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Osteoporosis: What You Can Do to Prevent It

Photograph by Twenty20

You've been seeing "Got Milk?" ads for years, and you know you need a hearty dose of calcium every day, but you rarely make sure you're following through. Does that sound like you?

With each passing year, you become more susceptible to osteoporosis, a condition that can wreak havoc on your livelihood, cause debilitating fractures or even lead to breaking bones. About one-fifth of women at age 70 have osteoporosis, according to the International Osteoporosis Foundation, and with the prevalence of fad diets and poor eating habits, the age of onset may continue to drop. Read on to learn how to protect yourself from the so-called "silent disease." It's a little more complicated than just drinking your milk.

When Do I Start Thinking About It?

"It's never too early to start preventative measures for osteoporosis," says New York-based registered dietitian Samantha Heller. "Children and teens should be consuming foods with calcium and vitamin D, and engaging in regular, weight-bearing exercise. And for women, osteoporosis is especially concerning now that so many people are on diets where they're restricting calories and then overexercising." This leaves you prone to osteoporosis breaks, she says, due to the combination of a lack of nutrients and added stress on weakened bones.

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And although you should ideally start great habits as early as possible, focusing on it in your 40s is also important. "Women reach peak bone mass by the age of 30," says Dr. Melina Jampolis, an internist and physician nutrition specialist based in California. "They really need to think about prevention as estrogen levels start dropping off in their mid-40s, especially if they have a family history or risk factors."

Am I at Risk?

Just being a woman is a major risk factor, but there are many more factors to consider. "Being a woman; age; genetics; having a thin or small build; being of Caucasian, European and Asian descent; smokers; inactivity and poor dietary habits are all major risk factors," Jampolis says.

In addition, if osteoporosis runs in your family and you've already gone through menopause, your risk increases due to having lower estrogen, which in turn lowers density. Also account for your lifestyle, medical history and the pills you consume daily. Taking certain medications, such as seizure medications or steroids, are risk factors," says Dr. Larry McCleary, author of the forthcoming "The Fracture Cure." "Also, a history of eating disorders, such as bulimia or anorexia; being immobilized or on long-term bedrest; [and] some chronic diseases, including autoimmune diseases such as rheumatoid arthritis and lupus" are also risk factors due to a lack of nutrients and not getting weight-bearing exercise.

What Are the Symptoms?

The toughest and scariest reality of osteoporosis is that there are virtually no warning signs. "There really are no symptoms, which is why it is called 'the silent disease,'" Jampolis says. "A broken bone is often the first sign, meaning the disease is already present." It's so important to think ahead and protect yourself, instead of having to treat once your bones have already deteriorated.

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How Can I Get Checked?

Your doc will probably start osteoporosis checks around age 50, but think about starting a dialogue earlier if you're concerned. "People often don't realize they have it until they break a bone," says McCleary. "However, osteopenia and osteoporosis can be diagnosed with DEXA (bone-density) scans. And there are now blood tests that measure markers of bone buildup and bone breakdown in the blood. A lot of doctors are not yet aware of these tests and are not requesting them." If you have known risk factors, talk to your doctor about the possibility of blood tests before you get a broken bone.

What Can the Disease Lead To?

"Osteoporosis can lead to bone weakness and fractures, most concerning in the hip and spine," says Jampolis. Although fractures don't sound life-threatening, they are livelihood-threatening, especially as you age. "It can lead to significant disability and pain, and, if in the spine, it can lead to loss of height," she says.

Bones become so fragile, explains McCleary, "A fracture can be caused by minimal trauma. Subsequent fractures can occur with little provocation. A person with severe osteoporosis may break a bone just by moving wrong or sneezing."

Here are five tips for preventing the bone-degenerating disease:

1. Weight-Bearing Exercise

To stop osteoporosis in its tracks, you have to stay active. Specifically, you have to pound the pavement. "Do weight-bearing exercises, like walking or jogging instead of riding a bike," Jampolis says. "You want to stress the bones as much as you can to make them stronger. Strength training is also essential."

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2. Calcium

Think of it as food for your bones. It's necessary to keep them strong and healthy, so be sure to drink your milk. "Calcium—anyone over the age of 2 needs to think about getting it in their diet," says Heller. "We all know about it, but I can't stress it enough. If you're lactose-intolerant, try fortified soy milk or orange juice and green vegetables." You need between 1,000 to 1,200 milligrams of calcium every day, depending on your age, according to the National Osteoporosis Foundation.

3. Vitamin D

If calcium is the bone's food, vitamin D is the mouth by which your bones are fed. This nutrient helps bones absorb calcium—but lots of people don't have enough of it. "Your body is designed to get vitamin D from the sun, so there's not a lot of it in food," Heller says. "Problem is, the sunlight's not strong enough in the winter, and in the summer we often wear sunscreen."

The good news is that you can get it into your diet in a variety of ways. "In addition to getting outside, you can take a supplement, or you can get it in some foods," Heller says. "Fortified dairy that's low-fat or nonfat, soy, yogurt, orange juice, fatty fish, sardines and whole grains all have it."

4. Potassium

You may know about vitamin D and calcium, but there's even more you can do to protect yourself. "Potassium is one (mineral) people don't know about, but research shows people with higher levels of potassium have higher bone density," says Heller. "Eat bananas, prunes, cauliflower, tomatoes, spinach and dried apricots. And basically, vegetables are great."

5. Balance

When in doubt, get all the colors of the rainbow into your diet. First, go green. "Another big one for prevention is vitamin K, which helps keep bones strong, as well," says Heller. "Green, leafy vegetables are a great source of it. Kale, broccoli, spinach, collard greens, Brussels sprouts, romaine lettuce."

In addition, add these nutrients into the mix for a well-rounded palate: "New research shows that magnesium, like in beans, nuts, seeds; vitamin C as in broccoli, orange, strawberry, kiwi; and carotenoids like those found in orange, yellow, and red fruits and vegetables, can all help. Eat a healthy, nutrient-dense diet with lots of fruits, vegetables and lowfat dairy," says Jampolis.

Keep it balanced, and you're more likely to keep osteoporosis at bay.

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