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
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
• 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
• 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
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.
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