We will all lose some bone density as we age. Leading an active lifestyle with weight-bearing exercise is critical to minimizing that loss (see last month's Joy, page 14), and so is proper diet.
Bone-density loss happens when more calcium is lost from the bones than is added. According to the National Academy of Sciences, the daily adequate intake of calcium for adults between 19 and 50 is 1,000 milligrams, 1,200 for those 51 and older.
What is your risk of developing an osteoporosis-related bone fracture? The World Health Organization's free, online Fracture Risk Assessment Tool — FRAX — can help. This program calculates the risk of developing a fracture later in life. You'll be asked height, weight and age, as well as several medical questions. The result is a lifetime percentage risk of fracture. To use it, visit www.sheffield.ac.uk/FRAX.
Teenagers need even more, with teenage girls being the group that falls farthest behind when it comes to getting enough calcium.
"It's about getting to your maximum (bone density). We need to get this message to our daughters and granddaughters," says Medford doctor Jill Steinsiek.
Because bones reach their maximum density by age 30, it is especially important for teenagers to get enough calcium.
"You can only absorb 500 milligrams at a time, so spread it out," adds Steinsiek.
An 8-ounce glass of skim milk has 300 milligrams of calcium. Dairy is the easiest source of dietary calcium, but there are other ways to get it.
"Leafy greens like spinach and kale are good sources. The calcium in kale, incidentally, is more easily absorbed by the body than many dairy products," says Steinsiek.
Vegans take heart. Broccoli, nuts, raisins, enriched grains, tofu and other soy products, as well as fruits such as oranges and blueberries all are fine sources of calcium.
"To properly absorb your calcium, you need vitamin D. Supplements, food and sunlight are all sources of vitamin D," says Steinsiek.
Ten to 15 minutes of sunlight a day — two to three times a week — on the face, hands and arms is needed for the body to synthesize vitamin D. But exposure to the sun should be tempered, says Steinsiek, due to the risk of skin cancer.
Canned fish such as pink salmon, sardines and mackerel are good sources of vitamin D, as are milk and orange juice that are vitamin D-fortified.
Steinsiek's favorite breakfast is yogurt, blueberries and calcium-fortified granola. She passes out a serving to each participant in the osteoporosis clinic she teaches at Medford Medical Clinic.
On a Friday morning in June, seven women, aged 60 to 80, reviewed the results of their recent bone-density scans — known as DEXAs — with Steinsiek. The primary statistic they consider is the T-score.
The Food and Drug Administration recommends this test for women older than 50 or following menopause. This first test serves as a baseline against which future scores are compared. A T-score of -1.0 to -2.5 indicates osteopenia, bone-density loss less severe than osteoporosis. A score greater than -2.5 indicates full osteoporosis.
Lois Richmond, of Medford, attended one of Steinsiek's recent classes to learn about ways to reduce her risk of developing osteoporosis. Based on her concern about developing osteoporosis, Richmond has changed her diet and added exercise.
"My 95-year-old mother has osteoporosis," says Richmond. "I'm concerned about the risk factors."
Heredity, according to Steinsiek, is the greatest influence on a woman's peak bone mass. The risk of hip fracture is 50 percent greater if you have a family history of fracture; it's a whopping 127 percent greater if it's happened to a parent.
While you can't change your genes, you can make lifestyle changes beyond diet and exercise to reduce the risk of developing osteoporosis.
"Smoking is a big risk factor for osteoporosis, as is low body weight. I recommend that women who weigh less than 127 pounds go above this weight," says Jaymey Sweeney, a family nurse practitioner in Medford.
A body-mass index of 21 or less also is used as an indicator of low body weight.
Because the rate of bone loss increases following menopause, some osteo patients take estrogen supplements. Sweeney cautions against this practice because the FDA has linked estrogen supplementation to an increase in breast cancer.
Moderating your alcohol intake also is a way to decrease the risk of developing osteoporosis. Consuming more than two drinks a day is associated with this disease.
Steinsiek's next osteoporosis seminar is planned for Sept. 10. Call 541-734-3430 for more information.