By Jeevan Jyoti, Student Pharmacist and Karen Kier, Pharmacist
On behalf of Healthwise Pharmacy

"No bones about it" is believed to have started in England around the 15th century. It described the unpleasant finding of bones in one's soup. Today we used the idiom to describe no hesitation or objection to something.

How can we maintain healthy bones?

Bone mineral density (BMD) is a measure of minerals in our bones and gives an indication of bone thickness or density. The measurement is evaluating mineral composition of the bone including the 2 most common minerals of calcium and phosphorus.

As we age, we lose bone and BMD decreases. Women after menopause have a significant risk of bone loss compared to men of the same age. Besides gender and age, other risk factors include a family history of osteoporosis (loss of bone), physical inactivity, smoking, alcohol intake, diets low in calcium and vitamin D, and non-Hispanic white women and Asian women. 

Bone loss is a gradual and silent condition until the loss is severe enough to see broken bones or fractures. Sometimes minor falls or even coughing can be enough to break a bone. The loss of bone in the spine can result in significant back pain and can shorten one's stature.

The best way to know if you have bone loss is to be screened. This can be done with a small machine using ultrasound to estimate bone density in areas like the heel and forearm. These tools are helpful for screening who may need more diagnostic evaluations. Further workups would include a DEXA (dual x-ray absorptiometry) scan of the hips and spine to measure thickness and strength of the bone.

There are steps to take to help prevent or slow down bone loss.

A study in JAMA Network Open evaluated how some lifestyle changes could slow the loss of bone. The researchers followed 924 adults including both men and women who were 55-75 years old, overweight or obese, and had metabolic syndrome. Metabolic syndrome is a cluster of conditions which increase the risk of heart disease, stroke, and type 2 diabetes. These conditions can include high blood pressure, high blood sugar, high cholesterol, and increase fat in the abdominal region. 

The study compared 2 groups. Each group followed a Mediterranean diet, but one group was encouraged to lose weight by lowering overall daily calorie intake. The individuals who ate a low-calorie Mediterranean diet, increased their exercise, and were supported during these changes lost significantly less bone mineral density (BMD) in their lower spine than those who did diet alone. 

The Mediterranean diet is high in fruits, vegetables, whole grains, legumes, nuts, olive oil, and lean protein sources, like fish. Moderate intensity exercises like brisk walking, biking, yoga or workouts with weights done 3 to 5 times a week can help strengthen the bones and improve overall mobility. It is important to go at a pace comfortable for you and slowly increase your exercise amount.

Calcium and vitamin D are good supplements to consider for managing bone health. Eat foods rich in calcium and vitamin D and consider supplements as well. Consult with your pharmacist or healthcare provider for recommendations.

There are no bones about it — your diet and exercise can help your bone health!