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Lifestyle Changes to Manage Osteoporosis

Lifestyle plays an important role in the treatment of osteoporosis. By making certain lifestyle changes, you may be able to slow bone loss and reduce your risk of fracture.

General Guidelines for Managing Osteoporosis

Eat a Healthy Diet
Good nutrition is essential for normal growth. A balanced diet, adequate calories, and appropriate nutrients are the foundation for development of all your tissues, including bone. Inadequate intake of calcium and vitamin D is thought to contribute to the development and progression of osteoporosis.
Calcium
Calcium is the nutrient most important for attaining peak bone mass and for preventing and treating osteoporosis. Depending on your age, recommended calcium intakes for adults fall between 1,000 and 1,200 mg per day. The majority of children, adolescents, and adults do not meet adequate calcium requirements.
You can increase your calcium intake by eating more calcium-rich foods such as low-fat milk, yogurt, cheese, sardines, soy products, and collard greens. Many foods such as orange juice, breakfast bars, and cereals are now fortified with calcium. If you are unable to get adequate calcium in your diet, talk to your healthcare provider or a registered dietitian (RD) about a supplement.
High dietary protein, caffeine, and sodium can adversely affect calcium balance, but the effects may not be as important in individuals with adequate calcium intakes.
Vitamin D
Vitamin D is required for optimal calcium absorption and bone health. Your skin manufactures vitamin D in response to direct exposure to sunlight. How much sunlight you need depends on where you live, the time of day, and the color of your skin.
Older adults and people who have little exposure to sunlight may have difficulty meeting vitamin D requirements. Most infants and young children in the United States have adequate vitamin D intake because of the fortification of milk. During adolescence, when consumption of dairy products decreases, vitamin D intake may be inadequate, and this may adversely affect calcium absorption.
Experts recommend a daily intake of between 400 and 1,000 international units (IU) of vitamin D.
Exercise Regularly
There is strong evidence that regular physical activity in childhood and adolescence contributes to higher peak bone mass. Exercise during later years, combined with adequate calcium and vitamin D intake, may help slow the decline in bone density associated with aging. Some evidence indicates that weight-bearing and resistance exercises are most likely to be beneficial.
To help reduce bone loss, engage in regular weight-bearing exercise. Examples include walking, running, tennis, dancing, hiking, and racquetball. Strength training can also help increase your bone density and keep your muscles strong, so that you are less likely to fall.
Do Not Smoke
Smokers have a higher risk of osteoporosis. A study reported in the Journal of the American Academy of Orthopedics suggests that smoking puts you at higher risk for developing osteoporosis.
Avoid Excessive Alcohol and Caffeine
Alcohol has several negative affects on bones. Alcohol can interfere with vitamin D metabolism, which results in impaired calcium absorption. It also increases magnesium excretion. In addition, alcoholics tend to have diets that are lacking in many key nutrients, including calcium and vitamin D.
Heavy drinking can affect hormone production in both women and men. In premenopausal women, chronic alcohol use can result in irregular menstrual cycles. This increases the risk of osteoporosis. Testosterone production may be affected in alcoholic men. Low testosterone levels have been linked to a decrease in bone formation.
Heavy alcohol consumption is associated with an increased risk of fracture. Alcohol affects your balance and gait, making you more prone to stumble, trip, or run into objects.
The relationship between caffeine use and bone health is not as clear-cut. Studies on the effect of caffeine on the bones have yielded mixed results. On the basis of the studies to date, current recommendations are for moderate caffeine consumption, which equals two or less cups of coffee per day.
Practice Fall Prevention
Fall prevention is always important, but especially for people with osteoporosis. Osteoporotic bones are fragile and, therefore, more easily broken. Most falls happen in the home. The National Osteoporosis Foundation makes the following recommendations to help make your home safe:
  • Floors—Remove all loose wires, cords, and throw rugs. Minimize clutter. Make sure rugs are anchored and smooth. Keep furniture in its accustomed place.
  • Bathrooms—Install grab bars and non-skid tape in the tub or shower.
  • Lighting—Make sure halls, stairways, and entrances are well lit. Install a night light in your bathroom. Turn lights on if you get up in the middle of the night.
  • Kitchen—Install non-skid rubber mats near sink and stove. Clean spills immediately.
  • Stairs—Make sure treads, rails, and rugs are secure.
  • Other precautions—Wear sturdy, rubber-soled shoes. Keep your intake of alcoholic beverages to a minimum. Ask your doctor whether any of your medications might cause you to fall.

When to Contact Your Doctor

  • If you have fallen and you think you may have broken a bone or need help preventing more falls
  • If you need assistance developing a healthful diet or exercise program
  • If you need assistance quitting smoking or drinking

References

Calcium and vitamin D: What you need to know. National Osteoporosis Foundation website. Available at: http://www.nof.org/articles/10 . Accessed July 22, 2013.

Calcium and vitamin D for treatment and prevention of osteoporosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated June 25, 2013. Accessed July 22, 2013.

Massey LK. Is caffeine a risk factor for bone loss in the elderly? Am J Clin Nutr . 2001;74(5):569-570.

Osteoporosis overview. NIH Osteoporosis and Related Bone Diseases National Resource Center website. Available at: http://www.niams.nih.gov/Health%5FInfo/Bone/Osteoporosis/overview.asp . Accessed July 22, 2013.

What women need to know. National Osteoporosis Foundation website. Available at: http://www.nof.org/articles/235 . Accessed July 22, 2013.

10/6/06 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Cockayne S, Adamson J, Lanham-New S, et al. Vitamin K and the prevention of fractures: systematic review and meta-analysis of randomized controlled trials. Arch Intern Med . 2006;166(12):1256-1261.

3/12/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Alekel DL, Van Loan MD, Koehler KJ, et al. The soy isoflavones for reducing bone loss (SIRBL) study: a 3-y randomized controlled trial in postmenopausal women. Am J Clin Nutr . 2010;91(1):218-230.

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