As we approach July 4th, our national celebration of independence from tyranny, I thought I might muse on the term “independent”.
From your responses to my latest survey, most of you appear to be interested in healthy aging with healthy eating, exercise & fitness right behind that, with a dose of alternative therapies and products.
Which is great because you are definitely in the right place to learn more about how you can maintain your health as you get older through eating well, moving your body regularly and with purpose, and be open to trying new modalities and products that I use and share with you. All of these things will help maintain your independence in the years to come.
If you read last week’s blog, you know my mom and sister took a tumble and although fine, my sister is scheduled for surgery on her wrist on Tuesday. I also shared with you that I was having a DEXA scan done to measure my bone density. I am happy to report that bone density in my spine increased 5% and the osteopenia in my hips is minor and unchanged from the last scan almost two years ago.
Did you know that women are more likely to develop osteoporosis, which is basically porous bones (osteo) that are less dense, resulting in increased likelihood of a break due to a fall? Our bones are lighter than men’s bones, and we live longer which makes this four times more likely. It doesn’t help if you are Northern European or Asian, either.
Osteopenia is the precursor to osteoporosis, which can cause fractures, stooped posture, pain and loss of height (yikes, I’m barely clearly 5 feet, as it is). We lose bone density more rapidly after menopause, due to lower estrogen levels, with half of us over 50 developing osteopenia. It can be stopped in its tracks (or even improved) when you know the risk factors and take corrective action now.
What are the risk factors?
Female, older than 50
Family history
Menopause before age 45
Removal of ovaries before menopause
Diet lacking in calcium & Vitamin D
Smoking
Drinking too much alcohol
Drinking too much caffeine
Taking prednisone or phenytoin for an extended period
Anorexia or bulimia
Cushing’s syndrome (an overproduction of cortisol)
Not exercising regularly
Hyperparathyroidism (overproduction of parathyroid hormone)
Hyperthyroidism (Grave’s disease)
Inflammatory diseases such as lupus, Crohn’s, or rheumatoid arthritis
The conditions above that are underlined are things we can (thankfully) do something about.
If you haven’t had a DEXA scan yet and you are perimenopausal or menopausal, I recommend you do. If you are perimenopausal, you want to get a baseline to find out where you are with your bone mineral density (BMD), which peaks at about age 35.
What the scan measures is the current density of your bones, which will be the only indication of osteopenia, as there is no pain associated with this condition. This low level x-ray will compare your bone density to that of a 30 year old, of the same sex and race. Here is the T-score the doctor will share with you after you take the test.
T-score Diagnosis
+1.0 to –1.0 normal bone density
–1.0 to –2.5 low bone density, or osteopenia
–2.5 or more osteoporosis
Your report may have the FRAX score on it a as well, which calculates the risk of breaking your hip (for example) in the next 10 years, based on your bone density and other risk factors you may have.
What can you do about it?
Did you notice I highlighted some of the above risk factors? That is because they are lifestyle-based risk factors, and you take corrective action now.
If you are diagnosed with osteopenia, your prescription will be improved diet and more exercise. Your doctor may recommend the following:
More calcium in your diet (1200 mg/day)
Vitamin D (800 IU )
It is always better to get the calcium and vitamin D from your diet rather than supplements, however with Vitamin D it is hard to get it from the sun, in the winter, in the Northern Hemisphere, and you may want to supplement intentionally at certain times of the year.
Calcium can be found in beans, broccoli, kale, sardines, wild salmon, spinach, soy and dried figs. Calcium and vitamin D are also in dairy such as cheese, milk and yogurt, so if you are vegan, you most likely need to supplement. I am on the fence regarding calcium supplementation as some studies have shown that calcium isn’t always absorbed well from supplement form or can even be harmful.
You will be advised to incorporate more exercise daily, such as a walk or running. Weight-bearing exercises and strength training are the best for building bone density. Biking and swimming are not weight bearing; however they do help with balance and muscle strength so by all means, don’t stop.
What other strengthening exercises can you do?
Glad you asked. These are so simple and can easily be incorporated into your daily routine:
Toe & heel raises -strengthens lower legs and improves balance
Stand facing the back of a chair and hold lightly with both hands
Keep heels on the ground and lift your toes off the floor, hold for 5 seconds and lower
Rise up on the toes and hold for 5 seconds and lower
Repeat 10 times
Daily
Prone leg lifts – strengthens lower back & buttocks, stretches your quadriceps
Lie on your stomach on a mat on the floor
Rest your head on your arms
Take a deep breath, press your pelvis to the floor and squeeze your buttocks
Slowly raise one thigh off the floor, knee slightly bent, and hold for a count of 2, return to floor
Repeat 10 times, each leg
2-3 times per week
Hip abductors – strengthen the hips and improves balance
Stand with your right side facing a chair, holding onto the back of the chair with your right hand
Put your left hand on top of your hip and raise your left leg to the side, keeping it straight
Keep your toe pointed forward.
Don’t raise your leg too high or your hip will rise.
Lower leg. Repeat 10 times
Change sides and do the same exercise 10 times with your right leg.