One of the silent diseases is osteoporosis, which can be defined as when more bone is resorbed by the body faster than it can build new bone, leaving it brittle and at risk for fracture. Men and women aged 50 on up will experience osteoporosis in their lives to the tune of every 1 of 5 men and every 1 of 3 women. Once you have a fracture of the vertebrae your likelihood of having another one goes up 5-fold and for other areas like the hip and wrist, the risk for another fracture to those areas goes up 2-3-fold. I know, one more thing you have to worry about as we get older right? Not trying to be grim just giving you the facts.
There are no outward symptoms until an event happens such as a fracture most commonly seen in the spine or hip. This can be due to a fall or repeated loading of compromised bone with activities as benign as tying your shoes being the tipping point (this is seen in individuals where all the risk factors for fracture line up). So, what can be done? I mean we are talking about a disease that affects millions of Americans, leading to billions of dollars in spending of their own money to deal with treatment and recovery, the shortening of lifespans of older adults who sustain fractures from falls, increasing incidence of death within a year by 25-30%. I know these aren’t easy to hear but the overall impact of being osteoporotic and the risks that follow need to be made aware of. The great thing is that there are proactive solutions that can be performed to ensure that you don’t become just another statistic.
What Proactive Things Can You Do?
First, if you are 50 years of age and up, it’s not a bad idea to get yourself a DXA scan (Dual-energy X-ray Absorptiometry), to confirm your bone density level. The great thing is that they are more affordable than ever with pricing as low as $50. I have even heard of mobile vehicles coming to you be able to administer the scan at your location (ie BodySpec). Getting a baseline measure is always important so you can see what your progress is over time.
Second, the current research suggests that overcoming a decrease in bone density is more of a task of consistency over a longer period rather than a quick fix. Haque et. al (2024) systematic review and Watson et. al (2018) randomized controlled trial both agree that High-Velocity Resistance Training (moving weights focusing on power which is how quickly you can move a given weight, with a weight load intensity level of >80% of a 1 repetition max) at a frequency of 2x per week or greater for at a minimum 6 months is needed to see gains in bone density. According the Watson et al. (2018) for women 58 years of age or older who were of low bone density (T Score < -1), with the study going for 8 months, this yielded an average 3% increase in lumbar spine bone density and a 13.6% increase in femoral neck cortical bone thickness (the latter handling >90% of compressive loading of this common area for osteoporotic fractures). A ramp-up for two months was needed to attain the right intensity level and to make sure the participants could safely perform the lifts.
So what exercises did they do? Interestingly enough, it was exercises that have become staples in gyms across the United States and the world. They performed 4 basic exercises:
The Dead Lift
The Back Squat
The Overhead Press
Jumping Down from the Apex of a Pull-Up
Five sets of 5 repetitions were performed for each. Not one of the 43 women sustained a fracture or any injury that stopped them from completing the study over 8 months. This revealed two things: one, that older adults particularly women are not as delicate as many of them perceive themselves. They can train progressively hard, without the fear of injury. And two, the earlier you start and stay consistent, the greater the percentage theoretically, you will improve bone density over time and definitively, slow the progression of decline.
Supplements, Diet, and Proactive Actions, What Helps?
The Bone Health And Osteoporosis Foundation (BHOF) recommends calcium intake recommendations: 1000 mg/day for men aged 19–70 years and women aged 19–50 years; 1200 mg/day for women 51 years and older and men 71 years and older. The safe upper limits (maximum daily amount that is not likely to cause harmful effects) of calcium ranges from 2000 to 2500 mg/day. There is no evidence that calcium intakes above recommended amounts lead to additional bone benefits. A balanced diet rich in low-fat dairy products, select dark greens, fish with bone, fruits, and veggies should contribute to your intake. Calcium supplementation should only be added if you know for a fact that you have a deficiency in dietary intake.
The BHOF also recommends 800 to 1000 units of Vitamin D per day with safe upper limits of 4000 units per day. This can be attained from 10-45 minutes of sun exposure, or a diet of mushrooms or meats such as fish and egg yolks. According to LeBoff et al. (2022) Vitamin D supplementation taken alone is not enough for optimized musculoskeletal health. Calcium intake needs to be sufficient in combination as well.
Lastly, cutting out smoking and alcohol benefits bone density as both items either affect the liver and kidneys, not allowing for Vitamin D to be converted to its active form or reducing calcium absorption in the small intestines. Leboff et al. (2022) expressed that alcohol intake of more than two drinks a day for women or three drinks a day for men may be detrimental to bone health.
Getting with a trusted dietician, primary care physician, or functional medicine physician can help you organize a more customized plan that fits your age, health status, and skin complexion (the darker you are, the less you are able to absorb vitamin D via sun exposure) when it comes to attaining sufficient dietary needs of calcium and vitamin D. Hormonal imbalances of estrogen and testosterone in our later years need to be checked as well as low levels contribute to low bone density. Once these factors have been set up for your success get another DXA Scan to see if change is trending in a positive direction. If you are unfamiliar with the exercises to attain optimal bone density health, Mobile Spine Specialist can assist in expertly navigating past and current injuries to build your body to perform this research-backed exercise program and movements. Remember that it takes about two months to be able to ramp up your body to be able to perform these movements at 80% or greater of your 1 rep max. You can’t just jump into it and expect to be safe doing so. With practice, they will no longer be intimidating and you may find yourself falling in love with your newfound physical capabilities!
References:
Haque, I., Schlacht, T.Z., Skelton, D.A., 2024. The effects of high velocity resistance training on bone mineral density in older adults: A systematic review. Bone 179, 116986.
LeBoff, M.S., Greenspan, S.L., Insogna, K.L., Lewiecki, E.M., Saag, K.G., Singer, A.J., Siris, E.S., 2022. The clinician’s guide to prevention and treatment of osteoporosis. Osteoporos Int 33, 2049–2102.
O’Bryan, S.J., Giuliano, C., Woessner, M.N., Vogrin, S., Smith, C., Duque, G., Levinger, I., 2022. Progressive Resistance Training for Concomitant Increases in Muscle Strength and Bone Mineral Density in Older Adults: A Systematic Review and Meta-Analysis. Sports Med 52, 1939–1960.
Watson, S.L., Weeks, B.K., Weis, L.J., Harding, A.T., Horan, S.A., Beck, B.R., 2018. High-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial. Journal of Bone and Mineral Research 33, 211–220.
