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June Health Tip by Dr. Hahn-Cover

Osteoporosis

Bone health is very important throughout the lifespan.  Osteoporosis is a change in the composition of bones that increases the risk of broken bones (fractures).  We think of osteoporosis as a problem of older people, but it is a problem set into motion as early as childhood. 

Good nutrition and normal patterns of walking and movement in our early years are important for good bone health.  Peak bone mass—the highest bone density we achieve during our lifetime (without medications which increase bone mass)—is typically reached by a person’s early 20s.  The recommended level for daily calcium intake is highest in the teenage years, at 1300 mg/day.  Adequate levels of vitamin D are also important for good bone health.  We make vitamin D when our skin is exposed to sunlight during the warmer months.  For people who prefer to protect their skin from sunlight, dietary vitamin D is important.  The recommended level for daily vitamin D intake is 200 IU from birth until age 51.  Also very important is regular exercise.  Weight-bearing exercises, like walking, dancing, or playing soccer, can increase bone density.

During early adulthood and midlife, continuing with the good habits established in childhood and adolescence is important.  The recommended level for daily calcium intake decreases to 1000 mg/day.  Recommendations for vitamin D intake do not change, and weight-bearing exercise remains important.  Midlife is a time of increased focus on bone health, especially in women.  Estrogen contributes importantly to bone health, and loss of estrogen with menopause can cause rapid bone density loss for several years after menopause. 

We start to worry about osteoporosis in a woman in her 60’s.  We consider testing all women for osteoporosis by age 65.  If a woman is at increased risk for osteoporosis (low body weight, early menopause, family history of osteoporosis, tobacco smoking), or has had a broken bone after menopause, we often test earlier. 

If a woman develops osteoporosis, there are several medications to help.  It is still important to maintain good habits with diet and exercise.  For people older than 50, the recommended calcium intake is 1200 mg/day and the recommended vitamin D intake is 400 IU/day.  For people older than 70, the daily vitamin D intake should increase again to 600 IU/day.  Regular exercise remains important, and is associated with a decrease in the risk of broken bones even in people with osteoporosis.  Exercises to help with balance and prevent falls may be especially helpful.

Please contact us if you would like further information about your bone health, or if you are concerned about your risk of osteoporosis.  You may also find the following websites helpful.

MedlinePlus: Osteoporosis
Health Information - bone disorders osteoporosis

Kristin Hahn-Cover, MD
Assistant Professor of Clinical Medicine
Department of Internal Medicine

For more information:
MU Health Sciences Library