Enhancing Bone Strength: A Key to Healthy Aging

For individuals who are getting older, can increasing bone strength help prevent fractures and optimize bone health?

Bone Strength

Bone strength is important, as a fractured hip can be serious for older individuals. A study found that for individuals in their 60s who had a hip fracture, 6.5% of women and 9.4% of men died within a year. Among individuals in their 80s, 13.1% of women and 19.6% of men died within a year. (Dimet-Wiley, et al., 2022)

Increasing bone strength can help prevent various issues. A small increase in bone mineral density has been shown to help reduce the risk of fractures, especially hip fractures. A decades-long study found that just a 3% increase in bone strength helps lower the chance of breaking a hip. Researchers enrolled two groups of individuals aged 60 and older, one in 1989 and the second in 1999.

• The bone mineral density of each subject’s femoral neck joint at the top of the thigh bone near the hip was measured.
• They then followed the subjects for years to see who experienced hip fractures.
• While the bone mineral density of the second group was only 3% higher than the first group, these subjects experienced a 46% reduction in hip fractures. (Tran, T. et al., 2023)

Bone Loss

Bone loss is progressive in men and women and increases as the body ages. Osteoporosis is a condition in which bone tissue deteriorates. (Department of Health and Human Services Office of Disease Prevention and Health Promotion. 2020) Bones constantly break down and reform as a normal remodeling process. If the balance of this process is impaired, osteoporosis develops, resulting in more bone breakdown than formation. While men and women experience bone loss, it’s more common in females. (National Institute of Arthritis and Musculoskeletal Diseases. 2022) Menopause is a risk factor because of the decline of estrogen (National Library of Medicine, Medline Plus, 2022). Estrogen reinforces bone strength by protecting against bone breakdown; with estrogen loss, bone breakdown increases. However, anyone of any age or background can experience bone loss due to the following:

• Endocrine disorders.
• Gastrointestinal diseases.
• Inflammatory diseases like rheumatoid arthritis.
• Certain cancers.
• Medication taken to treat these conditions, like steroids or oncology meds, can also accelerate bone loss. (National Library of Medicine. Medline Plus, 2022)

Exercise

While some loss of bone strength is common, several strategies exist to maintain bone health. Exercise, specifically weight-bearing activities, can increase bone strength. When bones and muscles are used to hold a position against gravity, this mechanically stresses the bone, causing it to reform stronger. Movement and physical exercise as medicine and the forces transmitted through the bones generate mechanical signals that tell the cells to increase bone formation relative to breakdown. Exercises focusing on posture, balance, gait, and coordination are recommended for individuals with osteoporosis to strengthen the core, quadriceps, and hip flexors. Different types of exercises can include:

• Walking to strengthen the spine and hips.
• Walking outside or on a treadmill provides more loading force to the bone.
• Planks and push-ups can strengthen the forearm and wrist bones.
• Holding a water bottle in each hand and lifting up and down 10 times together or alternating a few times a day.
• Side leg lifts can strengthen the hip and forearm bones simultaneously.
• Weight training provides the bones with a workout by having them support a weight load.
• Any exercise therapy program should be designed by a healthcare provider, physical therapist, and trainer according to the individual’s condition and appropriate for them.

Diet

What goes into the body definitely affects bone health. Calcium and vitamin D are key to bone building, but both are needed as vitamin D is needed to absorb the calcium ingested. Calcium can be found in:

• Dairy
• Dairy products and non-dairy alternatives are fortified with calcium.
• Leafy greens.
• Beans.
• Almonds.
• The recommended daily calcium intake for adults over 50 is 1,200 milligrams.

Vitamin D can come from:

• Sunlight
• Fish.
• Mushrooms.
• Fortified milk.
• Supplements.
• The recommended daily vitamin D intake for adults aged 70 is 15 micrograms and 20 micrograms for individuals over 70.

Studies have found that increasing calcium and vitamin D intake with supplements can help maintain bone health. Talk to a healthcare provider about whether supplements could be beneficial.

Hormone Therapy

Females also naturally produce testosterone, which promotes bone formation. As levels drop with age and negatively impact bone strength, hormone therapy could be recommended. Declining testosterone levels start with women in their 20s and men in their 30s. The typical drop in women is 1% to 3% yearly before menopause and stabilizes somewhat afterward. Female patients at risk of bone loss may be prescribed testosterone in various forms that continuously emit the hormone. The dosage is low, so patients do not experience unwanted hair growth or skin changes. Combined with estrogen, testosterone effectively increases bone growth in female patients. Not everyone is a candidate for hormone therapy, like individuals with a history of breast cancer, heart disease, blood clots, or liver disease. (National Library of Medicine. Medline Plus, 2019)

Making small adjustments can optimize bone health and overall well-being

At Injury Medical Chiropractic and Functional Medicine Clinic, we passionately focus on treating patients’ injuries and chronic pain syndromes to create personalized care plans that improve ability through flexibility, mobility, and agility programs tailored to the individual. Using an integrated approach, our goal is to relieve pain naturally by restoring health and function to the body through Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine protocols. If the individual needs other treatment, they will be referred to a clinic or physician best suited for them, as Dr. Jimenez has teamed up with the top surgeons, clinical specialists, medical researchers, and premier rehabilitation providers to provide the most effective clinical treatments. We focus on what works for you and strive to better the body through researched methods and total wellness programs.

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References

Dimet-Wiley, A., Golovko, G., & Watowich, S. J. (2022). One-Year Postfracture Mortality Rate in Older Adults With Hip Fractures Relative to Other Lower Extremity Fractures: Retrospective Cohort Study. JMIR aging, 5(1), e32683. https://doi.org/10.2196/32683

Tran, T. S., Ho-Le, T. P., Bliuc, D., Center, J. R., Blank, R. D., & Nguyen, T. V. (2023). Prevention of Hip Fractures: Trade-off between Minor Benefits to Individuals and Large Benefits to the Community. Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 38(11), 1594–1602. https://doi.org/10.1002/jbmr.4907

Department of Health and Human Services Office of Disease Prevention and Health Promotion. (2020). Osteoporosis Workgroup. Retrieved from https://health.gov/healthypeople/about/workgroups/osteoporosis-workgroup

National Institute of Arthritis and Musculoskeletal Diseases. (2022). Osteoporosis. Retrieved from https://www.niams.nih.gov/health-topics/osteoporosis

National Library of Medicine. MedlinePlus. (2022). What causes bone loss? Retrieved from https://medlineplus.gov/ency/patientinstructions/000506.htm

National Library of Medicine. MedlinePlus. (2019). Hormone replacement therapy. Retrieved from https://medlineplus.gov/hormonereplacementtherapy.html