It’s that wonderful time of the year for pumpkin-flavored everything, ghosts, ghouls, and skeletons decorating our living spaces! With Halloween right around the corner, I thought it might be fitting to dedicate a blog to “Building a Better Skeleton” and what we can do to ward off the “scary trends in our bone health.”
Let’s get the scary news over with first.
To start with, we have a serious problem with bone thinning in the United States. The National Osteoporosis Foundation reports that at least half of the U.S population over the age of 50 has osteopenia (pre-osteoporosis) or osteoporosis.
The National Osteoporosis Foundation estimates 54 million Americans are affected by osteoporosis and low bone density conditions, and if this trend remains unchanged it is predicted to increase to over 64 million by 2030. Those who sustain a hip fracture due to osteoporosis have a 15-20% mortality rate due to complications, while those who survive, less than half of them will regain full independent function.
OK, now for the good news.
What if I told you that your bony skeleton was designed to remain strong for your lifetime? Could it be that what you believe about aging and bone health is oversimplified and no longer scientifically accurate? Yes, both statements are true!
I have spent the last few years, learning what the science is saying about maintaining strong, fracture resistant bones as we get older.
I am excited to say that I have dedicated an entire chapter to the condition, Osteoporosis in my soon to be released book, Staying Healthy, Living Longer, 7 Powerful Principles to a Healthier You! due to be released this January 2021.
This blog will give you a quick peek into the primary factors affecting whether you will have strong, healthy bones as you age or be part of a growing population of those diagnosed with bone thinning, osteoporosis, or frailty.
Bone density is measured most commonly with a special kind of x-ray called a DEXA scan. This stands for Dual X-Ray Absorptiometry. The DEXA can will give you a number called a T-Score.
For those not familiar with the terms, Osteoporosis, literally means ‘porous bones’ and is diagnosed when a bone density scan T-score measures a -2.5 or less. ( more negative). Osteopenia is when a T score is -1.0 to -2.5. This is considered early-stage or ‘pre-osteoporosis”. Anything over -1.0 ( less negative) is considered normal bone density. A T score is calculated by comparing your bone density to that of a 25-30-year-old or those who should be at “peak bone mass”.
I want to mention here that the time to start thinking about your bone health is when it is the last thing on your mind. Early childhood. Building healthy bone early in life is an insurance policy against loss of bone in adulthood.
A bone density or DEXA scan is recommended for all those in menopause especially when risk factors are present. An important point to remember is that a T score is a snapshot of what has already happened to the structure of your bone and is not a current picture. In other words, It tells a story of what has already occurred and not what is occurring.
Bone mass as represented by a bone density ( DEXA) scan, does not directly translate to bone strength or the bone’s ability to resist fracture under normal daily stress. Many other variables must be considered.
Also, it is important to note that these scans ( T scores), look only at the quantity of bone and not the quality of bone. That is an important distinction that must be understood. You can have a lower bone density, yet have strong and resilient, fracture-resistant bones, or a higher bone density and have older bone that has not undergone reabsorption, that is prone to microfractures and failure.
Normal bone is a living, dynamic tissue. It responds to the stress placed upon it ( weight-bearing loads and resistance training) by strengthening and increasing its density and resiliency. It also responds to nutritional factors, body-wide inflammation, hormonal factors, gut health and even mental-emotional stress.
Normal bone undergoes remodeling as do all tissues. Old bone is reabsorbed by the body by specialized cells called Osteoclasts and new bone is laid down in its’ place by cells called Osteoblasts. Many factors affect these cells and the rates of remodeling, reabsorbing, and rebuilding.
Let me begin by stressing that Osteoporosis, like many chronic and progressive conditions, is not an isolated disorder. Bones exist within bodies and therefore, Bone health is highly reflective of general health.
What are the risk factors for Osteoporosis? Risk factors can be divided into “Fixed” and “Modifiable.”
There are some “fixed risk factors” that we have little or no control over. Such things as having a smaller body frame, being female, early or surgical menopause, and prolonged steroid use for an auto-immune disorder, and history of a family member with an early bone fracture.
However, many of the factors that increase our risk of osteoporosis and bone fracture are modifiable, lifestyle factors. These same modifiable, lifestyle factors are in play for many of the chronic diseases of our time. They share common pathways, therefore, bone thinning can indicate the presence of other health conditions.
Does Osteoporosis have symptoms or early warning signs? Rarely, but there are some subtle clues. One of the hallmark signs are changes in posture. In therapy I look for a rounding of the upper back. There may also be loss of height, periodontal disease, and loss of grip strength.
Here is a short list of the many factors that we can control.
- An Inflammatory diet,- what most of us are eating
- Poor nutritional status or nutrient deficiencies ( Mineral deficiencies, Vitamin D….)
- A Sedentary lifestyle and inadequate weight-bearing exercise; loss of lean muscle, also called Sarcopenia
- Excessive soda or alcohol consumption
- High-stress levels ( increased cortisol)
- Leaky gut, food sensitivities, and Celiac disease.
- Certain Medications
- Hormonal Imbalances
In part 2 of this short blog, I will focus on just two of the many factors that are controllable or modifiable; nutrition, and exercise. I will briefly discuss ways of preventing bone loss, building healthy bone with diet and exercise, as well as preventing falls and fractures.
“Having Healthy strong bones for life, is possible and starts with what you are doing right now.'”Tweet