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Monday Medical: Building better bones

Susan Cunningham/For the Steamboat Today

Far from being hard and brittle, the bones in our bodies are living, growing tissue. The denser and stronger bones are, the less likely they are to fracture and break.

In a place like Steamboat, where active lifestyles are common, it’s important to build and maintain healthy bones — especially for women.

“Living here and being on a mountain bike or on a horse or on a ski mountain leads to more falls,” said Dr. Diane E.B. Petersen, a Steamboat Springs OB/GYN. “Women need to have strong bones because an active lifestyle leads to falls.”



Bone turnover is natural and is happening all the time: a little bone is lost, and a little more is made. Children and teenagers grow much more bone than they lose, while adults can lose more than they make.

Both women and men are at risk for osteoporosis, a condition in which new bone production doesn’t keep up with bone loss, weakening the bone. According to the National Osteoporosis Foundation, 54 million Americans have low bone density or osteoporosis. One in two women, and up to one in four men over age 50 will break a bone due to the condition.



Men typically have heavier, denser muscles, which lead to higher bone mass. By comparison, women lose more bone mass during pregnancy and after menopause, leaving them at greater risk.

“The normal human body, which exercises and eats correctly, should build adequate bone density,” Petersen said. Once a person is older, “it’s really tough to build bone on your own. But you can preserve what you have.”

Building and maintaining bone requires proper nutrition and a healthy lifestyle. Petersen says it’s important for everyone — especially children, teenagers, pregnant women and postmenopausal women — to get enough calcium and vitamin D, both of which are critical to bone health.

“We have children who grow up on soda pop instead of milk. Calcium and vitamin D intake is probably the most important thing to kids’ bones being sound,” Petersen said. “A Happy Meal doesn’t contribute significantly to bone health, when the beverage is soda pop and the protein is a manufactured chicken paste.”

Milk and dairy products aren’t the only ways to get calcium. Broccoli, kale, bok choy, oranges and sardines are examples of other foods naturally high in the mineral.

“It’s easy to find calcium-rich foods and also, you can supplement,” Petersen said.

Petersen recommends getting 1,300 mg of calcium for women up to age 19, 1,000 mg for women ages 19 to menopause and 1,200 mg after menopause.

Just as important as calcium is vitamin D. Though it can be found in fatty fish and is added to certain cereals, milk and orange juice, the main source of vitamin D is the sun. However, since sunscreen use is important in preventing skin cancer, Petersen recommends taking a supplement.

Exercise also has a role in bone health: it contributes to stronger bones and helps people maintain balance and strength to prevent falls. Both weight-bearing and muscle-strengthening exercises are recommended.

Hormone therapies can help maintain women’s bones.

“We’ve known for many, many years that estrogen and progesterone help keep our bones stronger,” Petersen said.

Hormone therapies can have risks, and are best to discuss with a health care provider.

Bone density scans are routinely recommended for post-menopausal women and men age 50 or older. Scans are done for pre-menopausal women only if the women are high risk: for instance, they’ve had several bones break easily or in unusual places. Risk of osteoporosis can be exacerbated by smoking, consuming more than three alcoholic drinks a day, regular steroid use, a family history of osteoporosis or other diseases.

Once someone is diagnosed with osteoporosis, there are various medications that can reduce the loss of bone or help cells build more bone.

Maintaining bone health is always worth the effort, especially for the aging population.

“It’s safer than it was in the past to break a hip or fracture a bone, but the economic cost is large, and there’s a real quality of life impact,” Petersen said.

That’s why she makes sure she takes all the steps she can for healthy bones.

“I stay active, stay limber…get calcium in my diet, take vitamin D, stay on my low dose of estrogen,” Petersen said. “I don’t want to stop jumping horses or taking runs down the mountain.”

For more information, Petersen recommends checking out the National Osteoporosis Foundation at nof.org.

Susan Cunningham writes for Yampa Valley Medical Center. She can be reached at cunninghamsbc@gmail.com.


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