By Nermin Lazarus, DO
Lead Physician, Virtua Women’s Primary Care and Wellness Center, Moorestown

Like the frame of a home, you need strong bones to provide a stable foundation for your body that will literally stand the test of time as you age. 

But without proper care and maintenance, your bones can break down, lose density and become too weak to support your body. This puts you at high risk for breaks. 

In its earliest stages, this weakening is called osteopenia. As bones get more “porous” and weak, it’s called osteoporosis. The difference between osteopenia and osteoporosis has to do with something called a T-score, which is how the results of a bone mineral density test (DEXA scan) are reported. 

A T-score compares your bone mineral density to that of a healthy 30 year old.

• A T-score of -1 or above means you have normal bone mineral density.
• A T-score between -1 and -2.5 means you have osteopenia, or low bone mineral density.
• A T-score of -2.5 or below means you have osteoporosis, or very low bone mineral density. 

Moderate to advanced osteopenia and osteoporosis is treated with prescription medication. But, it’s much better to do all you can to prevent the onset all-together. 

What’s My Osteoporosis Risk?

Our bones are alive and constantly changing. Old bone tissue is always being replaced by new bone tissue, which needs calcium to form. 

But, by the time you’re 35, old bone tissue breaks down faster than new bone tissue can form. As a result, your bones might not have enough calcium in them, which leaves them weaker and more likely to fracture, or break. 

In an older person, a broken bone can be a very serious problem. People over age 65 who experience a bone fracture are more likely to have a dramatically shorter life expectancy and are more likely to experience frequent hospitalizations. 

For women, your doctor will probably recommend regular bone mineral density tests once you hit menopause, as postmenopausal women are at the greatest risk of developing osteopenia and osteoporosis. 

That said, anyone can develop osteopenia or osteoporosis at any age. 

Other risk factors include:

• Family history of osteoporosis
• A small or thin body frame
• Smoking
• Taking certain medications, like steroids or antacids, for long periods of time 

Since young women and men aren’t routinely screened for osteopenia or osteoporosis, and since you can’t feel bone loss happening, it’s a good idea for everyone to do their best to keep their bones dense and healthy.

Two Simple Steps to Healthier Bones

You can’t always prevent osteopenia or osteoporosis, but it’s absolutely worth the effort. I’ve seen my patients’ T-scores improve with only regular exercise and increased calcium intake. Here are my recommendations:

Exercise
Weight-bearing exercise is best for your bones, and the simplest weight-bearing exercise is walking. As you get stronger, you should go farther and faster, and then add ankle or wrist weights for greater benefits. Dancing, tennis and yoga are other great options. Aim for 30 to 60 minutes a day, at least 5 times a week.

Calcium
Younger adults should get around 1,000 milligrams (mg) of calcium a day.  Women over age 50 or men over age 70 need 1,200 mg a day. 

You can reach the calcium recommendation for your age/gender by eating a varied diet with plenty of healthy dairy like skim milk, yogurt and low-fat cheese, and green vegetables like bok choy and kale. Even sardines have a healthy amount of calcium.

But I advise against relying on dietary calcium alone, especially if you have other risk factors for bone loss. Research has shown that calcium is absorbed best when taken in smaller doses of 600 mg or less.  One calcium supplement of 600 mg daily added to your dietary intake is recommended along with vitamin D, which helps your body absorb the calcium.