In the last 18 months, some of your medical care, including Support for your bone health may have been left out. In the early months of the COVID pandemic – 19, for example, in a survey , a third of providers said they were not performing bone density testing.
Even before the pandemic, an estimate of 10 millions of Americans over 50 years had osteoporosis, a disease in which the loss of bone mass can increase the risk of fractures, according to some data. Additionally, 43 millions of people in the United States, including 16 millions of men had low bone mass (osteopenia), increasing the risk of developing osteoporosis.
The resulting fractures can be serious, even life-threatening: Research shows they are responsible for more hospitalizations than breast cancer, heart attacks or strokes among women older than 55 years. “When we talk about osteoporosis care, we have reached a global crisis,” says Dr. E. Michael Lewiecki, director of Clinical Research and Center for Osteoporosis in Albuquerque, New Mexico.
This is information on the latest trends in screening tests, lifestyle strategies and when medication is the best option to help you keep your bones in the best shape possible.
Stay up-to-date with your screening tests
A bone density test, a low-dose X-ray known as a DEXA scan, can tell you and your doctor how strong your bones are. It’s quick and painless: You lie on an exam table for 15 minutes while having specific bones scanned.
Women are twice as likely as men to suffer bone fractures due to osteoporosis, according to the National Osteoporosis Foundation (NOF). Therefore, women older than 65 years should undergo baseline screening tests, according to the preliminary recommendations of the U.S. Preventive Services.
However, younger women with risk factors for osteoporosis should also get screened, says Dr. Andrea Singer, Director of Bone Densitometry at MedStar Georgetown University Hospital in Washington, DC and spokesperson for the NOF. Risk factors may include a history of smoking, use of steroid medications, autoimmune disorders such as rheumatoid arthritis; certain types of previous fractures, chronic heavy drinking, and having diabetes, thyroid disease, or early menopause.
What happens when getting screened is a little more complicated for men. “People thought that osteoporosis was a postmenopausal disorder of women, and only in recent years 20 Osteoporosis in men has been recognized for years, ”says Dr. Robert Adler, an endocrinologist at Virginia Commonwealth University in Richmond. And it can have serious effects in men, in whom fractures tend to occur 10 years later than women, he says. In 800, the latest year for which figures are available, 381, 000 men enrolled in Medicare had osteoporosis-related bone fractures. From that number, 91, 000, almost a quarter, died in one year.
The NOF recommends that all men have a bone density test of reference to 70 years, but, Dr. George Abraham, MPH, president of the American College of Physicians, advises you to discuss this with your doctor if you have risk factors such as those mentioned above, for osteoporosis or low testosterone or a documented loss of height.
Both women and men who have a normal scan (results are given in the form “T-score”) may not need another test until a decade later. People who have osteopenia will need another follow-up scan 3 and 5 years later, and for those diagnosed with osteoporosis, they will need to repeat the test every 2 years.
And if you break a bone, it is important Have another scan to check the strength of your bones, but this doesn’t happen often enough. The NOF found that only 5% of men and 9% of women enrolled in traditional Medicare received a scan within 6 months of a fracture.
What to eat for have stronger bones
While some studies suggest that being overweight can protect bones, other research has found that a change in weight, weight gain or loss, can increase the risk of having a fracture.
However, a diet for strong bones also tends to help maintain a normal weight. A study published in the American Journal of Clinical Nutrition in 2018 found that a diet rich in fruits and vegetables, nuts, whole grains, olive oil, and fish increased bone density in the femoral neck, located near the top of the femur, in people with osteoporosis, over the course of 12 months. These diets can help control inflammation, and this can have a protective effect on bones, Lewiecki says. They provide a lot of magnesium and potassium, which are associated with improving bone density in older adults.
Calcium is also important, which helps to regenerate and preserve bones. Women under 50 and men under 70 need at least 1, 000 mg of calcium per day, and women over 50 and men over 70 should consume 1, 200 mg per day. Ideally, the calcium you eat should come from food, says Dr. Stephen Honig, director of the Center for Osteoporosis at NYU Langone Health, New York. (A cup of milk has approximately 300 mg; a cup of kale has 94 mg).
