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Exercise & Osteoporosis

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At menopause, women have an accelerated loss of bone mineral mass (2.5 to 5% per year) due to the changes in the estrogen levels in the body.


Osteoporosis is an age-related disorder characterized by decreased bone mass and increased susceptibility to fractures. Preventive measures can delay onset of and considerably reduce existing conditions. Exercise and diet play a major role as part of the preventive program for osteoporosis.

Loss of bone mineral content (BMC) is a universal phenomenon with increasing age. This loss though, is not manifested in any noticeable symptoms, painful or otherwise. When a fracture occurs or joint pain develops, indicating to the individual that something is wrong, the disease has progressed to an advanced stage.

Osteoporosis is quite a common condition, causing each year an estimated 1.5 million fractures of mainly the spinal bones and the hip bones, in those of 45 years of age and older.

Causes – explained

Bone is a spongy protein matrix in which crystals of calcium and phosphorous salts are embedded, from birth until death, bone tissue is continually being formed, broken down and reformed in a process called remodeling. The cells that break down bone are osteoclasts, and those that build bone are called osteoblasts.

Peak bone density is reached between ages 20 to 30.Osteoclast and osteoblast activity remain in balance until about age 45-50, after which osteoclast activity becomes greater and adults begin to slowly lose bone mass.

Women at higher risk

At menopause, women have an accelerated loss of bone mineral mass (2.5 to 5% per year) due to the changes in the estrogen levels in the body.

So, women are at a greater risk than men (four to one) and also have a 30 % lower peak bone mass to begin with.

Types of Osteoporosis

Type I osteoporosis (postmenopausal) is the accelerated decrease in bone mass that occurs when estrogen levels fall after menopause.

Type II osteoporosis (age related), which is the inevitable loss of bone mass with age that occurs in both men and women.

Secondary osteoporosis may develop at any age as a consequence of hormonal, digestive and metabolic disorders, as well as prolonged bed rest and weightlessness (space flight) that result in loss of bone mineral mass.

Although bone mass is an important factor in the development of this condition, bone architecture & structure, genetic, racial and lifestyle factors also play a large role. E.g. Bone mass is 10% higher in blacks than in whites. Caucasians and Asians are at a higher risk than Blacks.

Methods to prevent and combat osteoporosis

Prevention of osteoporosis focuses on increasing peak bone mass in the formative years and then addressing the reducing bone loss in later years.


There has been considerable evidence that when calcium intake is appropriate throughput life, a greater bone mass is developed in early adulthood, decreasing the risk of bone loss later in life.

The RDA or recommended daily allowance of Calcium for adults is 800 mg/day. The young and pregnant women need 1200 mg/day.

Calcium supplementation when combined with Vitamin D is recommended for postmenopausal women and others at high risk of osteoporosis.

Calcium intake through diet should be encouraged for all, especially the elderly.

Calcium rich foods are dairy products – milk, yogurt, cheese, leafy green vegetables, nuts and seeds.


A significant relationship exists between lifetime physical activity, bone mineral mass and lowered risk of fractures.

Children who engage in sports that produce impact loading on their skeletons (e.g. running, gymnastics and dance) have greater bone density. Athletes show a higher bone mass than inactive adults.

Exercise then, plays a major role in developing and maintaining bone mass. The importance of exercise for the elderly cannot be stressed further.

Exercise recommendations

Choose weight-bearing activities such as walking, running, racket sports as these are more effective in maintaining the density of the leg and spinal bones.

Gravity and muscle force exerted on the bone will increase bone size and density. Resistance and strength training in recommended allowances of frequency, intensity and duration according to age and gender should definitely be incorporated into ones training regimen.

For the elderly 6-8 exercises working all parts of the body, performed 2-3 times a week is adequate for maintenance. Flexibility of joints are maintained by including some stretching exercises in ones exercise program.

Exercise shall also help reduce the progress of the condition if osteoporosis has set in already. Care should be taken though. A physician’s assessment of the stage of advancement of the condition and his approval to continue or start physical activity is essential.

Non weight-bearing activities such as swimming, cycling are recommended here, so that minimal stress loading occurs on the already fragile skeleton.


Adopting a healthy lifestyle with balanced work, rest and minimal stress, goes a long way in the prevention of several major diseases, including osteoporosis.

Cigarette smoking and high intake of alcohol and caffeine have been linked to the development of the condition. It is never too late to refrain from these unhealthful habits.

Awareness about the disease and performance of routine bone density checks as part of master health checkups for the elderly lays the path to a fracture-free life.


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