September 23, 2019 | 90° F

ABRAHAM: Bone health requires initiative, early start

Opinions Column: Code Wellness


For many college students, worrying about bone health may not be their most pressing issue. Even after college, most people do not obsess over whether or not they receive an adequate amount of calcium and Vitamin D. Oftentimes we start thinking about the health of our bones when we reach midlife and older. The problem with this is that having healthy bones requires an early start, not when we are 50 years or older. An early start, preferably in childhood, that involves maintaining a healthy diet while engaging in regular weight-bearing exercises are preventative measures against bone loss.

When individuals do not take early and preventative steps to keep their bones healthy, they are at a greater risk for developing osteoporosis. The National Osteoporosis Foundation (NOF) estimates that "54 million Americans have osteoporosis and osteopenia (low bone mass), placing them at greater risk for osteoporosis." The NOF also stated that “approximately one in two women and up to one in four men age 50 and older will break a bone due to osteoporosis.” Osteoporosis is defined as a chronic, progressive disease, which causes bones to become porous, weak and brittle. Osteoporosis is also characterized by a low bone mineral density, which is identified through a scan called the dual energy absorptiometry scan. The scary part of osteoporosis is that it is often a silent disease. In other words, you may not even know that you have osteoporosis until an adverse event like a fracture occurs.

Osteoporosis affects both men and women, yet Asian and white post-menopausal women have the greatest risk. Individuals with osteoporosis may have back pain potentially related to a collapsed vertebrae, loss of height and fractures. There are both modifiable and non-modifiable risk factors for osteoporosis. Non-modifiable risk factors include race, gender, age, previous fractures, ethnicity, hysterectomy, menopause, long-term glucocorticoidtherapy and family history are just a few examples. Some modifiable risk factors include sedentary lifestyle, inadequate consumption of foods rich in calcium and Vitamin D, poor nutrition, frequent falls, excessive alcohol consumption, smoking and tobacco use.

Changing unhealthy habits can decrease the risk for developing osteoporosis. The International Osteoporosis Foundation (IOF) recommends that children, adolescents and adults avoid protein malnutrition and under-nutrition. Engaging in regular, weight-bearing exercises are beneficial. Walking, hiking, stair climbing, jumping, weightlifting, dancing, Tai Chi and even tennis are some examples of healthy activities. Exercise is great to build stronger and healthier bones. It is most helpful to engage in regular exercise throughout the lifespan. The IOF found that "women who sit for more than nine hours a day are 50 percent more likely to have a hip fracture than those who sit for less than six hours a day." The Mayo Clinic suggests that "more than two alcoholic drinks a day can increase (one’s) risk of osteoporosis." As does smoking — avoiding tobacco has numerous health benefits, beyond just healthy bones.

According to the Mayo Clinic, "men and women between the ages of 18 and 50 need 1,000 milligrams of calcium a day." Once women turn 50 and men turn 70, the daily amount of calcium increases to 1,200 milligrams per day. The key is to eat a calcium-rich diet while having an adequate level of Vitamin D. Vitamin D is crucial to helping the body absorb calcium. Individuals can get enough Vitamin D from sunlight. Some sources of calcium include dairy and non-dairy products (soy milk, almond milk, yogurt and cheese), calcium fortified Tofu, calcium fortified orange juice, dried figs and green leafy vegetables including kale, okra, broccoli and brussels sprouts. Excessive consumption of coffee and other caffeinated beverages should be avoided as these can inhibit calcium absorptions. It is very important to talk to your nurse practitioner or physician regarding any concerns you may have with your calcium and Vitamin D levels. Remember that too much calcium may increase the risk for kidney stones and cardiac problems. Furthermore, calcium supplements can be constipating. Therefore it is important to engage in regular exercise, eat foods containing fiber and ensure adequate fluid intake since these lifestyle changes can decrease the likelihood of constipation.

Risk for falling is a serious concern for those with osteoporosis. Some suggestions to make home environments safer include having secure stair rails, well-lit stairways and walkways, adding grab bars in bathrooms near toilets and tubs to help individuals get up safely, properly securing cords and wires, using a flashlight when walking around in the dark, removing area rugs as they may easily slide around and wearing rubber-soled shoes or slippers that provide support and traction.

For the most part, we do have power over our health. Engaging in regular exercise while making healthy lifestyle modifications in college can be a good start to ensuring healthy bones and a better quality of life.

Cilgy Abraham is a Rutgers School of Nursing senior. Her column, "Code Wellness," runs on alternate Mondays.


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Cilgy Abraham

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