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Strategies to Reduce Your Risk of Fractures

You may feel concerned or even frightened after being diagnosed with osteoporosis. However, the good news is that, armed with information and the support of your doctor, you can significantly improve your bone health and reduce your risk of future fractures with a combination of medication, diet, exercise, and lifestyle modifications.

Several medications are available to prevent and treat osteoporosis. These products have been proven effective at minimizing additional bone loss and reducing fracture risk. Your doctor can help you understand the benefits and risks of each of the following medications and select one that is right for you:

  • Bisphosphonate drugs: alendronate (Fosamax), 1 risedronate (Actonel), ibandronate (Boniva), and zoledronic acid (Reclast)
  • Calcitonin (Miacalcin and Fortical)
  • Raloxifene (Evista), a selective estrogen receptor modulator (SERM)
  • Teriparatide (Forteo), a form of the parathyroid hormone (PTH), which is secreted by the parathyroid glands
  • Estrogen therapy (also called hormone therapy when estrogen and another hormone, progestin, are combined).

In men, reduced levels of testosterone may be linked to the development of osteoporosis. Men with abnormally low levels of testosterone may be prescribed testosterone replacement therapy to help prevent or slow bone loss.

In addition to taking your medication, some of the most important things you can do are to follow a diet rich in calcium and vitamin D, maintain an adequate daily intake of protein, monitor your sodium intake, and get plenty of exercise.

Calcium is needed to maintain healthy, strong bones throughout your life. Unfortunately, most Americans do not get enough calcium from their diets. Dairy products such as milk, cheese, and yogurt are excellent sources of calcium, and some non-dairy foods such as broccoli, almonds, and sardines can provide smaller amounts. In addition, many foods that you may already enjoy - juices, breads, and cereals - can now be found fortified with calcium. Calcium supplements can ensure that you get enough calcium each day, especially in people with a proven milk allergy. The Institute of Medicine recommends a daily calcium intake of 1,000 mg (milligrams) for men and women, increasing to 1,200 mg for adults age 50 and older.

Calcium supplements are available without a prescription in a wide range of preparations and strengths. Many people ask which calcium supplement they should take. The “best” supplement is the one that meets your needs based on tolerance, convenience, cost, and availability. In general, you should choose calcium supplements that are known brand names with proven reliability. Also, you will absorb calcium better if you take it several times a day in smaller amounts of 500 mg or less each time.

Vitamin D plays a significant role in helping your body absorb calcium. The relationship between calcium and vitamin D is similar to that of a locked door and a key. Vitamin D is the key that unlocks the door, allowing calcium to enter your bloodstream. As we age, our bodies become less able to absorb calcium, which makes getting enough vitamin D even more important. The recommended daily intake for vitamin D is 400 to 600 IU (International Units). Many people get this amount through natural exposure to sunlight, which our bodies use to make vitamin D, and by consuming vitamin D-fortified foods such as milk. In addition, many calcium supplements are fortified with vitamin D.

Sodium, a main component of table salt, affects our need for calcium by increasing the amount of it we excrete in urine. As a result, people with diets high in sodium, or table salt, appear to need more calcium than people with low-sodium diets to ensure that, on balance, they retain enough calcium for their bones.

Protein in excess amounts also increases the amount of calcium we excrete in urine, but it provides benefits for bone health as well. For example, protein is needed for fracture healing. In addition, studies have shown that elderly people with a hip fracture who do not have enough protein in their diets are more likely to experience loss of independence, institutionalization, and even death after their fracture. The recommended daily intake for protein is 56 grams for men and 46 grams for women.

It is perfectly understandable that you want to avoid another fracture. No one who has broken a bone wants to revisit that pain and loss of independence. However, living your life “on the sidelines” is not an effective way to protect your bones. Remaining physically active reduces your risk of heart disease, colon cancer, and type 2 diabetes. It may also protect you against prostate and breast cancer, high blood pressure, obesity, and mood disorders such as depression and anxiety. If that isn’t enough to convince you to stay active, consider this: exercise is one of the best ways to preserve your bone density and prevent falls as you age.