Is Osteoporosis a Women’s Problem and Can It Be Prevented?
Falls and fractures are a common source of morbidity with aging. In fact, according to the World Health Organization, in the US alone, “20–30% of older people who fall suffer moderate to severe injuries such as bruises, hip fractures, or head trauma.” While many factors contribute to these statistics, osteoporosis undeniably plays a significant part. In this article, we’ll explain what osteoporosis is, who is at risk and how it can be treated and even prevented—at times without medication.
What Is Osteoporosis?
Osteoporosis is a thinning of the bones caused by hormonal changes or a deficiency in Calcium or Vitamin D. As the disease progresses, bones become increasingly brittle due to loss of tissue. Brittle bones can cause falls, or can be broken in falls that would be minor traumas to healthier bones.
To date, the common approach to managing osteoporosis is to wait until it occurs and then attempt to palliate with medications that are laden with side effects and are not tolerated by large numbers of people.
Women and Osteoporosis
Osteoporosis is primarily a disease of aging women. Older women are especially vulnerable because of the loss of estrogen—a hormone that supports bone density—during menopause. Bone breakdown actually begins as early as age 35 and progresses slowly to significant bone mass loss later in life and a higher risk of fractures in the spine, hip, and arm.
Following menopause, women can lose 20% of bone density in the first decade alone, and by age 80 many will have lost at least a third of their original hipbone density. The loss of bone density leads to fractures, which far too often result in hospitalizations, infections, and even death.
What Are the Risk Factors for Osteoporosis?
There are many risk factors for osteoporosis, some of which are non-modifiable, including family history, age, and gender. Other factors are modifiable, meaning they are things we can control. Smoking, alcohol consumption, lack of adequate Calcium or Vitamin D, and a sedentary lifestyle can all contribute to osteoporosis. Unfortunately, osteoporosis is often difficult to detect until you have a broken bone, painful symptoms or changes in posture or height.
How Is Osteoporosis Treated?
There are a host of medications approved by the FDA that have indications to treat bone density loss, but there has been much controversy surrounding the risk vs. benefits of these drugs. In general, osteoporosis medications work by slowing bone breakdown.
Doctors most commonly prescribe medicines known as bisphosphonates including:
Zoledronic acid (Reclast)
Hormone replacement is also commonly recommended, in addition to drugs that mimic hormones, such as Raloxifene (Evista). Bisphosphonates have been shown to reduce the chances of having a fracture. They are also often used because their side effects are mild, including nausea and heartburn.
Evidence has emerged linking bisphosphonates with far more serious side effects including atrial fibrillation (an irregular heartbeat) and osteonecrosis of the jaw. Given the seriousness of these risks, remedies that are alternatives to pharmacology should be embraced by anyone who wants to prevent osteoporosis.
Preventing Osteoporosis through Strength Training
Bone health can be promoted and maintained with strength training. Muscle contraction by definition stresses the bone, providing a stimulus that can result in increased bone density. On a cellular level, this involves the activation of osteoblasts that support bone integrity and prevent loss in density.
The magnitude of the risk reduction in osteoporosis that results from strength training is likely directly related to the stress and timing of the training stimulus.
How Strength Training Benefits Our Bodies
Strength is the ability to produce force against an external resistance. Your muscles move your bones and the bigger your muscles are, the more you can strengthen your bones. Your body has evolved to withstand stress by adapting to it; weight-bearing exercises force your bones to respond by becoming denser. As we age, we often stop doing hard things and we have less use for our muscles; this poses a big problem for our bones.
The less we use our body, the quicker these valuable structures are broken down. Maintaining muscle mass demands a lot of work from our bodies and if we do not actively use our muscles, our bodies break them down and turn them into fat. This, in turn, weakens our bones. Conversely, the bigger our muscles are and the more we use them, the more they can help strengthen our bones.
How Can We Make Sure to Use and Grow Our Muscles?
Barbell training is the best tool for providing calibrated bone stress to increase density. It uses the most amount of muscle over the longest range of motion to produce the greatest strength gains. The unique design of barbell equipment allows for athletes and amateurs of any age to use it safely. Weight can be added to the bar in increments as small as 1/4lb. Barbells also have the added benefit of training the entire skeletal system at once, using compound, total-body movements that make each exercise more effective than isolation exercises.
Developing Balance and Reducing Falls
In addition to improving bone density, barbell training can reduce fractures that result from falls. Every time you use a barbell, you are learning to balance with it either in your hands or on your back. This has a powerful impact on preventing falls and is a benefit of barbells that can’t be realized with resistance machines. Unlike barbells, machines do all the balancing for you and absorb much of the work.
Particularly for older women, staving off osteoporosis can go a long way in reducing vulnerability to falls, fractures, and even death. Of the options available, barbell training
presents the most rational preventative strategy, with no side effects. Plus, it provides an opportunity to reduce reliance on medications and contributes to your overall physical and mental health.
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