays a role, too. While most women are aware of the advice to take calcium supplements, both Chamberland and Macy remind us that your body more readily absorbs certain types of calcium. "Calcium carbonate and calcium citrate are both good sources," says Chamberland who also recommends vitamin D along with a "generally balanced diet" to help your body make use of the calcium. And because osteoporosis can be the result of other medical conditions, always discuss any supplements with your health care provider first.
Of course regular activity will have benefits beyond bone strength. Both Bonnie and Mary Jean have seen the difference. "I know my strength is improving," says Bonnie, who still enjoys digging in her garden. "It helps with my stability, too." And for Mary Jean, the real test occurred when she had another fall on her arm and no bones broke. "I figured this class is helping," she says with a smile.
With a balanced approach of exercise, nutrition and medication when necessary, you can dramatically improve your bone strength and overall health. "You can change the quality of your life," says Macy. "If you're willing to work at it."