Better Bone Health for Older Adults (FS-2023-0669)

Bone mass is the amount of minerals present in bones. Bone remodeling is the continuous regeneration of bones. Did you know that bone remodeling is observed throughout our lives? Remodeling is the regeneration of new bones. Even though our bone mass is predetermined by our genetics, we can maintain bone mass through a healthier lifestyle. Individuals who have a good bone mass during the early years of their life are more likely to maintain good bone health. It is also dependent on your eating and exercise habits. Women tend to have lower bone mass than men, making them more prone to Osteoporosis (Mayo Clinic, 2021; NIH: NIAMS, 2019).

AGE

Age is one of the significant factors that affect our bone health. Gradual bone loss is usually observed after the age of 40 (Mayo Clinic, 2021; NIH: NIAMS, 2019). Women in their Menopausal age are more prone to bone health issues due to lack of estrogen production. (Mayo Clinic, 2021; NIH: NIAMS, 2019). Eating foods with calcium and vitamin D and taking supplements if needed can benefit individuals above 50 years of age (Mayo Clinic, 2020).

CALCIUM

Calcium is an essential mineral to maintain good bone health. More than 99% of the calcium in our bodies is stored in bones. Calcium helps to maintain your bone mass and prevents excess bone loss. As we age, digesting lactose-based high-calcium products can be more challenging. In that case, opt for lactose-free options or talk to your healthcare professional regarding supplements. If you are between 50-70 years of age, consume 1,000 mg of calcium every day. If you are above 70 years of age, consume 1,200 mg of calcium daily to maintain your bone health (Mayo Clinic, 2020). Consume vitamin D to enhance the absorption of calcium in the body. The general recommendation of 600 IU (international units) for 50-70 years and 800 IU for 70 and older (Bobroff et al., 2017; Mayo Clinic, 2020).

TOBACCO AND ALCOHOL

Tobacco and alcohol can interfere with calcium absorption and circulation, which are essential to depositing calcium in bones. Excessive smoking can reduce estrogen levels needed for good bone health in women. Excessive alcohol consumption is also connected to bone loss leading to osteoporosis (Boden, 2023; NIH: NIAMS (2019).

PHYSICAL ACTIVITY

When we perform physical activities, they create a healthy stress response that encourages more bone generation. In addition, exercising is beneficial for maintaining good posture, balance, and strength to do everyday tasks without too much effort. To improve flexibility and balance, perform stretching, yoga, and tai chi. To improve the strength of your muscles and bones do weight-bearing exercises such as jogging, walking, stair climbing, dumbbell exercises, etc. (Mayo Clinic, 2020; Mayo Clinic 2021; NIH: NIAMS, 2023). Strength exercising (bodyweight, free weights, or weight-bearing exercises) can improve muscle strength and bone generation capacity.

Develop a goal to engage in at least 150 minutes of moderate-intensity aerobic activity for 75 minutes of higher-intensity aerobic activity or an equivalent combination of each per week (US Office of the Surgeon General, 2004).

MEDICATIONS

Long-term usage of corticosteroid medications prescribed to treat asthma allergies, lupus, and arthritis may damage your bones. Examples of these medications are prednisone, cortisone, prednisolone, and dexamethasone. Other drugs that might increase the risk of osteoporosis are aromatase inhibitors to treat breast cancer and anti-seizure medications, such as phenytoin. Calcium supplements can also interact with medications, supplements, and foods. General recommendations for taking iron supplements are to wait two hours before you consume calcium supplements or calcium rich foods such as Greek yogurt or milk. Take your calcium supplement one to two hours before or after you eat high-fiber foods. Always check with your healthcare provider or pharmacist about possible medication and supplement interactions (US Office of the Surgeon General, 2004).

PROTEIN

Protein is a building block for all our bodies. Bones are made of collagen protein that holds calcium and phosphorus. If your diet is deficient in protein, it can lower the protein in bones. This protein loss within the bones can further bone loss and slow down bone remodeling (May Clinic, 2020).

Falls are very common as we age. It can lead to bone fractures and breaks. Consider taking the following measures to prevent falls (NIH: NIAMS, 2019).

1. Exercise
   Exercise helps improve balance and coordination. Try to do some form of activity such as walking, seated exercises, tai chi, and stretches.
    
2. Create a safer space
   1. Get rid of things that can trip you on the floor and stairs.
   2. Remove small rugs.
   3. Add handrails at staircases.
   4. Keep things within reach and avoid stepping stools.
   5. Use grab bars in the bathroom and near the toilet.Use nonslip mats in the shower.
   6. Use brighter lights.
   7. Wear sturdy shoes that provide support and nonslip soles.

