Posted by Brigham and Women's Hospital May 4, 2015
Contributor: Dr. Meryl LeBoff, Director of the Skeletal Health, Osteoporosis Center, and Bone Density Unit in the Division of Endocrinology, Diabetes, and Hypertension at Brigham and Women’s Hospital (BWH), and Professor of Medicine at Harvard Medical School. Dr. LeBoff specializes in educating and treating patients with osteoporosis.
Osteoporosis is a disease that weakens the bones and increases the risk of fractures. Overall, approximately 54 million Americans have low bone mass or osteoporosis. The good news is that there is a lot you can do to prevent osteoporosis and new or repeat fractures.
“Although we have extremely effective therapies to treat osteoporosis, only about 25 percent of patients who experience a fracture are evaluated and treated for their underlying osteoporosis, resulting in a high risk of repeat fractures in the future,” says Dr. Meryl LeBoff.
- Know your risks – Knowing your risks is the first step to prevention. Risk factors for osteoporosis include increasing age, being female, low bone mass, history of fractures, smoking, certain medical conditions (e.g., rheumatoid arthritis), and the use of prednisone and a number of other medications. At BWH, experts use a tool that combines a patient’s bone density testing results with other key risk factors to determine a patient’s likelihood of a fracture. This score is used to help guide treatment. They also use a special bone density test to identify vertebral fractures that can indicate the presence of osteoporosis.
- Exercise – Exercise, particularly weight-bearing exercises like walking, is important for good bone health. Balance training also can help prevent falls – a leading cause of fractures. People who already have osteoporosis should avoid forward-bending of the spine, or exercises that involve twisting or jerking of the spine, and should consult with a physical therapist regarding appropriate exercises.
- Calcium and vitamin D intake – Make sure that you are getting enough calcium and Vitamin D. Most adults need 1,000 to 1,200 milligrams of calcium a day (depending on age), and Vitamin D is important in all climates. People who do not receive adequate amounts of these nutrients through their diet may benefit from supplementation, if advised by their doctor. Dr. LeBoff is evaluating the effects of Vitamin D, with or without omega 3 fatty acids, on fractures and a number of other bone health outcomes as part of a large research study.
- Smoking cessation – Smoking is a risk factor for osteoporosis, and quitting is necessary for overall good health, including bone health.
- Limiting alcohol consumption – Alcohol consumption is another risk factor for osteoporosis, so limiting alcohol consumption is important, especially if other risk factors for fractures are present.
- Treat the underlying cause of a fracture – If you experience a fracture, make sure that you are evaluated and treated for osteoporosis. Today’s medical therapies can help prevent future fractures, and newer medications currently under evaluation may help build bone in people with low bone mass.