Bone is a living and growing tissue. Throughout life, bone is constantly being renewed in a process called remodeling. During remodeling, old bone is removed (resorbed) and it is replaced with fresh new bone.
Why has osteoporosis been called a "childhood concern"?
During childhood, the teen years, and early adulthood the skeleton grows and bones become larger, denser, and stronger especially when you practice bone healthy actions. Peak bone mass, defined as the maximum bone density you will ever have, is usually reached between ages 16 and 25. Peak bone mass is largely determined by your genetic makeup. You cannot change your genetics. Some people are born with the tendency to have thick bones and some are not. The goal is to take bone healthy actions to reach the highest bone mass that your genetics will allow. People who attain higher peak bone mass have larger and more dense bones and are less likely to get the bone-thinning disease called osteoporosis later in life.
What are bone healthy actions?
Bone healthy actions to help reach peak bone mass during youth include:
In addition, it is important for young women to have regular menstrual periods. Estrogen, the female hormone that controls the menstrual cycles also protects the bones. It is important for a young woman to discuss her menstrual history and bone health with her health care provider.
What happens to bones in the adult years?
In adulthood, most people no longer build bone mass. Bone healthy actions continue to be necessary; in adulthood they help you maintain your bone mass. Regular physical activity, good nutrition, and healthy lifestyle choices are important ways to help prevent bone loss in the adult years.
At any adult age, your bone mass is the result of the amount of peak bone mass attained minus the amount of bone loss.
Your likelihood of getting osteoporosis depends on the amount of bone mass you reach at peak and the rate and duration of bone loss. People with a low peak bone mass and a high rate of bone loss are more likely to develop osteoporosis. Those with a high peak bone mass and slow rate of bone loss are the least likely to get osteoporosis. Others have a risk that falls somewhere in the middle.
As women and men age, do they lose bone mass differently?
Women experience an earlier, much more dramatic loss of bone mass than men. The rapid loss of bone mass usually occurs at the time of menopause (when the ovaries stop producing estrogen) and continues for several years. Menopause is the permanent loss of monthly periods for 12 months in a row without another medical reason and usually occurs between the ages of 45 and 55. The rapid loss of bone mass is related to a dramatic decline in estrogen, the female hormone that protects bones. When several years have passed since menopause, the rate of bone loss slows down and then may increase again after age 70.
Men do not have a rapid bone loss with age because they do not experience a dramatic decline in either estrogen or testosterone (male hormone) levels. This helps protect men from osteoporosis. Men experience slower bone loss later in life, around age 70 years or older, when estrogen and testosterone levels start to decline.
Though bone loss at menopause and with advancing age is inevitable, the rate of loss varies among individuals. The rate of loss is influenced by genetic factors (that you cannot control) and lifestyle factors (that you can control). You can slow the rate of bone loss by taking bone healthy actions.
Does age influence the risk for fractures (broken bones)?
Broken bones as a result of osteoporosis generally do not occur until later in life even though damage to the skeleton can begin many years earlier Spine fractures increase most dramatically beginning at age 50. The increase in the rate of hip fractures occurs later, after age 65.
If you were to compare two women with the same bone density, one age 50 and the other age 80, they would have very different risks for most types of fractures. The 80 year-old would have a risk for hip fracture several times greater than the 50 year-old.
Does age increase the risk of all types of fractures?
Age does not increase the risk of all types of broken bones. The risk of a wrist fracture does not increase steadily with age. In women, wrist fractures are more common after menopause but then the risk remains the same and even declines after age 65. This may occur because older women tend to be less active in activities that lead to the types of falls that tend to cause wrist fractures. In addition, studies have shown that older women tend to fall differently than younger women. This happens as a result of having less strength and slower reflexes resulting in being less able to quickly extend their arms during a fall.
At what age do I need to be concerned about my bones?
Bone healthy actions should begin in childhood and continue throughout your lifetime. The earlier that prevention measures are taken, the more impact they will have on reducing your risk of osteoporosis. Still, it's never too late to take action to promote healthy bones. Bone healthy actions are the keys to enable you to build strong bones in youth and maintain bone mass in adulthood.
Bone Healthy Actions to Maintain Strong Bones in Adulthood:
Eat a variety of healthy (nutrient-rich) foods. Make half your plate vegetables and fruit, add lean protein, include whole grains, select heart-healthy fats, and remember to include a calcium-rich food or drink at each meal. For more information about healthy food choices, go to www.choosemyplate.gov
Reach and maintain a healthy weight. Eat the amount of calories and protein you need. The amount that you need will depend on your height, weight, age, physical activity level, and medical condition.
Get the calcium you need. It is recommended that adults consume 1000 to 1200 milligrams (mg) of calcium each day. It is best to get calcium from the foods you eat. Foods rich in calcium such as low fat dairy foods (milk, yogurt, cheese), dark green leafy vegetables (bok choy, broccoli, collard greens, kale, mustard greens, and turnip greens), canned fish (sardines, salmon) eaten with bones, or calcium-fortified (with calcium added) foods. The body uses calcium best when it is spaced through the day. Try to eat a calcium rich food at each meal or snack. If you think that you are not getting the recommended amount of calcium in the foods you eat, it is important to consult with your healthcare provider to find out if a calcium supplement is right for you. Calcium supplements should not be taken without the advice of your healthcare provider. Too much calcium taken on a routine basis, particularly from supplements, may be harmful.
Get the recommended amount of vitamin D. There are only a few good natural sources of vitamin D including fatty fish such as catfish, eel, mackerel, salmon, sardines, tuna and shiitake mushrooms. Small amounts of vitamin D are added to all cow's milk, some types of beverages (almond, coconut, rice, or soy beverages and orange juice), yogurt, cheese, and nutrition bars. Check with your healthcare provider to find out how much vitamin D is recommended for you. Your healthcare provider may tell you to take vitamin D supplement in order to get the recommended amount of vitamin D.
Be physically active. Your bones get stronger and denser when you make them work. Walking, climbing stairs, and dancing are impact (or weight-bearing) exercises that strengthen your bones by moving your body against gravity when you are standing. Resistance exercises such as lifting weights or using exercise bands strengthens your bones and your muscles too! Tai Chi is an example of physical activity that improves posture and balance to help decrease the risk for falls and fractures. Exercise can be easy; try 10 minutes at a time, adding the minutes up to reach your goal.
Don’t smoke. If you do, STOP. Call 1-800-NYQUITS for information about how to quit.
Limit alcohol. Before drinking alcohol, it is important to speak to your healthcare provider about possible interactions with your medication or your medical condition. Too much alcohol can be harmful for your bones and your overall health.
Take action to prevent falls. Most broken bones occur as a result of a fall that can be prevented. Some actions to prevent falls at home include using nightlights, removing or securing scatter rugs, and getting rid of clutter.
For more information about aging well, click on New York State Office for the Aging website.