Suppose your doctor recommends an osteoporosis bone-building drug based on your bone density scan. Should you take the drug? Or is it better to increase calcium in your diet or perhaps take calcium supplements? A new University of Illinois study urges patients to take the conservative approach first: diet. And supplements.
In fact, “For many people, prescription bone-building medicines should be a last resort,” states Karen Chapman-Novakofski, a professor of nutrition at University of Illinois.
The dietary approach to bone-building is through an increased consumption of calcium and vitamin D. The U of I study reports that when adults take this route, the result is an increase in their bone mineral density.
However, a supplementation approach will yield the same results. So if this is the case, why would a doctor want to prescribe a drug that increases bone mineral density or is designed to fight against osteoporosis? It may be as simple as the physician not believing that the patient will alter her diet to include more calcium-rich and vitamin D fortified foods, nor take calcium and vitamin D supplements.
On the flip side, what would be the downside of taking an osteoporosis prescription drug? Chapman-Novakofski says that osteoporosis drugs are expensive, but even if your insurance will cover them fully, they can still leave side effects. And believe it or not, one possible side effect, she says, is a higher risk of hip fractures!
Thus, a patient should first try the diet and calcium supplement approach, and only if these do not work, should osteoporosis drugs be used. And watch out for bone density tests, says the researcher. They show only quantity of bone, not quality.
What this means is that such a scan may show quantitative improvement after taking an osteoporosis drug, but you can still be at risk for fractures.
She explains how the osteoporosis drugs work: “Bisphosphonates, for instance, disrupt normal bone remodeling by shutting down the osteoclasts — the cells that break down old bone to make new bone. When that happens, new bone is built on top of old bone. Yes, your bone density is higher, but the bone’s not always structurally sound.”
Why might a woman not want to increase calcium intake to lower risk of osteoporosis? She may be afraid of weight gain. However, lead study author Karen Plawecki says that weight gain does not have to happen just because a woman increases calcium intake. She recommends that menopausal women take 1,200 mg daily of calcium. Three glasses of skim milk will yield around 900 milligrams calcium. Three glasses = about 300 calories.
Which foods are fortified with vitamin D and calcium? Yogurt, orange juice, bread, cereal, meal replacement bars and drinks, to name a few. Plawecki says that a low-sodium diet seems to enhance bone density, and women should avoid high-sodium habits. This means avoid processed or smoked meats, and canned foods (unless they come in a low-sodium version). Watch out for cheese, which is often high in sodium.
An increase in magnesium and potassium will also help fight osteoporosis, and eating more fruits and vegetables will increase these minerals.
There is another significant component to bone health: exercise. I’m a certified personal trainer, and it’s easy for me to recommend that women must hit the weights hard to subject their bones to maximum stress. A bone that is stressed in this way is forced to become stronger to adapt.
Two notable weight-bearing exercises that will drive up bone density and durability are 1) Heavy barbell deadlift s, and 2) Squats while holding a barbell in front with straight arms. Unfortunately, I rarely see women doing either of these exercises at the gym. These are among the top bone-building exercises, but other types of exercise will help prevent osteoporosis, such as impact cardio, dumbbell strength training, and resistance machine work.