Ask the Expert: Better Bone Health at Any Age

Dr. Thomas Moyad

Maintaining bone health is important in reducing the risk of osteoporosis, a disease that causes thinning of the bones. The condition impacts as many as 10 million Americans, with 34 million more having low bone mass, or osteopenia. Dr. Thomas Moyad, a Sharp-affiliated orthopedic specialist, answers questions about bone health. 

At what age should women begin building and maintaining stronger bones?
Building and maintaining healthy bone begins early in life with proper nutrition and exercise to build bone mass. By age 30, bone mineral density starts to slowly decay, so it is vital to build bone mass with good nutrition and weight bearing exercise early in life and reduce the loss of bone that occurs beginning in the third decade. Both vitamin D and calcium are important nutrients needed for bone growth and preservation.

What is peak bone mass and how is it impacted by age?
Peak bone mass is the point in an individual's life where the density of his or her bone is the greatest, typically at age 30. From that point, bone mass begins to slowly deteriorate. After the age of 30 we all lose a small fraction of bone mass each year. For women, the amount of bone loss tends to accelerate after menopause, which frequently leads to osteoporosis in later years.

What causes osteoporosis? Are symptoms easy to recognize?
We can categorize osteoporosis to primary and secondary causes. Primary osteoporosis is generally due to an age-related loss of bone without an associated underlying medical disease that contributes to bone loss. The majority of cases of osteoporosis are primary, without an associated disease.

On the other hand, secondary causes of osteoporosis involve diseases or chemicals that affect bone mineral metabolism. There are numerous secondary causes of osteoporosis such as  hypothyroidism, steroid induced osteoporosis, hypocalcemia (low levels of calcium) and hypogonadism (low functional activity of the gonads, a reproductive gland in males and females).

Unfortunately, there are no symptoms or signs of osteoporosis. Without proper prevention and medical follow up, the first sign of osteoporosis is frequently a fracture which may lead to more serious or life-threatening conditions.

How can my doctor determine if I have osteoporosis?
The first thing the doctor should do is perform a thorough history and physical. Based on information obtained from the medical history, the patient may be deemed a candidate for a bone mineral density test often called a DEXA scan. This scan can show if there is low or severe bone loss relative to a patient's age.

How does diet affect bone health? What foods can I eat to help prevent osteoporosis?
A diet that is rich in calcium and vitamin D can help dramatically reduce risk of osteoporosis by maintaining healthy bone mass. Depending on a women's age, recommended daily calcium intake ranges from 1000 to 1400 mg. Additionally, post-menopausal women should have 800 IU per day of vitamin D; the average adult should have 400 IU of vitamin D per day. Furthermore, those with low bone density and low vitamin D levels may require a dose of vitamin D that is significantly higher than 800 IU.

Are there other ways to help manage and reduce the risk of osteoporosis?

• Perform regular weight bearing exercises such as walking, treadmill and weight lifting activities
• Eat a well balanced diet and make sure to obtain the adequate amount of vitamin D and calcium either through diet or supplements, if necessary
• Avoid smoking
• Drink in moderation and avoid excessive alcohol consumption
• Ask your doctor if you are at risk of osteoporosis and if a DEXA scan is indicated to evaluate your bone density

If you are diagnosed with low bone mass, talk to your doctor about medical treatment.

Find a San Diego Orthopedic Surgeon
To learn more about orthopedics at Sharp or to find a Sharp-affiliated doctor, search for San Diego orthopedic surgeons or call 1-800-82-SHARP (1-800-827-4277), Monday through Friday, from 8 am to 6 pm.

For More Orthopedics Information
To find general information about orthopedics, visit Orthopedic Surgery in Adult Health or read the Orthopedics News archive.