Drs. Oz & Roizen: Your To-Do List for Strong Bones

Bone health isn’t just a topic for your grandma to read about. It should be a lifelong concern for everyone at all ages. Here are the docs’ do’s and don’ts:

Q: I’m 37 and very healthy, but my mother and uncle have osteoporosis. What should I do now to protect my bone health in the future? 

A: Jump! Sounds kooky, but stay with us. Let’s start by talking about bones and the bone-building process. On the surface, bones seem simple: They’re white and hard, and they’re great for dog toys and Halloween parties. But in reality, bones are more misunderstood than Bob Dylan’s lyrics. Your skeleton is a living, changing organ, continously replenishing itself and regenerating to replace old or damaged bone.

Bones also aren’t as rock-solid as you might think. Their structure is more like a honeycomb, a solid mass dotted with tiny holes. After you turn 35, your interior bone-recycling program slows down, and those honeycomb holes get larger as the hard substance in between gets thinner—meaning your bones become weaker, more porous, and more susceptible to injury and fractures. If you develop full-blown osteoporosis, those injuries can happen as a result of shockingly minor movements, even coughing or placing your elbow on a table.

Dietary changes (or supplements, if your doctor recommends them) can help stave off this deterioration. Calcium, which you can get from spinach, collard greens, salmon and low-fat dairy products, helps bones stay strong. Vitamin D helps your bones absorb that calcium, and you’ll find it in fortified milk and orange juice as well as in fatty fish, many mushrooms and eggs (don’t skip the yolks!). Vitamin C, found in citrus fruits, bell peppers, kale and broccoli, helps keep cartilage young and prevents bone loss. Finally, vitamin K, found in chicken and low-fat cottage cheese, aids in moving calcium from your blood to your bones.

And we now know that the right kind of stress and strain on your bones can make them stronger, too, because bones strengthen and rebuild in response to demands. That includes resistance exercise, high-impact movements such as jogging, jumping rope, playing basketball and, it turns out, good old-fashioned hopping (that said, if you already have osteoporosis or are recovering from an injury, check with your doctor about safe physical activities).

According to a 2014 study in the American Journal of Health Promotion, premenopausal women who hopped as high as possible from the floor 10 times in a row, twice a day (with a 30-second break between each jump), increased the bone mineral density in their hip bones by 0.5 percent over four months. If that sounds like small potatoes, consider that women in the control group, who did no jumping, lost 1.3 percent of their bone density during the same period.

Now’s the time to start this habit: The earlier you start, the more benefits you’ll see.

Q: I’m lactose-intolerant. How can I get my fill of calcium when I can’t eat dairy products? 

A: Good news: Dairy isn’t the only way to boost dietary calcium. There are plenty of non-dairy sources of the good stuff, including canned fish such as sardines or salmon (with bones), seeds, nuts, beans, green beans, and leafy greens such as kale, collards, spinach, broccoli and bok choy. Plus, there are plenty of calcium-fortified foods, such as soy products (soy milk, tofu and tempeh), fortified cereals and breads, and orange juice. Each of these sources has different rates of calcium absorption—and include other nutrients that affect absorption—so your best bet is to eat a solid variety of healthy, colorful foods. (That’s a good move for your health in lots of other ways, too, including weight control, better blood sugar levels and more energy.)

You also might consider grabbing a 600-mg supplement of calcium citrate. Just don’t go overboard, because taking more than that level as a supplement is associated with prostate cancer, and what’s linked to prostate cancer usually proves to be a risk factor for breast cancer, and vice versa.

Q: What are the symptoms of osteopenia? Will I have achy bones? Or is it only detectable with a test? 

A: Osteopenia, or lower-than-normal bone density (but not as low as osteoporosis), isn’t something you can feel. Having osteopenia does make it easier to break a bone, but interestingly some fractures from osteopenia don’t even cause pain. So the condition is detectable only through a painless bone density test; your doc can prescribe one—probably called a DEXA, QCT or SXA exam, for short.

If you want to gain a sense of your risk, use the World Health Organization’s fracture risk assessment tool. Be aware that certain attributes raise your risk: being female, thin, white or Asian; having a history of eating disorders or metabolic problems; having gone through chemotherapy or radiation; regularly drinking sodas; smoking; limiting physical activity; drinking in excess; and having a family history of osteopenia or osteoporosis.

Bottom line: Women older than 65 should undergo a bone density test, and so should younger postmenopausal women who have one or more of the additional risk factors outlined in the previous paragraph.

Q: I have a vitamin D deficiency even though I’m taking D3 combined with my calcium supplement. My doctor now wants me to try vitamin D2. What’s the difference between these two types of vitamin D?

A: One comes in strawberry Flintstones flavor, and the other doesn’t. Kidding! You can get vitamins D2 and D3 from the sun, food and supplements. Both D2 and D3 are available over the counter at about the same price, but there are some differences. Vitamin D3, or cholecalciferol, is the same kind of D that our cells naturally synthesize when our skin absorbs UVB rays from the sun. We don’t naturally generate D2, or ergocalciferol, which is derived in supplement form by irradiating yeast and fungus.

Vitamin D3 seems significantly more potent than D2 in boosting vitamin D concentrations and storage in the body, although most of us can’t spend enough time in the sun to create sufficient amounts (and shouldn’t, because you need sunscreen-free exposure for D synthesis, and more than 10 to 15 minutes spent without protection can damage skin), so food and supplements make the most sense.

We recommend sticking with the D3 (because D2 doesn’t seem to be as effective), but add more: at least 1,000 IU daily if you’re younger than 60 and 1,200 if you’re older than that. You should be aiming for a blood serum level of 50 to 80 ng/dL, so keep getting your levels checked, and have a detailed sit-down with your doctor to understand the plan for raising them. 

 

This article appears in the October 2015 issue of SUCCESS magazine.

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Michael Roizen

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