PREVENTION OF OSTEOPOROTIC FRACTURES
I. Education
A. Become aware of modifiable risks and change behaviors where appropriate.
B. Discuss your medical conditions and medications you are taking with your primary care physician and ask about the risks for osteoporosis you carry.
C. Obtain a DXA scan to assess your bone mineral density if appropriate.
D. Reliable, authoritative and FREE sources of osteporosis educational materials on the Web:
1. American Academy of Orthopedic Surgery
2. National Osteoporosis Foundation
3. University of Cincinnati Bone Health & Osteoporosis Center
II. Eat a Proper Diet
A. Calcium
1. Goal for all people >6 years old = 1,200-1,500 mg per day. (This includes the amount consumed through the diet and supplements.
B. Vitamin D
1. 15 minutes of exposure to sunlight (without sun screen) per day is adequate for most young people, but the skin's ability to convert sunlight to vitamin D diminishes with age.
2. Consume 700-800 IU of vitamin D per day if no bone problems exist.
3. Consume 1,200 IU of vitamin D per day if you have osteopenia or osteoporosis.
C. Beware of Vitamin A!
1. Try to limit your daily intake of supplemental vitamin A to no more than 2,500 IU (Especially damaging is the "retinol" or "retinoid" forms of vitamin A).
D. Regulate alcohol intake.
1. Alcohol consumption at a rate of 2 drinks per day is associated with decreased bone formation.
2. Recommendation is for women to consume no more than 1-3 alcohol beverages per week and for men to limit their consumption to 2-4 drinks per week.
E. Limit caffeine consumption.
1. Recommendation is to limit intake of caffeine-containing beverages to 2 cups of coffee per day (or an equivalent amount of caffeine-containing sodas per day).
F. Elminate tobacco use!
1. Smoking alters estrogen metabolism by decreasing its availability for bone building activities. Smoking not only decreases the production of new estrogen, it also serves to degrade the circulating estrogen already in the body. The bottom line is this: SMOKERS HAVE LESS OF THE BONE-PRESERVING EFFECTS OF ESTROGEN THAN NON-SMOKERS.
III. Exercise
A. Weight-bearing exercises (e.g. walking, stair climbing, dancing and tennis) should be engaged in almost daily for 35-45 minutes per day. If you are not already in the habit of exercising, ask your primary care physician for guidelines regarding how much exercise is appropriate for you at this time. (You may also request a referral to a physical therapist). A good long term goal is to walk 12-15 miles per week.
B. Strength building or resistance exercises should be performed 2-3 times per week to maximize your treatment of bone demineralization disorders. (When patients combine walking with this type of exercise training, maximum results are experienced).
C. Balance training should be engaged in 2-4 times per week, especially for those individuals with a tendency toward frequent falling episodes. Examples of balance training are: standing on 1 leg (preferably in a corner) for 1 minute per leg and Tai Chi exercise classes/tapes.
IV. Use good body mechanics when bending and lifting.
A. To pick things up, bend your knees and keep your back straight.
B. Avoid bending at the waist.
C. Ask for help when you need to reach or lift something.
V. Reduce safety hazards in the home that predispose people to falling.
A. Remove throw rugs.
B. Keep all rooms free from clutter, especially on the floors.
C. Keep all electrical and phone cords out of walking paths.
D. Keep a flashlight with fresh batteries by the bed stand and use it.
E. Use handrails when going up and down stairs.
F. Place non-slip strips on wooden or smooth-surfaced stairs.
G. Securely tack down stair carpeting.
H. Equip your bathroom walls beside tubs, showers and toilets with grab bars.
I. Apply adhesive strips in bathtubs and showers.
J. Always be on alert for small pets and objects on the floor.
K. Wear shoes with sensible soles that grip well.
L. Avoid walking on slick, icy or poorly lighted surfaces.
M. Have good lighting in all rooms. Use at least 100-watt bulbs in every room.
