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Tuesday, September 26, 2023

Building Stronger Bones in Seniors

New research leads to hope for therapies that can rebuild bone at any age, while current recommendations to maintain bone health have changed slightly.

A fifth of American women aged 50 and older have osteoporosis, and more than half of them have bone loss visible with a scan. Although they may not realize it, a third of older men have detectable bone loss, too. Given that a third of older women worldwide and a fifth of men will develop a fracture related to bone loss, it’s a subject of much importance among older adults. 

Many seniors aren’t aware of their bone loss, given that bone density checks are not always a part of routine care. All women should be assessed at menopause, according to physician Nancy Lane, who specializes in rheumatology research, while men should be evaluated at age 70. People with a family history of hip fracture or who have had a fracture as an adult ought to be checked earlier.

Diet Recommendations Are Modified

Research around the best diet for bone health has been ongoing. Results of a large recent study  surprised many scientists. The research found no reductions of fractures in healthy adults aged 50 and over who took vitamin D supplements for five years. The same team found that the supplements also did not improve bone density.

New Hope for Rebuilding Bone  

The common mantra for older adults is that once you lose bone, you can’t restore it. But new research is revealing promising pathways to fill in porous bone. At FIU (Florida International University), scientists have discovered a treatment that can be taken as a pill – a breakthrough for cheaper, effective treatment. “Our experiments in the lab showed small molecule activators delivered orally improve bone density, an exciting discovery that could lead to a new treatment for osteoporosis,” says study author Alexander Agoulnik, FIU professor and interim chair of the Department of Human and Molecular Genetics.

At the UC Davis School of Medicine, rheumatologist Lane has been working with medications to grow bone. “Our group did a lot of work with the parathyroid hormone,  which is a bone-growing peptide,” she says, “and the anti-sclerostin antibodies, which grow bone fast. Once you grow bone you can hang onto it. It's just a matter of getting the people diagnosed, treated, and not lost to follow-up. I think that's the biggest area that needs to be addressed.” 

“Food and incidental sun exposure likely provide enough vitamin D for healthy adults,” says endocrinologist and study lead Meryl LeBoff of Brigham and Women's Hospital in Boston. However, it’s important to note that participants were healthy adults. She advised that people with osteoporosis continue a vitamin D and calcium regimen.

What are some things we can consume to help protect bones? Plenty of calcium is first on the list – much more than most of us normally consume. Dairy products, sardines, and tofu are good sources, as well as kale and broccoli. Fortified breakfast cereals and orange juice work, too. Authorities recommend 1,200 milligrams a day for women after 50 and men after 70. Getting it from food is optimal for the accompanying nutrients and continuous absorption, but some may need an additional supplement. 

Surprisingly, your morning cup of joe may be helping bone health. Research from Hong Kong University showed that a trio of digestive by-products of coffee correlated with greater bone density of the lumbar spine and femur. Lead study author Ching-Lung Cheung says, “Coffee intake, if not excessive, should be safe for bone, and if you still have concerns, add milk!”

And while you probably know that more than a daily drink or two of an alcoholic beverage is detrimental, you may think that fizzy water is also something you should avoid. It actually doesn’t make bones weaker. But what does? Cola and soda pop appear to be the real culprits. 

Exercise is Essential

Bones need workouts to stay strong, just like your muscles. The very best ones are those that put body weight on your skeleton, such as climbing stairs, dancing, racket sports (pickleball players, that’s you!), yoga and walking. But you also need to do repetitions for muscle strength. Any kind of lifting, using machines or weights, pushups and squats are all good for building strength. 

And if you smoke, stop. It’s not only bad for bone health, but for many other diseases as well.