Osteoporosis is a bone disease known and experienced by many individuals, regardless of age, gender, and race. This bone disease develops when the amount of mineral deposited in your bone decreases or when the quality or structure of bone changes. Osteoporosis is often called a silent disease and may go unnoticed until you experience severe symptoms or break a bone. It is a major cause of fractures among post menopausal women, usually observed in the spine, hip, and wrist bones (NIH. 2022; NIH: NIAMS, 2019; US Office of the Surgeon General, 2004).

SYMPTOMS OF OSTEOPOROSIS (NIH, 2022)

• Back Pain
• Loss of height over time
• A stooped posture
• Bones more prone to fracturing/breaking
• Bones become so fragile that even minor stresses, falls, lifting, bending, or even coughing can cause a bone to break

WAYS TO PREVENT OSTEOPOROSIS (Mayo Clinic, 2020; NIH, 2022)

• Stay physically active and perform weight-bearing exercises such as walking and exercising with some weight
• Consume moderate amounts of alcohol
• Avoid smoking
• Take prescribed medication
• Eat a healthy diet high in calcium, vitamin D, zinc, magnesium, and vitamin C

RISK FACTORS OF OSTEOPOROSIS

The following factors can make you prone to osteoporosis (NIH. 2022; US Office of the Surgeon General, 2004)

• Sex: women are more prone than men
• Age: post-menopausal for women, 70 and above for men
• Body size: slender and thin boned
• Family history of osteoporosis
• Diet low in calcium and vitamin D
• Changes in the estrogen hormone levels
• Medications: consult your healthcare professional to assess this risk factor
• Lifestyle: inactivity, drinking and smoking excessively

Osteoporosis is not the only common bone disease that affects us during older age. Other bone diseases can be debilitating to our health. Talk to your healthcare provider about your symptoms to manage and prevent bone diseases.

• Rickets and osteomalacia: Cause bone deformities and fractures due to inadequate vitamin D. It can occur in childhood and adulthood.
• Kidney disease: Renal osteodystrophy (usually results from end-stage kidney diseases) can cause fractures.
• Paget’s disease of bone: This can be caused by genetic and environmental factors that cause bones to deform and become weaker. (NIH: NIAMS, 2019)

Bones are integral to our health. They help protect vital organs, store minerals, and perform movements. The earlier you start caring for your bone health, the stronger your bones will be no matter the age progression. Eat foods high in calcium, vitamin D, and protein. Include at least 150 minutes of moderate-intensity exercises per week and take supplements suggested by your healthcare professional. Talk to your healthcare provider about drug interactions between your medications and supplements. Osteoporosis is not the only bone disease that affects bones. Educate yourself and reach out to your healthcare professional with the bone health checklist to support your bones for independence and optimal quality of life.

REFERENCES

• Bobroff, L., Valentin-Oquendo, I. (2017). Facts About Vitamin D. University of Florida Extension. https://edis.ifas.ufl.edu/pdffiles/FY/FY20700.pdf
• Boden, S. (2023). Effects of Stopping Smoking and Alcohol Abuse on Osteoporosis. Spine Health. https://www.spine-health.com/conditions/osteoporosis/effects-stopping-smoking-and-alcohol-abuseosteoporosis#:~:text=Smoking%20in%20any%20amounts%20has,shown%20to%20increase%20bone%20loss.
• Mayo Clinic (2021). Bone Health: Tips to Keep Your Bones Healthy (2021). https://www.mayoclinic.org/healthylifestyle/adult-health/in-depth/bone-health/art-20045060
• Mayo Clinic (2020). Five ways to build strong bones as you age. https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/5-ways-to-build-strong-bones-asyou-age
• National Institute of Health. (2022). Calcium. https://ods.od.nih.gov/factsheets/Calcium-5. HealthProfessional/
• National Institute of Health: National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). (2019). Bone Health and Osteoporosis: What It Means to You. https://www.bones.nih.gov/health-info/bone/bonehealth/bone-health-life-health-information-basics-you-and-your-family
• National Institute of Health. (2022). Overview of Osteoporosis. https://www.niams.nih.gov/health-topics/osteoporosis
• US Office of the Surgeon General (2004). Bone Health and Osteoporosis: A Report of the Surgeon General. https://www.ncbi.nlm.nih.gov/books/NBK45513/