Good to the Bone

If your body is a temple, then your skeleton is the framework. And while your
external architecture may seem youthful and vibrant, there could be a lot of potential
cracks under the surface. Learn how proper exercise and nutritional supplements can
help you avoid a structural breakdown—perhaps even bone-weakening osteoporosis.

By Susan Weiner

September 2006

Not so long ago, the idea of reaching middle age seemed daunting: People between ages 40 and 60 were expected to abandon youthful pursuits and start shopping for the rocking chair. These days, thanks to fitness clubs, more sophisticated nutrition knowledge and improved medical care (if not universal access to it), the prevailing wisdom is that the bar defining middle age has risen. For many people, 50 truly is the new 40.

But the midlife crisis for bone health comes a lot sooner; it typically hits between the ages of 25 and 30, when the body stops building bone and bone density begins to slowly decline, leading to increased risk for breakage. The result: more than 1.5 million hip, vertebral, wrist and other osteoporotic fractures each year.

Bone health should be a top priority. Yet, a mere 10% of the nearly $20 billion in annual costs associated with osteoporosis—the bone-weakening disease that often leaves fractures and disability in its wake—is spent on prevention. In fact, according to the US Surgeon General, at least half of all individuals over age 50 will suffer fractures by the year 2020. For most of us, however, simple steps can easily optimize bone health throughout our lives. These include modest changes in diet, the use of nutritional supplements and—perhaps most importantly —starting an exercise regimen.

Most people know that calcium-rich foods and supplements can help ward off skeletal fragility, yet few know that weight-bearing exercise is an effective weapon against weak bones. Such activity not only helps maintain bones but can actually increase their density, since bones build up in response to the increased resistance from the muscles being exercised. Exercising also builds muscle strength, coordination and balance, which can help prevent falls and related fractures.
“Weight-bearing exercise actually helps out osteoporosis,” says Robert Berry, DC, who teaches classes on building stronger bones at his chiropractic offices in Montour Falls, Corning and Rochester, New York. “The best exercises by far are step aerobics and weightlifting with a low amount of weight but high repetitions.” With proper exercise, nearly anyone can delay or even prevent their skeleton from ever becoming middle-aged.

Bone Building 101

Consulting with a health care provider or personal trainer before launching into a regular exercise program makes solid sense. “When it comes to combating osteoporosis, if you are going to do weight-bearing exercise, you have to make sure your body can bear the weight,” advises Thom Ouimette, NASM, personal trainer and founder of The Body Project in Utica, New York. “It’s essential to start out with corrective exercise training and core training—the area from your neck to your hips—before progressing into muscle-building exercises.”

Posture has a lot to do with how the skeleton ages, so Ouimette assesses a person’s posture as well as their muscle flexibility before determining a personalized exercise program. “You don’t want to cause further damage to your body while you are trying to help your bones,” says Ouimette. And in an era when many people spend most of their day sitting in front of a computer, Ouimette says there is an increase in those suffering from “forward head” and rounded shoulders, conditions that can cause discomfort and further damage if not taken into consideration when planning an exercise program. Ouimette wants his clients to “build the body from the inside out,” which include strengthening the spine, an approach especially essential for anyone with mature bones.

Every fitness routine, says Ouimette, should start with stretching, and beginners should focus on building core strength and stronger muscle and bone with exercises that include chest and shoulder presses, pull downs, squats, lunges, leg extensions, abdominals, hovers and twists with a rubber band. The majority of these exercises can be accomplished safely using a stability ball, a great complement to any core-building regimen. The best overall exercise is pushups, which are effective for nearly everyone. Once you’ve gained strength and good muscle memory, more weight-bearing exercises, including lifting weights, walking, hiking, tennis and stair climbing, should be added.

“When you are beginning a workout, you want to err on the side of caution. It’s prudent to start out with corrective exercise training and core training, progressing into muscle building,” urges Ouimette. “Don’t push it right away. Start with lighter weights and higher reps and gradually increase your weight. Remember that once you’ve begun a routine, you have to bring your body to fatigue while doing the exercise in order to achieve its full benefits.”

Use It or Lose It

While the Surgeon General recommends weight-bearing exercise for at least 30 minutes each day, a study conducted at the University of Washington determined that women who exercised for one hour just three times per week experienced a 5.2% bone mineral increase after nine months, and a 6.1% increase after 22 months. Participants combined weight-bearing exercises with non-weight-bearing aerobic activities, like cycling and rowing. In addition to exercise, food intake included 1500 mg of calcium a day, from diet and supplements, and 50 IU of vitamin D.

Not up to a strenuous workout? Anyone who just walks for exercise can experience a lower incidence of hip fractures than those who don’t walk regularly. Even for those who can’t walk, simple exercises have been found to build bone mass. While the saying “use it or lose it” certainly holds true for bones and muscles, anyone can take steps to prevent osteoporosis.

“It’s never too late,” says Susan Brown, PhD, CCN, director of the Osteoporosis Education Project; she also teaches the Better Bones Better Body Program (www.betterbones.com), a holistic bone-health program. “There are people in nursing homes who have been able to build bone one or two percent lifting a little weight even from wheelchairs, so the body always responds to the mechanical force put on the bone. You always have the possibility to enhance it.”

Of course, the more mobile you are, the more chance you’ll build bone, since diverse workouts are more likely to strengthen the body than a limited routine. Robert Berry notes that even those experiencing minor osteoporotic pain can mix up their program and stimulate bone growth, so long as they avoid activities that compress the spine, knees and hips.

“What I try to tell people,” says Berry, “is to switch it up. Ideally, we should be working out five days per week, so do something like step aerobics on Monday, take a day off and on that day do swimming, which is just going to increase your range of motion. It’s also going to open everything up for them. Wednesday, get right back to step aerobics, take a day off, do a little swimming. It doesn’t mean that you have to swim laps; even walking in water, just getting that movement can make a huge difference.”

Supplement Your Skeleton

In addition to exercise the body requires bone-building nutrients. According to both the New England Journal of Medicine and the Journal of the American Medical Association, studies consistently show that vitamin D and calcium can reduce fracture rates among elderly patients in nursing homes.

Researchers aren’t quite certain how magnesium works. But according to one study this mineral may increase density by boosting bone-building hormones. Numerous other studies show that women who consume vitamin K supplements may improve bone density and decrease their risk of bone fractures, while zinc has been shown to stimulate bone formation and inhibit bone loss in animals.

Some people turn to Traditional Chinese Medicine (TCM) for bone support. A TCM practitioner would use a combination of acupuncture and herbs, since—according to traditional beliefs—the kidney governs bone and stores the qi (energy) for bone and marrow. An acupuncturist would energize the qi at points that stimulate kidney energy, and would recommend a combination of herbs that boost estrogen levels and provide minerals for the skeleton. The practice of qi gong and tai chi, as well as other types of exercise, may enhance muscle tone and improve balance and coordination, reducing the risk of falls and subsequent bone fractures.

So whether you’re 20-something or 80-something, you can strengthen your bones. Like a car that requires quality gasoline and regular maintenance, your body requires proper, ongoing care. By simply incorporating regular exercise and healthy nutrient intakes from childhood through adulthood, you can help keep your bones in peak condition for years to come. After all, your body is the vehicle you’re going to transport yourself in for the rest of your life. Fortunately, it’s almost never too late to put the brakes on bone loss.

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