Much has been written about the importance of maintaining good bone health. The reason this subject is so important is because, later in life, both men and women can be susceptible to falls which result in bone fractures if our bones are not strong.  

Many of us are aware of people we know who have fallen and who have sustained hip fractures. Hip fractures can have devastating consequences including being unable to walk independently and the health risks associated with surgery to repair the fracture. People who have brittle bones, otherwise known as osteoporosis, are more susceptible to hip fractures.   

Reasons we are more susceptible to falls as we get older are because our sense of balance declines and there is usually some deterioration in our vision as well. In 2005, it was estimated that 2 million people in the United States experienced bone fractures due to osteoporosis, many caused by falls. Therefore, the key focus should be to prevent falls as well as strengthen our bones in order to avoid the serious consequences of hip and other bone fractures. 

Osteoporosis (brittle bones) is a consequence of aging in both men and women. In women, the decline in estrogen levels in the body that occurs after menopause is a major contributor. In men, there is a corresponding decline in testosterone levels that also results in osteoporosis.  

There are other factors that contribute to osteoporosis besides aging, which include cigarette smoking, a sedentary lifestyle, as well as a very thin body build. In addition, certain medications can contribute to osteoporosis, the most well-known example is prednisone. 

What can be done to improve the strength of our bones? There has been a suggestion that taking calcium and vitamin D supplements would be helpful in improving bone strength. Recently, the U.S. Preventative Services Task Force, which is an organization that makes recommendations about the effectiveness of preventative care measures, weighed in on this subject.  

In April 2018, it published a recommendation that is contrary to what has been the conventional wisdom. Their conclusion is that there is not good scientific evidence to recommend taking more than 400 units of vitamin D and more than 1,000 mg of calcium daily for the prevention of fractures in post-menopausal women. They also make the same comment, with respect to pre-menopausal women as well as men of all ages. There are a number of medications available which can help to build bone strength, and do require a prescription from a physician or other healthcare provider, to initiate treatment. 

Another approach emphasizes the benefit of exercise. It has long been known that weight bearing exercise like tai chi, jumping rope or even just walking can help to build stronger bones as well as improve a person’s sense of balance. Recently, there has been an acknowledgement of the benefits of lifting weights, which can help to promote improved bone strength.  

It turns out that stressing our bones through exercise can help to stimulate them to become stronger. This raises questions about the common advice that women with osteoporosis should avoid anything strenuous even lifting a child or a heavy grocery bag. A recent scientific study that originated in Australia, showed that weight lifting and other forms of weight bearing exercise can actually result in an increase in bone density of the lumbar spine.  

If one were to embark on a program of lifting weights, this should be done under the supervision of a physical therapist or an athletic trainer, because lifting weights can be associated with muscle strains and other possible injuries if done incorrectly. It is suggested that before starting a weight training program, it is important to start with exercises that build core strength, balance and flexibility then move on to the challenges of lifting weights which hopefully help to stave off the signs of aging. 

Dr. Mark Roth writes about internal medicine for the Cleveland Jewish News. He is an internal medicine physician with University Hospitals.  

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