Tips for maintaining bone density and the prevention of bone loss

Whether you have been diagnosed with osteoporosis (brittle, fragile bones due to bone loss), or have another medical condition that can lead to bone loss. Or maybe you’re just trying to ensure you have healthy strong bones to last throughout your life. No matter the reason for your interest in bone health you may have wondered if there is anything you can do at home to ensure good bone health.

Bone is a living tissue. It is constantly breaking down old bone cells and building up new bone cells This process is called bone remodelling and if the balance of breakdown and buildup becomes dysregulated or faulty then disease can occur. There are diseases of too much bone, but I will focus here on the conditions of bone loss and how we can help prevent it or try to maintain the bone density we have at present.

There are many factors that can contribute to the loss of bone which can then lead to bone fractures, loss of height or stooped posture. Some of these factors include:

• Certain medical conditions like osteoporosis, hyperparathyroidism, chronic kidney or liver disease, malabsorption syndromes like celiac disease, Crohn’s and ulcerative colitis as well as other conditions with chronic hormone imbalance.
• Use of certain medications including glucocorticoids (steroids), some anti-seizure medications, proton pump inhibitors (used for acid reflux), long term anti-coagulants and some chemotherapeutic agents just to name a few.
• Poor nutrition – This doesn’t accelerate bone loss per say but instead fails to support healthy bone maintenance.
• Low estrogen levels as seen in menopause.
• The natural effects of aging.
• Smoking and excessive alcohol use

Some of the reasons why you may lose bone density are hard to control and not necessarily preventable. Research shows however, that there are things we can do at home to help slow the rate of bone loss or at the very least support the requirements for bone maintenance.

It is important to note that these aren’t short term changes that make a difference quickly. These are lifestyle changes that improve your chances of maintaining bone health over time and should be incorporated as early as possible and consistently, even if you don’t have increased bone loss risk yet. Basically, everyone no matter the age, gender, race or health status should be including these strategies to help ensure lifelong bone health.

First and foremost, before we get to the lifestyle changes for improved bone health, I need to mention that you must follow your doctor(s) advice and medication recommendations regarding your own personal health situation. Never discontinue prescription medication without the advice of your physician. Even though some medications may contribute to bone loss, your doctor may still prescribe them to you because the benefit from this drug outweighs its potential cost.

Also, if you have been diagnosed with a health condition that is known to contribute to bone loss it is important to manage that condition. If your disease is depleting your bones and you don’t get treatment for the disease itself these lifestyle changes will not be able to help very much. Treat the cause first.

All that being said here are some lifestyle changes that can help improve bone health:

• Stop smoking. Smoking is a major contributor to poor bone health and bone loss.
• If you consume alcohol do so within moderation. Current guidelines for bone health recommend no more than 2 alcoholic beverages per day.
• Incorporate weight-bearing and resistance exercise for at least 30 minutes, 3 times per week. These include walking, hiking, jogging, lifting weights, training with resistance bands etc. All of these exercises put stress on your bones which encourages them to be in bone building state.
• Optimize your diet. Bone health requires adequate protein, calcium and vitamin D.
  • Good protein sources: meat, poultry, seafood, eggs, dairy products, soy products, as well as quinoa, lentils and beans.
  • Good calcium sources: milk, cheese, yogurt, green leafy vegetables, nuts and seeds.
  • Good vitamin D sources: fortified milk, salmon, mackerel and other fatty fish. Sun exposure on bare sunscreen-free skin is the best and easiest way to get adequate vitamin D. When we are exposed to unfiltered sunlight our skin cells produce vitamin D from cholesterol. It doesn’t take much sun to get an adequate dose. Melanocytes (the pigment cells of our skin) protect the inner layers of skin and tissue from sun damage. The more pigment you have in your skin the harder it is for the sun’s rays to penetrate deep enough to produce vitamin D. For this reason, people need different amounts of sun exposure to get the recommended vitamin D dose depending on the level of darkness of their skin. Please remember that It is still important to protect yourself from sunburn or excessive sun exposure. If you are going to be outdoors for long periods only leave skin bare and without sunscreen for as long as is well tolerated even if it is less than what you believe is needed for good vitamin D levels. You can always go out more frequently and for shorter periods of time to top up your D levels. As a general rule see the sun exposer guidelines below.
    • Fair skinned people – 10-20 minutes of midday sun 3 times/week.
    • Dark skinned people – 20-40 minutes of midday sun 3times/week.
• Talk to your health care professional as to whether you should take vitamin and mineral supplements. The general guidelines for nutritional intake of certain bone friendly nutrients are listed below. The amount listed includes all sources of the nutrient including diet and supplements. There are many websites and apps available that can help you calculate your dietary intake if you are not sure. Try MyFitnessPal, MyNetDiary, or use your web browser to search “Nutrition Facts”. Please do not take “mega doses” of any nutrients without instruction from your doctor.
  • Calcium
    • Men and premenopausal women – at least 1000mg/day
    • Postmenopausal women – 1200mg/day
  • Vitamin D
    • Men and premenopausal women – 600 IU/day
    • Postmenopausal women and men over 70 years of age – 800 IU/day
    • If you have been diagnosed with low vitamin D by a blood test your doctor may prescribe a different vitamin D dose for you until your vitamin D levels improve.

In summary to maintain optimal bone health see your doctor to rule out or discuss management of any contributing medical conditions, take your medications exactly how they were prescribed and try to eliminate any modifiable risk factors for bone loss. Then you can start incorporating exercise, optimize your diet and discuss vitamin/mineral supplements with your physician.
Hopefully by following all of the appropriate guidelines you can maintain strong, healthy bones for years to come.