Dr. Lindsey Rentschler on Preventing Osteoporosis: 7 Key Steps

Osteoporosis—a bone-weakening disease—is a major health threat for millions of Americans. In fact, half of all women and a quarter of men will suffer a bone fracture because of osteoporosis. These fractures, which often occur in the hip, spine or wrist, can be devastating and lead to chronic pain, loss of independence and, in some cases, death.

“Hip fractures are the most serious of all because they dramatically increase the risk of death. About 20 percent of those who suffer an osteoporotic hip fracture die within one year, either from complications related to the fracture itself or from surgical repair,” endocrinologist Dr. Lindsey Rentschler with Endocrinology Associates of BCH told a crowd of more than 200 people during a free health lecture held in Boulder.

“Fortunately, there are steps you can take to prevent osteoporosis from ever occurring,” she said.

HOW TO KEEP YOUR BONES STRONG
Dr. Rentschler described seven ways you can help keep your bones healthy and strong.

1. Maintain a healthy body weight.
Studies show that body weight correlates with bone mineral density. Being underweight increases the risk of bone loss. Also, one study suggested that losing a moderate amount of weight in middle age may mean losing not just unwanted fat, but also bone density.

2. Consider hormone therapy, if appropriate.
Dr. Rentschler explained that there is a direct relationship between the lack of estrogen after menopause and the development of osteoporosis.

“Lowered estrogen levels in women at menopause tend to weaken bone. Women lose up to 20 percent of bone density in the 5 to 7 years after menopause. By age 80, women will have lost 33 percent of hip bone density,” she said.

If you wish to use hormone therapy to prevent osteoporosis, talk with your doctor to weigh the benefits of this therapy against your personal risk for heart attack, stroke, blood clots and cancer.

3. Quit Smoking Cigarettes
According to Dr. Rentschler, smoking cigarettes is one of the worst things you can do for your bones. Studies show a direct relationship between tobacco use and decreased bone mineral density. Also, women who smoke tend to experience menopause earlier, which may lead to increased bone loss.

4. Limit your alcohol, caffeine and cola intake.
Dr. Rentschler mentioned that consuming more than two alcoholic drinks per day raises the risk of bone loss. She also recommends having less than three cups of coffee per day because research has linked heavy caffeine consumption with lower mineral bone density. Additionally, research suggests that caffeine in carbonated colas may do the same.

5. Consume enough calcium and vitamin D.
Calcium and vitamin D are essential for building and maintaining healthy bones. Dr. Rentschler said the amount you need every day depends on your age and sex:

She stated that good sources of calcium include:

• Dairy products such as milk, yogurt and cheese. “Adding 1 tablespoon of nonfat powdered milk to foods is an easy way to add more calcium to your diet.”
• Dark green leafy vegetables such as collard greens, turnip greens, kale, okra, dandelion and mustard greens.
• Soy products such as tofu.

If you find it difficult to get enough calcium in your diet, consider taking supplements. However, Dr. Rentschler cautioned to look carefully at supplement labels because too much calcium has been linked to kidney stones.

“Look at serving size and take doses of just 500-600 milligrams at a time. Drink extra water to avoid constipation. And, ask your pharmacist about interactions with other medications,” she stated.

Dr. Rentschler recommended visiting the International Osteoporosis Foundation Dietary calcium calculator at iofbonehealth.org/calcium-calculator to find out whether you’re getting enough of this important mineral in your daily diet.

In terms of vitamin D, she said usually people tend to get enough of it from sunlight. However, sunlight might not always be a good source for those of us who live at high altitudes or regularly use sunscreen to avoid the risk of skin cancer.

According to Dr. Rentschler, good sources of vitamin D include:

• Fatty fish such as salmon or tuna.
• Vitamin-D fortified foods (some dairy products, cereals or orange juices).

She said if you find it difficult to get enough vitamin D in your diet, supplements such as Vitamin D2 (ergocalciferol) and Vitamin D3 (cholecalciferol) are an option. She warned, however, to make sure you’re not already taking medications and supplements with vitamin D. Most multivitamin products contain between 600 and 800 IU of vitamin D and more than 10,000 IU of vitamin D each day is not recommended.

6. Eat foods high in other important minerals and vitamins.
Dr. Rentschler explained that calcium and vitamin D aren’t the only minerals important for bone health. Several others also play a role, including magnesium, potassium and vitamins K and C. Here are some excellent food choices for sources of:

• Magnesium = spinach, beet greens, okra, tomatoes, artichokes, potatoes, raisins and collard greens.
• Potassium = tomatoes, raisins, potatoes, spinach, sweet potatoes, papaya, oranges, bananas and prunes.
• Vitamin K = kale, collard greens, spinach, mustard greens, turnip greens and brussels sprouts.
• Vitamin C = red and green peppers, oranges, grapefruits, broccoli, strawberries, papaya, pineapple and brussels sprouts.

7. Exercise your bones.
“Engaging in physical activity for at least two-and-a-half hours per week can help you build strong bones and slow bone loss,” explained Dr. Rentschler.

She said high-impact, weight-bearing exercises—aerobics, hiking, jogging or running, jumping rope, stair climbing and tennis—promote the formation of new bones and keep them strong. If you need to avoid high-impact exercises consider low impact aerobics, stair-stepping machines or walking.

Combine this exercise with muscle strengthening exercises: lifting weights, exercising with resistance bands or engaging in yoga or Pilates.

OTHER PREVENTIVE STEPS
Dr. Rentschler mentioned that medications can help the body maintain or build bone. Doctors often prescribe them for people, especially women, who are at greater risk of getting osteoporosis. Ask your doctor whether medication to prevent osteoporosis is a good idea for you.

View PowerPoint slides from the free health lecture on “Preventing and Treating Osteoporosis.”

To make an appointment with Dr. Lindsey Rentschler, call 303-415-8940.