Your Bone Health and Exercise


A strong skeletal is necessary for supporting an active lifestyle and is a must have for resilient longevity and lifelong independence. Our bone mass peaks around 17 to 30 years of age and is maintained until around 50 (menopause for women). After age 50 bone density decreases and decline is accelerated with insufficient nutrition, absence of physical activity and/or insufficient bone loading exercises.

Mature adults:

The American College of Sports Medicine (ACSM) recommends that people 30 to 50 years of age perform more weight bearing exercise (such as jogging, walking, hiking, jumping, stair climbing) and exercises that load the skeletal system ( hip and spine) with exercises such as squats, leg press, push-ups, pull-ups, row, chest press, and overhead press. Non-weight bearing exercises such as swimming and bicycle riding do not provide enough stimulation to maintain and build bone density.

Midlife adults:

People age 50 to 65 need to continue with these healthy bone preserving lifestyle habits and work towards building a reserve in muscle strength and bone density so that you can withstand unexpected events or accidents and have the resilience to bounce back.

With many people having professions that requires them to be seated for many hours in the day, poor posture, increasing body weight and body fat, physical inactivity and absence of regular exercise leaving them with a body that does not have a reserve and at high risk for developing disease, chronic pain and injury. Preparing the body for successful aging and the ability to enjoy retirement requires the adoption of healthy lifestyle habits, sooner rather than later.

Older adults:

People 65 to 80 years of age and beyond often experience continued bone loss and fractures after a fall or spontaneous fracture when the bone becomes soo weak that it cannot support bodyweight. Sedentary lifestyle, too much sitting and lying down accelerates bone loss and contributes to muscle weakness which increases risk for falls, fractures and loss of independence. Exercise, especially resistance training and continued weight bearing physical activity is necessary for performing activities of daily living with ease, for supporting an active lifestyle, for living independently and for longevity. Make sure that you receive optimal nutrition that fuels your body, nutrition that provides the nutrients benefitting bone density and prevention for development of chronic medical conditions heart disease, diabetes type 2, hypertension, hyperlipidemia, cancer, etc.) and will contribute to a high quality of life.

What is Osteoporosis?

Osteoporosis is very low bone density and is diagnosed with a DEXA scan that measures bone mineral density (BMD). Osteopenia is low bone density. Both osteoporosis and osteopenia increase fracture risk.The T-scores that represent bone mineral density can predict fracture risk. Having an accurate bone mineral density test that shows T-scores of the lumbar spine (L1, L2, L3, L4), femoral neck and hip provides your personal trainer or physical therapist with necessary information to design an exercise program that promotes building or rebuilding bone density in these key areas and avoid to exercises and movements that increase fracture risk.

A sneeze, a cough, bending or flexing the spine while swinging a golf club or a daily activity can cause spinal compression fractures, problems with balance and muscle weakness can lead to a fall and hip fracture. Kyphosis or scoliosis can occur as the result of spinal compression fractures that heal in a misaligned position. Building muscle strength in the trunk around the spine and hip can help maintain posture providing support to the spine itself and trunk stability so that you can enjoy a wide variety of recreational and daily activities. Posture maintaining and corrective exercises should be included in your daily activities and /or exercise program.

Exercise and Osteoporosis Prevention

Exercise recommendations for osteoporosis prevention and exercise with osteoporosis is different.

Osteoporosis Prevention

The ACSM recommends that daily physical activity for the promotion of bone density is making the majority of your exercise weight bearing. To prevent osteoporosis ACSM suggests walking, jogging, rope jumping and stair climbing for 150 minutes a week. High intensity resistance training exercises that focuses on the trunk, hip and spine is recommended 2 to 3 times per week, 2 sets of 8-10 repetitions.

Exercise with Osteoporosis

When you have been diagnosed with osteoporosis, ACSM's recommendation is to perform weight bearing aerobic exercise 4 to 5 days per week 30 to 60 minute sessions, walking is an excellent choice. Focus more on duration than intensity. Avoid high-impact exercise such as jumping or jogging due to fracture risk. Resistance training exercises that focuses on muscles surrounding the hip and spine and to avoid exercises and movement that increase fracture risk. Intensity level depends on the severity of the bone density. Be careful with certain yoga and pilates poses that can contribute to spinal fractures. Exercises should be specific and be performed consistently to benefit your bones. Resistance training can include exercises on the floor, seated, standing, machine, hand weights, resistive bands and tubing. Make sure to include balance exercise to your program and when you experience balance problems these exercises should targeting your specific balance impairment.

Do not know if you have osteoporosis or osteopenia?

I realize that not everyone knows the status of their bones and may not have had a bone density scan or choose not to have a bone density scan. Exercise training must be based on the available research on how to maintain and sustain your bone health and should include weight bearing cardiovascular exercise, resistance training that focuses on muscles that surround and load the hip and spine, focus on posture and core stability, and includes balance exercises to optimize mobility and prevent falls.

Nutrition

For bone to maintain and regain their strength and to fuel your body to support your lifestyle it needs to receive sufficient nutrients.

With increase in chronic medical conditions and illness the National Institute of Health (NIA) states that unhealthy lifestyles, especially poor eating habits are contributing to the spread of obesity, diabetes, and cardiovascular disease. The NIA states that healthy eating may be best achieved with a plant-based diet, which they define as a regimen that encourages whole, plant-based foods and discourages meats, dairy products, and eggs as well as all refined and processed foods. Dairy products are not necessary for calcium to build and sustain your bones and meat and eggs are not needed to build muscle.

Research shows that plant-based diets are cost-effective, low-risk interventions that may lower body mass index(BMI), blood pressure, HbA1C, and cholesterol levels. Plant based diets also contribute to reducing the number of medications needed to treat chronic diseases and lower ischemic heart disease mortality rates. The NIA states that physicians should consider recommending a plant-based diet to all their patients, especially those with high blood pressure, diabetes, cardiovascular disease, or obesity.

Additional Medical Problems?

When you have been diagnosed with additional medical issues other than osteoporosis or osteopenia (rheumatoid artists, heart disease, type 2 diabetes, hypertension, high cholesterol, cancer, etc.) it is important to receive an exercise program that is safe and effective, and is tailored to benefit all your medical problems. We know now that by following healthy lifestyle habits we can improve health and function, and can even reverse some of the most severe medical conditions. A Lifestyle Medicine practitioner, attentive doctor, personal trainer and/or physical therapist can get you on track to better health and resilient longevity.

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