Prevention and treatment of osteoporosis have drawn a good deal of attention over the last few years. There have been a number of multinational studies about osteoporosis that have demonstrated the value of medical treatments. Prevention and treatment decisions for women and men with osteoporosis are based on current knowledge from these multinational studies, combined with logic and intuition about possible long-term benefit for the individual. Other studies have shown that lifestyle modification alone does not result in dramatic reductions in osteoporosis if one is already eating a reasonable diet adequate in calcium and vitamin D.

Diet: calcium and vitamin D

It is recommended that adults obtain 1000 mg to 1500 mg dietary calcium daily for good bone health. This level can often be achieved in the diet with servings of dairy products. If the diet is lacking in calcium, however, then calcium supplementation is strongly recommended. It is further recommended that adults take in 400 IU of vitamin D daily, and that seniors take up to 800 IU daily, although further research is needed to determine the best level of vitamin D in the elderly. In countries where dairy products are not supplemented with vitamin D, it is particularly important to make sure that there is good vitamin D supplementation.

Alcohol and smoking

Heavy alcohol use is strongly associated with osteoporosis. It is advised that women and men with osteoporosis limit their drinking to occasional social use or moderate use. Similarly, smoking is bad for bone health. Women who smoke have earlier menopause by a few years in comparison with a non-smoking group. Also, many types of estrogen used to treat osteoporosis are frequently not effective in smokers.

Regular exercise

Regular exercise is important to improve bone density and also important to improve muscle strength and balance, which prevents falls. The best and safest exercise is weight-bearing physical activities such as walking. Other good exercises include climbing stairs, dancing, and exercises such as Tai chi, all of which improve balance and prevent falls. Younger individuals may be able to do more vigorous exercises to prevent bone loss. In individuals with severe osteoporosis, impact activities such as downhill skiing, basketball, or tennis might be avoided. Other activities that involve twisting motions such as golf might also need to be curtailed. Physicians and physiotherapists could help you decide what is an appropriate exercise program.

John P. Wade, MD 
in association with the MediResource Clinical Team