Weight-Bearing Physical Activity
A sedentary lifestyle is an important risk for osteoporosis. Weight-bearing and high
impact exercise are important for osteoporosis prevention and treatment. Examples
include walking, hiking, jogging, playing basketball, playing soccer, climbing
stairs, weight training, playing tennis, and dancing. Adequate weight-bearing
physical activity early in life is also important to reach peak bone mass. In addition
to strengthening bone, physical activity increases muscle strength, coordination,
and balance, all factors that reduce the risk of falls and other accidents that cause
Adults should engage in at least 30 minutes of
moderate physical activity most, but preferably all, days of the week. Children
should engage in at least 60 minutes of moderate physical activity most, but preferably
all, days of the week. Adequate levels of calcium intake can maximize the positive
effect of physical activity on bone health during the growth period of children,
an important time to maximize bone mass through physical activity. Some young
females, particularly those training intensively for athletic competition, exercise
too much, eat too little, and consequently experience amenorrhea. This increases
their risk for low bone mass and fractures, especially overuse (stress) fractures.16
Although another vulnerable time for women is just before and after menopause,
with exercise, postmenopausal women can maintain or increase bone mineral density
Smoking can lead to lower bone density and a higher risk of fracture, and this risk
increases with age.
Regular consumption of as little as 2 to 3 ounces a day may cause skeletal damage
and increase the risk of bone loss and fractures, even in young women and
men. The risk of vertebral and hip fractures in men increases greatly with heavy
alcohol intake, particularly with long-term intake. People who drink heavily are at
increased risk of fractures both because of bone loss and increased risk of falling.
Nutrition, protein, calcium, and vitamin D
Most calcium in the American diet comes from milk, milk products, and foods with
high levels of animal protein. National nutrition surveys show that many people
consume less than half the recommended amount of calcium. However, the U.S.
recommendation for calcium is set high. Vegetarians absorb and retain more calcium
from food than do non-vegetarians, and there is little evidence that calcium
intakes below the Dietary Reference Intake cause health problems for vegetarians.
Calcium deficiency in vegetarians is rare.
Food sources of calcium include non-fat dairy products, such as milk and yogurt,
but it is often not recognized that excellent sources of calcium are plant-based.
They include dark green, leafy vegetables, such as broccoli, collard greens, bok
choy, spinach, turnip greens, kale, okra, Chinese cabbage, dandelion greens, and
mustard greens. Other good sources include sardines and salmon with bones; tofu;
almonds; and foods fortified with calcium, such as fruit juices, cereals, soy beverages,
calcium-set tofu, and breads. Although most people can get adequate calcium
from food, a calcium supplement may be recommended by a health professional.
Too much vitamin A
High doses of vitamin A may increase bone resorption and decrease formation.
Vitamin A may also harm bone by diminishing the ability of vitamin D to increase
intestinal calcium absorption. Studies find that excessive preformed vitamin A (retinol)
intake from food or supplements, but not beta carotene (found in fruit and
vegetables), is linked to an increased risk of osteoporosis and hip fracture rates
among women. One study found that a daily intake of 1,500 μg or more of vitamin
A doubled the risk of osteoporosis and hip fractures in women aged 28 to 76. An
18-year study published in the JAMA found that among postmenopausal women,
the risk of hip fracture was almost doubled among women with retinol intakes of
about 2000 μg per day or higher compared with those with intakes of less than
about 500 μg/day.26 One International Unit (IU) = 0.3 micrograms (μg) of retinol.
It is best to avoid intake of preformed vitamin A (retinol) of 650 μg or 2000 IU or
greater per day.
Sex hormone abnormalities
Abnormal absence of menstrual periods (amenorrhea), low estrogen level (after
menopause), and low testosterone levels in men predispose to osteoporosis.
This eating disorder is characterized by an irrational fear of weight gain and avoidance
of normal amounts of food. Because the onset of anorexia nervosa frequently
occurs during puberty, when there should be maximal bone mass accrual, adolescent
girls and boys with anorexia nervosa are at high risk for reduced peak bone
The medications that can contribute to bone loss include long-term use of glucocorticoids
(steroid medications), long-term treatment with certain antiseizure drugs,
gonadotropin-releasing hormone (GnRH) drugs used to treat endometriosis, excessive
use of aluminum-containing antacids, certain cancer treatments, and excessive
This blog presents opinions and ideas and is intended to provide helpful general information. I am not engaged in rendering advice or services to the individual reader. The ideas, procedures and suggestions in that are presented are not in any way a substitute for the advice and care of the reader’s own physician or other medical professional based on the reader’s own individual conditions, symptoms or concerns. If the reader needs personal medical, health, dietary, exercise or other assistance or advice the reader should consult a physician and/or other qualified health professionals. The author specifically disclaims all responsibility for any injury, damage or loss that the reader may incur as a direct or indirect consequence of following any directions or suggestions given in this blog or participating in any programs described in this blog or in the book, The Building Blocks of Health––How to Optimize Your Health with a Lifestyle Checklist (available in print or downloaded at Amazon, Apple, Barnes and Noble and elsewhere). Copyright 2021 by J. Joseph Speidel.