For bone health, diet and yearly checkup are musts

(MCT) If you're one of the lucky ones, you'll go through life never giving a second thought to your bones: They don't break or weaken or fail to produce red blood cells in their marrow.

But many people do face bone problems, especially as they age. Researchers estimate that one in three women and one in five men worldwide will sustain a fracture because of osteoporosis, and the number of broken hips is expected to skyrocket as the population ages.

However, the means exist to promote bone health, some as simple as adjusting your diet and getting an annual bone checkup.

"Osteoporosis is a significant public-health issue that causes serious problems and may indirectly lead to death," said Dr. Brian Cruickshank, a clinical assistant professor of orthopedics with the division of sports medicine at Stony Brook University School of Medicine. "The key to preventing this disease is knowing and correcting the factors that we can control."

Specialists say bone density is the main issue to worry about.

"As we age, we tend to lose the scaffolding inside the bones that give them their strength," Cruickshank said. "If a bone becomes too weak or thin, we call it osteoporosis. Weak bones tend to fracture easier and can affect an individual's posture."

Exercise, however, helps strengthen bones and keeps them from deteriorating. Best for your bones is so-called weight-bearing exercise, which puts weight on your bones as you move against gravity. Walking, jogging, climbing stairs, playing tennis and dancing are all weight-bearing, as is weightlifting. Swimming and biking are not. A side benefit: Exercise can help prevent falls because it also improves muscle strength, coordination and balance.

Calcium and vitamin D also are crucial. "It's so important for young people to eat dairy — milk and yogurt," said Dr. Frank Bonura, chief of obstetrics/gynecology at St. Catherine of Siena Medical Center in Smithtown.

Other good sources of calcium and vitamin D, he said, include green leafy vegetables, an especially good source for vegetarians, vegans and those who can't tolerate dairy products. "I like to tell students to remember that the dinosaurs had big bones, and they didn't have milk or yogurt," he said. "That's because they ate a lot of green, leafy vegetables."

Supplements, however, remain open for debate.

Earlier this year the U.S. Preventive Services Task Force reported that there hasn't been enough research to know whether taking both vitamin D and calcium supplements offers any protection against broken bones for men and for women who haven't gone through menopause. There's also insufficient evidence, it said, on whether large doses of the supplements could prevent fractures in older women, but it noted that lower doses — less than 400 international units (IU) of vitamin D-3 and less than 1,000 milligrams of calcium — do not prevent fractures in older women but do make the development of kidney stones more likely.

Cruickshank suggested talking to your doctor to find out what would be best for you. Bonura said he recommends that senior women take 1,000 international units (IU) of vitamin D-3 each day with their main meal. He tells his patients to keep the vitamin bottle on the kitchen table so they remember to eat it with food.

The task force also recommended that all women older than 65 have regular bone-health screenings, as should younger women who are at higher risk for bone problems.

"If you are a woman over 50 and have a broken bone, have noticed your posture becoming more hunched or stooped or noticed sudden back pain, you should also see a medical professional," Cruickshank said.

For men, the task force noted that current medical evidence isn't strong enough to support regular bone-health screenings. However, Bonura said he recommends them for men 70 and older.

Medications can be positive or negative.

In people who have existing bone problems, Cruickshank said, "there are medications that can be prescribed by physicians to slow or stop bone loss or build new bone, increase bone density and reduce fracture risk." On the other hand, he said, "there are also medications that are used to treat other conditions that may cause bone loss."

Bonura said that although the prescription drugs that can improve bone health work well, "no drug reduces fractures 100 percent." That's why preventing falls becomes especially important for older people, who often don't recover after hip fractures and die within the next year, he said.

He noted that some elderly people use specialized underwear that features discs designed to protect the hip in a fall. However, a 2010 review of existing research found that it's not clear if this provides any real protection.

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