Resisting Osteoporosis
Exercise and strength training build bone

Right now, you can take steps to boost your bone health--literally. "Every step you take, striking your heel on a hard surface, creates a stress on your skeleton. In response, your skeleton strengthens and renews itself," promises Judith Andariese, R.N., director of the Osteoporosis Center at the Hospital for Special Surgery (HSS) in New York City.

Over 10 million Americans - 80% of them women - already have osteoporosis. With its weak, brittle bones, the disease causes about 1.5 million fractures a year in the U.S. alone.

Here are some proven approaches to help avoid or lessen your risk of brittle bones:

Try Pumping Iron
The pull of gravity on your bones stimulates bone-building cells. To help nature along, try weight-lifting. And you don't have to be muscle-bound to benefit.

In a landmark Tufts University study, 20 sedentary post-menopausal women attended two weekly supervised weight-lifting sessions of about 45 minutes. In one year, the women gained an average of 1% in bone density. They also maintained bone mineral content, dramatically increased strength and total muscle mass, and improved balance. In contrast, the control group lost about 2% of bone density and had declines in all measured areas of bone. "High-intensity resistance training has the added benefit of influencing multiple risk factors for osteoporosis," explains Miriam E. Nelson, Ph.D., Director of the Center for Physical Fitness at the Tufts University School of Nutrition Science and Policy, who headed the study.

But reduced risk of bone loss was just the beginning. Members of the weight-lifting group were soon rollerblading, playing tennis, gardening, shoveling snow, or walking more, "doing things they hadn't done in years. They became more youthful," she says.

It doesn't matter whether you lift weights at home or at a fitness center, "relatively healthy people can do resistance training, at any time of the day. Just adapt it to your lifestyle: do it watching television; meet with friends on weekends to lift weights," Dr. Nelson suggests.

In fact, you don't even need conventional dumbbells. Heavy cans of food will do, as long as you use two cans of equal weight, grasped in each hand.

Get Moving
Weight-bearing aerobic activity is also critical for healthy bones. The HSS Osteoporosis Center recommends walking, running, jogging, aerobics, tai chi, and walking down stairs. "Climbing stairs has cardiovascular benefits, but doesn't especially help bone. Going down stairs, you strike your heel harder," Andariese explains. (Stair-climbing machines are fine if you have no joint problems.) Folk or ballroom dancing is ideal, especially for people who do it for two hours, several times a week. Virtually any activity where your bones support your weight will help.

"Incorporate weight-bearing exercise into activities of daily living," Andariese urges. "Fit it in when you can. Walk down the stairs. Stride, don't stroll. Do heel impact exercises a few minutes a day. Simply stand erect, go up on your toes, and come down on your heels. Get off the bus or train a few blocks early and walk briskly to your destination. Put a little more oomph into everything you do every day!"

A new study suggests that more vigorous exercise could boost bone density in certain fracture-prone bones in older women -- so that those bones could be as strong as men's.

Researchers at the University of California and the U.S. Department of Veterans Affairs in San Diego measured the bone mineral density (BMD) of 94 men and 58 women triathletes over age 40, and found that the BMD in the upper thigh bone and the lower spine (common sites for fractures later in life) were equal in both sexes, even though men typically had stronger bones elsewhere.

The upper thigh and lower spine bones are less compact than others in the body, and are metabolically more respodsive to exercise and good nutrition. The researchers say the data suggests that intense physical exercise could curtail bone loss in women over 40, and underscores the importance of exercise in general. In fact, when it comes to exercise, they conclude, the more the better-- as long as it's compatible with a person's overall health and doesn't involve excessive strain.

Of course, most of us are not triathletes. But even moderate exercise will bring some rapid returns -- such as more energy and mood-boosting effects. Be aware, though, that bones change much more slowly than muscle tone. The effects of exercise and strength training are also site-specific: working your biceps will not only tone those muscles, but will also increase bone density in your arm (as will playing tennis).

So you need a well-rounded regimen to improve bone density in your hips, spine and upper body.

Take Steps Now
It's never too late, or too early, to start a bone-benefit program. Of course, truly preventive steps should take place between ages 13 and 24, when bone is being formed (so tell your daughters, granddaughters, and nieces.) This includes getting plenty of calcium. Aim for 1,500 mg a day after age 5 1; 1,000 mg if you're pre-menopausal. (Moms take note: adolescents need 1,300 mg a day.) You'll also need 400 international units (IU) of vitamin D (600 IU after age 70). Get some extra vitamin K, too (found in green leafy vegetables); studies show it may help prevent hip fractures.

Since all of us begin to lose bone by age 35, it's wise to start weight-bearing and resistance exercise by your fourth decade. Dr. Nelson recommends a combination of these activities, two or three times a week, from 20 to 45 minutes per session.

Even if you already have signs of osteoporosis, you'll benefit from exercise. The HSS Women's Sports Medicine Center has a five-point exercise program tailored for women with osteoporosis, that works on posture, balance and specific stretches for flexibility. Physical therapist Lizz van Wilgen cites Tai Chi and dance as superb ways to improve balance and lessen the likelihood of falling. (In fact, one study found that Tai Chi decreased falls in older women by up to 47%.)

Experts advise anyone with osteoporosis to have a physical therapist design a set of individual exercises (like those from physical therapist Margie Bissinger, featured below). "Resistance exercise need not be with machines or weights. It can be your own body weight against gravity, such as leg lifts, or you can use exercise bands," van Wilgen notes. Avoid high-impact aerobics or any type of movement that jars the spine.

Take steps now, even if you're on hormone replacement or a bone-building drug like alendronate (Fosamax) says Dr. Nelson. "These drugs are very helpful, but they'll help much more if you eat well and exercise, too." Andariese agrees. "Though we're living longer and acting younger, our bodies still age. Better bones are a lifelong goal."

Carol Milano


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