FAMILY MEDICINE® COLUMN

By John C. Wolf, D.O.Associate Professor of Family Medicine Ohio University College of Osteopathic Medicine

EXERCISE AND PROPER DIET CAN HELP PREVENT OSTEOPOROSIS

Question: Does exercise play a role in dealing with osteoporosis? If so, what limitations or special directions should be followed?

Answer: I imagine you and most of my readers know that osteoporosis is a disease in which the bones become weakened. In more severe cases, the bones can become so weak that they break while doing simple "day-to-day" activities like walking or looking over your shoulder as you back up your vehicle. Each year in the U.S. about 1.3 million broken bones -- or fractures as doctors call them -- are attributable to osteoporosis, with most victims being 45 or older. These fractures are not only painful but are also often fatal. You may be surprised to learn that upwards of 40,000 Americans die each year from causes directly attributed to osteoporotic fractures. 

Women, particularly Caucasian women, are afflicted more often than men with osteoporosis. Some additional risk factors for this condition, in addition to being a woman after menopause, are surgical removal of the ovaries before the normal age of menopause, being thin, smoking tobacco, a diet with insufficient calcium, not exercising regularly and chronic use of some medicines. The most common medicines that can cause problems are the "cortisone" type of steroids, with oral prednisone being the most commonly prescribed one. 

Bones are made of stored minerals - mostly calcium - and several types of living bone cells. Some of these cells constantly dissolve existing bone, and at the same time, others lay down new bone. All bones, whether in an adult or a child, are continually undergoing this type of change. Normally during adult years, the amount of bone formed is equal to that lost. This produces no net change in the strength of bones because the quantity of stored minerals and living bone cells remains constant. 

The loss of bone strength from decreased mineral content can result in a crushing type of fracture in the vertebra in the region of the shoulders and low back. Other common locations for osteoporosis fractures are in the lower arm and also in the hip. Most of these fractures occur suddenly with only minor exertion. Sometimes this is no more than lifting a light object, jumping out of a car, stumbling over a curb, suffering a minor fall or even just riding in a car traveling a bumpy road. The fracture produces acute pain in the area of injury that is accompanied by a great deal spasm in the surrounding muscles. 

In order to build strong bones, the body needs calcium - about 1500 milligrams of it each day. This won't guarantee freedom from osteoporosis, but it certainly does reduce the risk of this dreaded illness. 

Regular exercise is important in reducing the risk of osteoporosis too, because it is the strong muscular pull against bones that encourages bone growth. Therefore, working out with weights or against resistance machines is theoretically better than simple aerobic activity such as swimming or fast walking. 

So exercise is important, but it is also important to remember that starting a new exercise program is different for those who have risk factors for osteoporosis. The new exercise can put you at risk of heart attack and injury to joints, tendons, muscles and bones. Therefore, I suggest that you talk to your doctor before you begin an exercise program. He or she can help you determine what exercises would benefit you most as well as establishing a training schedule. 

Since you are concerned about osteoporosis, you may also want to talk to your doctor about a bone mineral density test and medicines that can help prevent or reverse the course of osteoporosis.

"Family Medicine" is a weekly column.

To submit questions, write to: John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.

Past columns are available online at http://www.FamilyMedicineNews.org.