Too many people think osteoporosis is a disease that affects only older women. While the risk of experiencing a broken bone increases dramatically with age, this often symptomless disease can be prevented if women act now -- no matter how old they are.
Practicing healthy lifestyle habits helps build and maintain bone mass and guard against osteoporosis. "Nutrition and exercise must go hand in hand for good bone health," says Holly Thacker, MD, director of the women's health center at the Cleveland Clinic Foundation, and author of Women's Health: Your Body, Your Hormones, Your Choices (Cleveland Clinic Press).
Because women, in general, make less bone than men -- and lose it faster -- we're more likely to develop low bone density, which in severe cases can result in a decrease in height, lost teeth, and fragile bones that are likely to break. In fact, half of all women will experience an osteoporosis-related fracture in their lifetime. But this debilitating condition can be stopped. Whether you're in your 30s, 40s, or 50s, our easy diet tips will pave the way to your bone-healthy future.
Adequate intake of calcium is key to preventing osteoporosis, even in your 30s.
Pop calcium twice a day. The average woman consumes about 600mg of calcium from food in a day -- that's only half the recommended daily allowance for thirtysomethings of 1,200mg. Therefore, taking additional calcium is almost always necessary. But since your intestines can digest only 300 to 500mg of calcium at a time, it's better to take one calcium supplement twice a day.
Order salmon. Strive to eat this fish at least twice a week. While salmon's calcium punch benefits your skeleton, it is also rich in omega-3 fatty acids, which Swedish researchers have recently linked to higher bone-mineral density. What's known for sure is that omega-3s improve mood, contribute to better heart and breast health, and increase energy levels. "So, if nothing else, you'll have the get-up-and-go to head to the gym -- thus improving your bone health," says Dr. Thacker.
Take D alone. Chances are you don't get enough vitamin D from sunlight. "This is especially the case now that women slather on moisturizer with SPF to prevent wrinkles and skin cancer," says Dr. Thacker. Your body needs adequate amounts of vitamin D to absorb calcium.Even though some foods are fortified with D, and a few, such as fish and egg yolks, contain this vitamin naturally, 40 to 70 percent of Americans are still deficient and need a supplement. Dr. Thacker recommends taking D on its own. Why? Taking A and D together, as they're often sold, can result in too much A, which puts women at increased risk for hip fractures. This is because retinol, the active form of A, may weaken bones.
As you enter your 40s and approach perimenopause, you will inevitably start to slowly lose bone density and strength. This process causes no visible symptoms. But making changes to your diet now will shore up your body against the drop in estrogen levels at menopause that dramatically increases the risk for a break due to osteoporosis.
Start your day with an iron-fortified cereal. The hormonal changes that come with perimenopause can cause you to lose more blood when you menstruate and therefore more iron. Researchers have found that this mineral is directly linked to a healthy bone density. Iron is thought to help promote the production of collagen, a central component of bone. In a study of women in their 40s, 50s, and 60s, those whose daily iron consumption hovered around 18mg (the amount found in 1 cup of some fortified cereals) had the greatest bone-mineral density. Plus, iron-fortified cereals often contain added calcium -- and they're typically low in calories. So it's a win, win, win.
Enjoy what you eat. Not a fan of the cereals with added iron? Start adding blackstrap molasses to any bread or cookies you make. This sweetener is rich in both iron and calcium.And don't worry if you don't like fish, which is also recommended by doctors for good bone health. There are plenty of ways to get omega-3 fatty acids from foods that you do enjoy. Eat a small handful of walnuts or almonds every afternoon or go ahead and sprinkle some ground flaxseeds on your hot or cold cereal in the morning.
Ask your doc for a blood test. To find out how much vitamin D you currently have in your blood, request the 25 hydroxy-vitamin D-level test. For optimum bone health, your level should be over 31. But to reduce your cancer risk and improve your overall health, strive for between 40 and 50. Start taking vitamin D right away if your numbers are low. Women of color should be especially vigilant: Extra pigment in the skin makes it even harder to absorb enough sunlight to make vitamin D.
In the 5 to 10 years right after menopause bone loss is rapid. It's estimated that postmenopausal women lose up to 3 percent of their bone mass every year. Eating right and getting plenty of exercise remains of the utmost importance.
Take even more calcium. When women enter menopause their intestines no longer absorb calcium as well as they used to. Why? Menopause brings on a decrease in estrogen, which is needed to help with the absorption process. It's recommended that women over 50 get a whopping 1,500mg of calcium a day. So consider taking a supplement three, rather than two, times daily.
Swap in soy. While the benefits of soy are still widely debated, research indicates that soy produces positive estrogen-like effects in some women, resulting in stronger bones -- and fewer hot flashes. Soy milk and tofu are rich in calcium and often have added D, which, in addition to benefiting the skeleton, may also blunt menopause symptoms. So go for a soy burger instead of a hamburger or grab a handful of soy nuts rather than peanuts. You'll get the additional bonus of lowering your cholesterol.
Skip the cod liver. Many doctors recommend cod liver oil supplements to their patients, but few women listen, says Dr. Thacker. While the oil is a great source of vitamin D, something that women need even more of as they age, you can get your daily dose through food sources. Check your supermarket's produce section for irradiated mushrooms, which are safe and have extra D due to ultraviolet light exposure. Venison is another vitamin-D-packed lean choice. Research shows that women who take in extra vitamin D are less apt to suffer a break from falling than those who do not -- plus the vitamin reduces cancer rates by up to 70 percent.
When lifestyle changes alone are not enough, you may need a medication to improve your bone density.
Benefits: Reduces bone loss that leads to spine and hip fractures. Comes in tablet or liquid form.Keep in mind: Must be taken once a week in the morning with only water. May cause upset stomach.
Benefits: Seems to reverse bone loss throughout the skeleton and can be taken just once a month.Keep in mind: So far proved only to reduce the risk of spine fractures. May upset the stomach.
Benefits: Helps to decrease the risk of spine and non-spine fractures and comes in a form with added calcium.Keep in mind: Can be taken weekly or daily. May be associated with some gastrointestinal upset.
Benefits: The first (and currently the only) once-a-year osteoporosis medication.Keep in mind: Must be given intravenously in a doctor's office or another outpatient setting.
Benefits: Comes in a pill or patch form and in a wide variety of doses.Keep in mind: Recommended only for women who are dealing with menopause symptoms.
Benefits: Provides the beneficial effects of estrogen and reduces the risk of invasive breast cancer.Keep in mind: Must be taken weekly and shouldn't be used by women at risk for stroke.
Copyright © 2008. Used with permission from the May 2008 issue of Family Circle magazine.