Make A Wish!

Thursday I was at my mother-in-law’s house for Thanksgiving and saw the turkey carcass sitting on the counter.  I saw the bones sitting there and got thinking about how important it is to have healthy bones (I know, I think about weird things at family functions).  From the wishbone to the leg bones to the spine, those bones supported Tom as he gobbled his way around the turkey farm getting ready for his big day.

Have you ever broken the wishbone with another person on Thanksgiving?  Two people each hold a side, make a wish, and pull.  The one who gets the bigger half (the half with the connector piece in the middle) gets their wish granted.  The one whose half of the wishbone is weaker, more brittle, goes without.

Ask anybody who’s ever had a broken bone and they’ll tell you it’s an attention-getting experience.  I have a lady in the hospital who just had her SECOND broken hip repaired.  I had someone in the office today who was recently taken off Fosamax because her bone density is now better and, for now, she doesn’t need it.  We spend a lot of our time talking about bone health, measuring bone density and checking for bone injuries.

Bones are amazing structures.  They form from cartilage before we’re born and gradually accumulate calcium, magnesium, phosphate and other minerals and salts which strengthen them.  They are a massive storehouse of these minerals, which are critically important to several major systems in the body including the heart and nervous systems.  The metabolism of the skeleton is impacted by the function of the endocrine system (hormones) and the kidneys, among others.  They keep us from turning into a puddle of goo, support the fingers of violinists and pianists while they make incredible music, and protect the heart, lungs and brain from injury.  Bones are cool!

This week I would like to talk about a few ways for you to keep your bones healthy.  There are a number of risk factors for decreased bone density, also called osteopenia (less severe) and osteoporosis (more severe).  Being a woman, getting older, having a close family member with osteoporosis, being of Asian or Caucasian descent, and having a slender bone frame are all risk factors for osteoporosis.

The major ways we can keep our bones healthy are by feeding them and stressing them!  We have to take in the nutrients the bones need to keep them strong.  We also have to put some stress on those bones, because impact is the major signal to encourage bones to get and stay strong.

Calcium, magnesium and vitamin D are the main nutrients the bones need to stay strong.  A low lifetime intake of calcium increases the risk of osteoporosis.  Magnesium is needed too.  Vitamin D is a nutrient we’re just starting to understand better.  In northern Ohio it’s really hard to get all the vitamin D you need from sunshine, so supplementing is important.  Calcium and vitamin D are found in dairy foods.  Those who don’t drink milk should take a supplement.  You should get 1000-1500 mg of calcium and about 1500 units of vitamin D daily, so check your intake and supplement if you need to.  Check here for my recommendation for bone-health supplements.

There are two opposing forces working on your bones.  One type of cells, called osteoclasts, break down bone matrix.  A different class of cells, called osteoblasts, build up the bone matrix.  Healthy bone requires both types of cells working together.  Exercise, particularly impact exercise (like walking, jogging, aerobics, anything that involves your feet hitting the floor) is an important stimulus for bone remodeling.  This stimulates the osteoclasts to remove old, tired or worn-out bone matrix and the osteoblasts to replace it with fresh bone matrix.

Hormones like estrogen and testosterone shift the balance towards the osteoblasts and promote healthy, strong bone.  After menopause a woman’s osteoblasts lose one of their stimuli and can get a little lazy, leading to the gradual loss of bone.  This can be offset somewhat by vigorous impact exercise.  It’s important to realize all exercise is not equal for the purpose of bone health.  Swimming and biking, while great for cardiovascular health, do NOT protect the bones.

It’s also important to know that smoking and alcohol use increase the risk of osteoporosis (scientists aren’t sure why this is).  If you smoke, PLEASE make a commitment to quit and talk to your doctor about it.  Limit your alcohol intake to 5-7 drinks weekly for women, 10-14 weekly for men.  There are medications, such as seizure drugs and steroids, that impact bone health too.  If you have specific questions about your risk factors for osteoporosis, please talk to your doctor.

My wish for your bones is that you feed them plenty of calcium and vitamin D, and that you work them out to keep them strong.  I wish that you NOT experience the fragility and fractures that come with osteoporosis!

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2 thoughts on “Make A Wish!

  1. Pingback: What Makes A Man? | Jennifer Wurst, MD

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