8 Facts About Osteoporosis (That You Might Not Know)
In-office screening tests are not reliable
3. You may have risk factors that increase your chance of developing osteoporosis
Risk factors that can increase the likelihood that you’ll develop osteoporosis include your age, gender, lifestyle choices, and medical conditions and treatments.
Bone density testing is strongly recommended if you have the following risk factors:
- You are a woman who is over the age of 50.
- You’re a post-menopausal woman who is tall (over 5 feet, 7 inches) or thin (less than 125 pounds): Women undergo rapid bone loss in the first 10 years after entering menopause, due to the decrease in estrogen, a hormone that protects against excessive bone loss.
- You’re a woman who experiences irregular periods.
- You are a man with low testosterone and estrogen levels.
- You’re a man with clinical conditions associated with bone loss, such as rheumatoid arthritis, chronic kidney or liver disease.
- You’re a male or female older than 65.
- Your parents or grandparents have had a family history or signs of osteoporosis, such as a fractured hip after a minor fall.
- You’ve experience a fracture after mild trauma.
- You have poor nutrition and/or are deficient in Vitamin D and calcium.
- You consume a lot of sugary drinks such as soda.
- You are sedentary (inactive) and do little or no exercise (especially weight-bearing exercise).
- You experience high levels of emotional stress and depression.
- You smoke or have smoked in the past.
- You drink one or more alcoholic drinks per day.
- You’ve had x-ray evidence of vertebral fracture or other signs of osteoporosis.
- You have had hormone treatment for breast or prostate cancer.
- You have high bone turnover, which shows up in the form of excessive collagen in urine samples.
- You have a dowager’s hump, also known as kyphosis or hyper-kyphosis (excessive curvature of the spine).
- You have or have had any of the following medical conditions:
- Celiac disease
- Inflammatory bowel disease (IBD)
- A thyroid condition, such as hyperthyroidism
- A parathyroid condition, such as hyperparathyroidism
- Have type 1 (formerly called juvenile or insulin-dependent) diabetes
- Female athlete triad (includes loss of menstrual periods, an eating disorder and excessive exercise)
- Malnutrition or eating disorder (bulimia or anorexia)
- Rheumatoid arthritis (RA)
- Multiple sclerosis
- Parkinson’s disease
- Ankylosing spondylitis
- Liver disease, including biliary cirrhosis
- Chronic kidney disease
- Spinal-cord injury
- Chronic obstructive pulmonary disease (COPD), including emphysema
- History of bariatric (weight loss) surgery such as gastrointestinal bypass
- Organ transplant
- Blood disease such as multiple myeloma, leukemia or lymphoma
Bone density testing is also recommended if you use medications that are known to cause bone loss. Some of these medications include:
- Steroids (glucocorticoids) such as cortisone and prednisone used to treat conditions such as asthma or arthritis, Crohn’s disease, lupus and allergies
- Anti-seizure medicines (only some) such as Dilantin® (phenytoin) or Phenobarbital
- Chemotherapeutic cancer drugs
- Medications used to treat marrow and collagen disorders
- High-dose thyroid replacement medications
- Aluminum-containing antacids (they interfere with the intestinal absorption of calcium)
- Proton pump inhibitors (PPIs) such as Nexium®, Prevacid® and Prilosec® (calcium absorption from food is less efficient in the absence of stomach acid)
- Selective serotonin reuptake inhibitors (SSRIs) such as Lexapro®, Prozac® and Zoloft®
- Gonadotropin releasing hormone (GnRH) such as Lupron® and Zoladex®
- Medroxyprogesterone acetate for contraception (Depo-Provera®)
- Aromatase inhibitors such as Arimidex®, Aromasin® and Femara®
- * Note: This list may not include all medicines that may cause bone loss.
4. Osteoporosis is not systemic and CAN be spot-treated
Osteoporosis is not a systemic (whole-body) disease, but an indication of where your bone is not loaded correctly. This means that if you have osteoporosis, your bone loss is most likely not happening over your entire skeleton, but just in a few places.
In order to regenerate your bone, you need to know where you have signs of bone loss. If you are given a diagnosis of osteoporosis or osteopenia (slightly lower than normal bone density levels), ask your physician WHERE the density is low. When you know which areas of your skeleton have bone loss you can treat those areas with appropriate forms of exercise.
The areas where most people experience bone loss are:
- Vertebrae (bones comprising the vertebral column/spine)
- Head of the femur bone (top of the thigh bone, commonly (and incorrectly) referred to as the hip bone)*
* Fun fact: You do not have a “hip bone” – nobody does. The hip is a joint made from the pelvis and the thigh bone, which is called the femur.
5. When treating osteoporosis, exercise is more important than nutrition
Many people attribute poor nutrition to be the cause of osteoporosis. While proper nutrition is a requirement for healthy bone growth and maintenance, the break down in bone density is mostly mechanical in nature. All bone growth begins with a mechanical signal.
This signal begins with osteoblasts (bone building cells) being “squished” within the bone. When mechanoreceptors (sensors sensitive to physical deformation) within the osteoblasts get “squished,” they send a signal to the bone to grow. Without this “squish,” the nutrients that support bone growth can’t do their job… meaning that something mechanical needs to happen in order for your bone tissue to grow.
What “squishes” these cells?
Movement creates a “squish”… but not just any kind of movement, it needs to be weight-bearing.
For optimal bone regeneration, you need as much “squish” in the bone-growth cells as possible. In order to get the greatest amount of “squish” that tells your bones to change and become strong, your body must first move with enough force and impact that lets your muscles work and pull against the bones.
