What to know about osteoporosis and exercise

Q: To my surprise, my doctor tells me I have osteoporosis. I feel fine, but want to do everything I can to slow down bone loss. I currently exercise but am not sure how to proceed.

A: Osteoporosis is a condition of low bone density, increasing the risk of a fracture or break. Worldwide, one in three women and one in five men over age 50 will suffer a broken bone due to osteoporosis. The most common fracture sites are the hip, wrist and spine, although any bone in the body can be affected.

Known as a ‘silent disease’ because there are rarely symptoms, a diagnosis of osteoporosis can lead some people to stop exercising. The truth is that being active has been shown to not only help prevent osteoporosis, but slow bone loss once it has already begun. The key is in knowing what types of exercise to engage in and which to avoid. This is why before beginning an exercise program, it is important to check with your doctor for specific guidelines, as the degree of bone loss determines what type of exercise is ultimately best for you. Bone density can be assessed by scanning the body with a special type of x-ray machine. Along with regular exercise, treatment may include dietary modifications and/or supplementation.

Tips:

Weight-bearing and resistance training exercises are ideal for building muscle and bone mass. Weight-bearing exercises are those that require the bones to fully support your weight against gravity. Examples are walking, stair climbing, dancing or using an elliptical machine, while nonweight bearing exercise includes biking, swimming, water aerobics and rowing. Resistance training places mechanical force (stress) on the body, which in turn increases bone density. It is generally recommended to start by lifting light weights in a slow and controlled manner, gradually increasing resistance as you become stronger.

Individuals with osteoporosis should avoid the following types of activity:

■ Step aerobics and high-impact activities such as running, jumping, tennis.

■ Activities that involve rounding, bending and twisting of the spine.

■ Moving the legs sideways or across the body, especially when performed against resistance.

■ Rowing machines, trampolines.

■ Any movement that involves pulling on the head and neck.

Certain factors increase the likelihood of developing osteoporosis. Risk factors that we can control are: Sedentary lifestyle, excess intake of protein, sodium, caffeine and/or alcohol, smoking, calcium and Vitamin D deficiencies and taking certain medicines. Body size (small frame), gender, family history and ethnicity are all risk factors that cannot be controlled. Women can lose up to 20 percent of their bone mass in the 5 to 7 years after menopause, making them more susceptible to osteoporosis.

It is never too early to start thinking about bone density. About 85-90% of adult bone mass is acquired by age 18 in girls and 20 in boys. Children on average are much less active than in past generations. Studies with ages 8 years through adolescence and young adulthood have shown that high-intensity, short duration exercise appears to elicit the greatest bone density increase.