How to take care of your bone health

May is Osteoporosis Awareness Month. Osteoporosis is a disease in which, over time, bones become thinner, more porous and less able to support the body. Bones can become so thin that they break during normal, everyday activities like stepping off a curb, or picking up a grocery bag. 

I first became interested in bones as a young dancer. I was studying body alignment, and I became fascinated with the skeleton and the remarkable intricate architectural structure of bone. It led me to do a graduate thesis on bones, to discover weight-bearing exercise for bone building, and to design Skeletal Fitness®, the first bone-loading workout in the U.S. To understand how and why exercise works, here’s a quick look at how your bones work.

On the outside, bones seem solid and rock-like but they’re not. They’re living tissue.

There’s the smooth, hard shell we see on the outside called cortical bone, and the amazing crisscrossed, honeycomb-like structure on the inside called trabecular bone. The combination of cortical and trabecular bone make our skeletons strong, light, flexible and efficient.

The structure of trabecular bone is the secret ingredient. The trabecular bracing structure is located at precisely the correct angles to absorb the maximum force.

So, when you jump over a puddle or run for a bus, it’s the trabecular bracing that directs the force to the strongest part of your skeleton and prevents a bone from breaking.

Most of us aren’t aware of our beautiful bone structure. But it hasn’t gone unnoticed or underutilized.

The structure of trabecular bone was copied by the French bridge builder Gustave Eiffel, who wanted to build the tallest man-made structure in the world. When he built the Eiffel Tower in 1889, he calculated the positioning of the braces in the curves of the legs to direct any force, like high winds, on the entire structure to the strongest area — the four legs. This is why the Eiffel Tower has stood the test of time.

Courtesy image

That’s fine for an iron tower. If part of it becomes weakened, you can see it and fix it. But what happens to weakened or damaged areas of our skeletons?

I was astonished to find out that bones are pretty smart. They don’t grow to adult size and then stop.

Our skeletons are constantly getting rid of old, weakened bone tissue and replacing it with new, healthy bone.

In a process called remodeling, old, weakened areas are broken down and replaced with new well-formed tissue.

Our bodies replace about 10% of our bone tissue each year. So every 10 years we pretty much have a new skeleton.

But in bones with osteoporosis, the remodeling process has gotten out of whack. Weak bone is broken down and little or nothing takes its place.

Those sturdy crisscrossed structures disappear. Bones get weaker and start to fracture. Fractures occur most often where there is the most trabecular bone.

The three areas most at risk for osteoporotic fracture are the spine trabecular bone, the hip trabecular and the forearm at the wrist.

So if you have osteoporosis, the vertebrae start to squash under the weight of the torso. The thigh bone at the hip is next. It can break just by stepping into a sudden turn. And the wrist will likely break if you put out your hands to catch yourself in a fall.

Osteoporosis is most prevalent in women after menopause when they lose the protection of the hormone estrogen, which helps keep bone density at healthy levels. Men get osteoporosis too, but usually much later when testosterone levels drop.

But there’s a lot you can do to prevent osteoporosis and maintain bone health. Studies with athletes have shown that putting just enough stress on our bones helps them maintain themselves and grow. 

Weight-bearing exercise like walking, jogging, aerobic dance and resistance training stimulate the remodeling process and promote bone growth.

Exercise should be site-specific. Do weight-bearing and resistance exercises for the whole body but pay special attention to the areas most at risk — the spine, hip and wrist. 

Calcium and vitamin D are also important. Women under 50 should get 1,000 milligrams of calcium daily. If you’re 51 or older, you need 1,200 mg a day. Men under 70, 1,000mg. 71 and older 1,200 mg. Try to get as much calcium as possible from food. Dairy products and leafy green vegetables are rich in calcium. 

Read food labels. They’ll tell you how much calcium is in there.

Vitamin D is made in the skin. It helps your body absorb calcium.

Both women and men under 50 need 400-plus international units a day. Over 50, 600. Over 70, 800. In Florida, eight to 10 minutes of unscreened sunlight a day is enough for healthy vitamin D levels. But there’s a delicate balance between sunlight for vitamin D and an increased risk of skin cancer. 

It’s hard for most people to get enough D without supplements. If you are a person at higher risk for skin cancer, vitamin D supplements may be the way to go. Your dermatologist can help you find the right balance for you.

Your bones are living tissue. Take care of them as you would any other body part and they’ll take care of you.