osteoporosis-and-fracture-prevention.

WELLNESS / OSTEOPOROSIS AND FRACTURE PREVENTION.

OSTEOPOROSIS AND FRACTURE PREVENTION.

Osteoporosis is a common problem that causes bones to become abnormally weak and easily broken (fractured). Women are at a higher risk for osteoporosis after menopause due to lower levels of estrogen, a female hormone that helps to maintain bone mass. Preventive treatments are available that can help to maintain or increase your bone density. If you have already been diagnosed with osteoporosis, therapies are available that can slow further loss of bone or increase bone density.

OSTEOPOROSIS PREVENTION
Some of the most important aspects of preventing osteoporosis include eating a healthy diet, getting regular exercise, and avoiding smoking. These recommendations apply to men and women.

- Diet—An optimal diet for bone health involves getting enough protein and calories, as well as plenty of calcium and vitamin D, which are essential in helping to maintain proper bone formation and density.

- Calcium intake — Experts recommend that pre-menopausal women and men consume at least 1000 mg of calcium per day; this includes calcium in foods and beverages plus supplements (eg, pills), which you might need if you don't get enough calcium from your diet. Postmenopausal women should consume 1200 mg of calcium per day (total of diet plus supplements). However, you should not take more than 2000 mg calcium per day, due to the possibility of side effects.

The main dietary sources of calcium include milk and other dairy products, such as cottage cheese, yogurt, and hard cheese, and green vegetables, such as kale and broccoli.

If you don't get enough calcium through your diet, the doctor might suggest supplements. Supplements come in the form of calcium carbonate or calcium citrate. Calcium carbonate works best when taken with food, while calcium citrate can be taken on an empty stomach. Supplements are often recommended for women since they are at higher risk of developing osteoporosis and they often don't consume enough through foods and beverages. If you need to take more than 500 to 600 mg/day of calcium in supplement form, you should take it in separate doses (eg, once in the morning and again in the evening).

- Vitamin D intake — Experts recommend that men over 70 years and postmenopausal women (ie, women who no longer have monthly periods) consume 800 international units (20 micrograms) of vitamin D each day. This dose appears to reduce bone loss and fracture rate in older women and men who have adequate calcium intake. Although the optimal intake has not been clearly established in premenopausal women or in younger men with osteoporosis, 600 international units (15 micrograms) of vitamin D daily is generally suggested.

Milk supplemented with vitamin D is a primary dietary source of vitamin D; it contains approximately 100 international units (2.5 micrograms) per 8 oz (236 mL).
Alcohol — Drinking a lot of alcohol (more than two drinks a day) can increase your risk of fracture.

- Exercise — Exercise may decrease fracture risk by improving bone mass in pre-menopausal women and helping to maintain bone density in women who have been through menopause. Furthermore, exercise can strengthen your muscles, improve your balance, and make you less likely to have a fall that could lead to fracture or other injury.
The benefits of exercise are quickly lost if you stop exercising.

- Smoking — Avoiding or quitting smoking is strongly recommended for bone health because smoking cigarettes is known to speed up bone loss.

- Avoiding falls — Falling significantly increases the risk of osteoporotic fractures in older adults. Taking measures to prevent falls can decrease the risk of fractures. Such measures may include the following:

> Removing loose rugs and electrical cords or any other loose items in the home that could lead to tripping, slipping, and falling

> Providing adequate lighting in all areas inside and around the home, including stairwells and entrance ways.

> Avoid walking on slippery surfaces, such as ice or wet or polished floors.

> Avoid walking in unfamiliar areas outside.

> Reviewing drug regimens to replace medications that may increase the risk of falls with those that are less likely to do so.

> Visiting an ophthalmologist or optometrist regularly to check your vision.

OSTEOPOROSIS SCREENING

Screening for osteoporosis for women 65 years and older and for women under 65 who have gone through menopause and have risk factors (such as past fracture, certain medical conditions or medications, or cigarette or alcohol use). Screening involves physical examination, discussion of the person's history, and measurement of bone density through imaging tests. Bone density testing is discussed in more detail separately.

OSTEOPOROSIS TREATMENT
Who needs treatment with medication? — People with the highest risk of fracture are the ones most likely to benefit from drug therapy.

> Postmenopausal women and older men

> Premenopausal women.

MONITORING RESPONSE TO TREATMENT

If you take medication to prevent or treat osteoporosis, your doctor will monitor you to see how well it is working. This typically includes the measurement of bone mineral density with dual-energy x-ray absorptiometry (DXA). Some people also get blood or urine tests; these can give information about the rate of bone turnover (ie, how quickly old bone is resorbing and new bone is forming).