Vitamin D is also important because it helps the body absorb calcium. The NOF recommends that adults older than 50 receive from 800 to 1, 000 international units per day . Fortified dairy products and cereals contain vitamin D. And your skin produces it in response to sunlight, but it can be difficult to get enough this way, so ask your doctor about testing your vitamin D levels on your blood.
Also pay attention to proteins. “Studies have shown that inadequate amounts of protein are associated with an increased risk of fractures, which makes sense, because it makes up a large part of bone,” Lewiecki says. Men over 50 years need 56 grams per day; women over 50 years need 46 grams. (3 ounces of skinless chicken is approximately . If you are a vegetarian, be sure to consume enough plant protein, such as legumes and nuts.
And limit alcohol and caffeine because drinking a lot of both has been linked to bone loss. The National Institute of Arthritis and Musculoskeletal and Skin Diseases recommends that women consume no more than one alcoholic drink a day and men no more than two, and the NOF advises everyone not to drink more than three cups of coffee a day.
You should also do the right exercise
Physical activity can help you maintain bone density, even after menopause, when density tends to decrease .
Weight-bearing movements, such as walking and resistance training, are ideal. It is necessary to perform from 30 to 60 minutes of moderate activity (such as brisk walking), or of 20 to 30 minutes of vigorous aerobic activity every day, along with 10 to 15 minutes of resistance exercises (you can use light dumbbells, resistance bands, or your own body weight). This, along with balance training, can also help prevent falls by strengthening the muscles that help you stay upright.
For more specific information, the National Institute on Aging has a exercise plan for older adults that includes balance, cardio and strength: Go to nia.nih.gov and search for “four types of exercise”. (Note: If you’ve already had a spinal fracture or have osteoporosis, talk to your doctor and possibly a physical therapist before doing resistance training, Adler says.)
One study found that, a diet rich in fruits and vegetables, nuts, whole grains, olive oil and fish increased bone density in people with osteoporosis over the course of 12 months.
When to start and when to stop the medications
If you have been diagnosed with osteoporosis (or osteopenia with a high risk of fracture), your doctor may recommend medications to reduce the chance of having a bone fracture. But the type and how long you will need them varies. Most people start with bisphosphonates, such as alendronate (Binosto, Fosamax), ibandronate (Boniva), and risedronate (Actonel, Atelvia), which slow bone breakdown. For severe osteoporosis, some experts recommend starting with self-injectable anabolics, such as abaloparatide (Tymlos) and teriparatide (Forteo), which regenerate bones.
Because bisphosphonates can cause upset and heartburn and, in very rare cases, thigh fractures or jaw damage are not recommended for more than 5 years. Anabolics, which can cause dizziness, leg cramps and nausea, are generally not prescribed for more than 2 years because their long-term effects are still unknown.
After this time, your doctor He will prescribe a bisphosphonate or, if you don’t respond to bisphosphonates, then he will prescribe the drug denosumab (Prolia). It can increase bone mass, but its benefits decrease once you stop using it.
After 5 years on a bisphosphonate, most people should be tested to see if they need to take a break. of the drug, Adler says. But about 2 years after stopping treatment, if a scan shows a decrease in bone density, your doctor may prescribe a bisphosphonate again.
Note Editor’s Note: This article also appeared in the December issue of 2021 of Consumer Reports On Health.
Consumer Reports is an independent, nonprofit organization that works side by side with consumers to create a fairer, safer, and healthier world. CR does not endorse products or services, and does not accept advertising. Copyright © 2021, Consumer Reports, Inc.
Consumer Reports has no financial relationship with the advertisers on this site. Consumer Reports is an independent nonprofit organization that works with consumers to create a just, safe, and healthy world. CR does not endorse products or services and does not accept advertising. Copyright © 2021, Consumer Reports, Inc.