This is done through weight-bearing exercises such as:
- Stair climbing
- Playing racket sports and team sports
- Jumping (jumping jacks, jumping rope, doing vertical jumps, etc. – Note: if you’ve been diagnosed with osteoporosis, first consult with a physician to see if jumping is safe for you)
- Performing bodyweight exercises
- Lifting weights
Not all exercise gives you strong and healthy bones. Non-weight bearing movements such as swimming, cycling and using an elliptical machine are not the most beneficial exercises for your bones. In fact, studies have shown that although swimmers and cyclists may have healthy hearts, lungs and muscles, their bones are not much different from people who do not exercise.*
* Interesting fact: Astronauts lose up to one percent of their leg bone mass per month while in in space, and people who suffer a spinal cord injury lose up to half of their shin bone mass. The take away from these examples of what happens when you do not weight-bear is: If you can perform weight bearing movements, do them and do them often!
6. “Weight-bearing” does not always mean “lift weights”
Any resistance exercise will help build bone density and this can be done with resistance bands, dumbbells, barbells, kettlebells, boulders, etc. However, weight-bearing doesn’t always have to be lifting weights. Doing bodyweight exercises like squats, lunges, jumps, crawling, climbing, etc. also count as weight-bearing movements.
With osteoporosis, bone loss at muscle attachment sites is not usually the issue. The biggest problem in osteoporosis is bone degeneration in the hips (and eventual fracture), while the second largest issue is bone loss (and then fracture) in the vertebrae/spine.
When you perform a cookie-cutter resistance program, you most likely will strengthen muscles and add bone density throughout your body, but you may not do a good job targeting the bones that have osteoporosis (again, these are usually your hips and spine).
To remedy this, vary weight-bearing exercises. Rotate between strength training with weights and strength and conditioning routines with just your bodyweight.
To target osteoporosis problematic areas:
- Learn which of your bones have low bone density. Find out which bones and areas of your body have experienced bone loss.
- Follow a balanced movement program specific to your needs. Choose a weight-bearing workout routine that targets your entire body but also focuses on the areas with bone loss.
- Walk. Walking is the best bone-building weight-bearing exercise you can do. It’s also better than running because bone building favors lower impact loading (walking) as opposed to high impact and frequent loading cycles (running).
- Create a program that combines a practical resistance training with walking. Your program should include movements that target your bone loss areas and be designed to improve your balance, strength and coordination by mimicking many of the movements you do on a daily basis. It should also challenge you by having you do movements you’re not used to. Be sure to include bodyweight exercises. Natural movement exercises are fantastic for building bone density, muscle strength, mobility and balance. Rotate your training sessions: walk one day and do resistance training the next.
- Your workout sessions don’t have to be long. As little as 15 to 30 minutes of weight-bearing exercise a day can help.
- Occasionally lift heavy things. Challenge yourself by lifting heavy weights or objects every so often. You don’t have to do every time you exercise and you you do not have to lift weights in a gym. You can use your own bodyweight for resistance. Lifting heavy can mean lifting your bodyweight for a few pull-ups or pushups. It can also be in the form of lifting 100 pounds with a barbell or rock if you normally lift 70 pounds or lifting 8 pounds with a kettlebell if you regularly lift 3 pounds during a session.
7. You can improve bone density and strength at any age
Evidence shows that with the combination of weight-bearing movement and whole-foods nutrition, you can stimulate bone formation and retain calcium in the bones that are bearing the load at any age.
8. Dowager’s “hump” is not caused by osteoporosis – it’s a cause of osteoporosis
Dowager’s hump, also known as hyper-kyphosis, is an excessive curvature in the upper spine. It was once believed (and sometimes still is) that this hump is the result of weak, osteoporotic bones that have collapsed forward because they are unable to hold up the weight of the spine.
However, more recent research shows this is not the case. Hyper-kyphosis of the spine is actually a risk factor for osteoporosis, not the cause.
Why is hyper-kyphosis a risk factor for osteoporosis?
When you have hyper-kyphosis, you also have an extreme forward head posture. This forward position of your neck and spine puts less weight on the bones which sit below it and less loading of the bones increases your risk for osteoporosis.
Proper body alignment is essential to healthy bone growth.
If you want to prevent or treat osteoporosis, it’s essential that you stay mindful of your body alignment and posture. Improve the load-bearing effects of your daily walks and exercises by stacking your body. Here are some things to focus on:
- Stand with a tall posture and don’t round your shoulders.
- Don’t walk with your torso way in front of or behind you.
- If you have a forward head posture or too much curve in your spine, perform flexibility and mobility exercises that will help bring your muscles to their correct lengths. Strengthen weakened muscles with corrective exercises.
- Osteoporosis is a bone disease that occurs when the body loses too much bone, makes too little bone, or both.
- French pathologist, Jean Georges Chrétien Frédéric Martin Lobstein, was the first to give osteoporosis its name.
- Causes of osteoporosis include aging, poor diet, a sedentary lifestyle, hormonal changes, certain health conditions, and some medications.
- DEXA (DXA) scanning is the most accurate method to diagnose osteoporosis and assess an individual’s risk for developing osteoporotic fractures.
- Osteoporosis is not a systemic disease and a diagnosis does not mean you have osteoporosis in all of your bones.
- Weight-bearing exercise (doesn’t always have to be supplemented with “weights”) and proper nutrition are essential components to preventing and treating osteoporosis.
- You can build bone density at any age.
- Dowager’s hump is a risk factor of osteoporosis, not the result.
- Proper alignment and posture are important for healthy bone growth.
If you have anything you’d like to share about osteoporosis or have questions, please leave a comment below this article. I want to hear from you!
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When she is not slaying fat and building muscle, Jennifer can be found trekking barefoot, traveling, cooking and refining her photography skills. She also enjoys reading and writing about food culture, history and the science of human movement.