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  • Jennifer L. Gerard

The INs and OUTs of Osteoporosis

Updated: Jan 20

According to the National Osteoporosis Foundation, one out of every two women with osteoporosis will break a bone in their lifetime. In fact, many women do not even know they have osteoporosis until their first fracture, often from a minor fall. Incidence of osteoporosis is greater than heart attack, stroke and breast cancer combined. Let that sink in a minute. Over 50 million American men and women are at risk for an osteoporosis-related fracture and the time to be concerned is now. Women continue to lose bone every year and the normal menopause process accelerates bone loss due to declining estrogen. It's never too early to start thinking about bone health and even small changes can have positive results.

Menopause is a normal process. If you are a woman, you will experience menopause. Unfortunately, you will also experience some degree of bone loss. It's normal and related to decline in estrogen. The good news is, there are steps you can take to keep your bones strong and decrease your risk of fracture. Let's dive in to the Ins and Outs for osteoporosis prevention...

Calcium in IN

Calcium is a building block for bone and helps keeps them strong. You can assure adequate calcium in your diet by consuming calcium-rich foods like dairy, fish and green leafy vegetables. Did you know girls reach 85-90% bone mass by 18 then bone mass declines over time until menopause when it further accelerates? So, adequate calcium is important well before menopause but it's beneficial to start anytime. Not sure how much calcium you are already getting in your diet? Click here for a handy reference from UCSF. Who knows? You might be doing better than you think and may even find some new foods to add to your nutrition plan!

A word about supplements: if you are consuming adequate calcium (1000 mg/day if you are younger than 50 and 1200 mg/day if you are 50+) then you likely don’t need to add a calcium supplement. If you are consuming less than the daily recommended amount, a calcium supplement is a great way to fill the gap. Talk to your health provider if you need specific guidance for your age and overall health status.

Activity is IN

Exercise slows bone loss so get out and get moving! Weight bearing activity like walking is generally safe and easy on the joints. Shoot for 30 minutes of activity most days or about 150 minutes every week. It’s OK to break it up into smaller sessions and what’s important is that you are moving! Bonus: walking is good for your strength and balance too which can help prevent falls.

Estrogen is IN

Did you know estrogen replacement in menopause (with or without progesterone) is FDA approved for prevention of bone loss during menopause? When estrogen declines during the normal menopausal process, bone health suffers. Because of less estrogen, bone deteriorates faster than it is replaced. The result is weaker bones. Estrogen is not for everyone including those with a history of breast cancer, blood clot or uncontrolled high blood pressure. Talk to your provider to see if estrogen is right for you.

So, now that you've learned about the INs, what's OUT for bone health? Let's take a look at some of the choices you should consider for bone health and overall well being.

Smoking is OUT

Smoking has loads of health consequences but did you know smoking also accelerates bone loss? Nicotine in cigarette smoke prevents absorption of calcium and vitamin D therefore causing low bone density and increased risk of fracture. What's even worse is if you do smoke and suffer a fracture, it will take longer to heal and there is a higher risk for complications. The first step is quitting and there are excellent resources available here.

Heavy Alcohol is OUT

Excessive alcohol has been linked to an increase in hip, spine and wrist fractures. Alcohol interferes with the balance of calcium in the body and affects the hormones/vitamins that protect bones. Alcohol use can also lead to more falls which means more fractures. It's best to not consume alcohol at all but if you do, do so in moderation.

Calcium, exercise and estrogen are IN. Smoking and alcohol are OUT. So, what are some changes that you can start today to take care of your bones? I personally am going to be more mindful about my calcium intake and focus on calcium-rich foods over supplements.

Leave a comment below to share and encourage others!


Telemedicine services are available from Jennifer Gerard, APRN, FNP-C for menopause management (and smoking cessation)! Services are available in Florida, Idaho, Iowa, Maryland, Nebraska, New Mexico and North Dakota. Click below to learn more!

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