If you maximize bone density during youth and maintain it during midlife, you’ll slow the loss of bone in later years. When osteoporosis does develop, it is critical to seek quality medical care. This can reduce the risk of spontaneous or accidental hip fracture, which is the 12th leading cause of death in postmenopausal women and a major disabler of the elderly.

These strategies can help you and your loved ones prevent osteoporosis:

• Consume adequate calcium daily.
Children ages 1 through 10 need 800-1,000 mg (milligrams); adolescents and young adults ages 11 through 24: 1,200 to 1,500 mg; men 25 through 60: 1,000 mg; men 65+: 1,500 mg; women 25 through 50: 1,000 mg; women 50 through 65 (postmenopausal on estrogen): 1,000 mg; women not on estrogen: 1,500 mg; women over 60: 1,500 mg; pregnant or lactating women: 1,200 to 1,500 mg.

One cup of yogurt, milk, calcium-fortified orange juice, soy milk, or 1 1/2 oz of cheese have about 300 mg each; one cup of steamed kale, 1/2 block of tofu or 3 oz canned salmon with the bones have 150 mg and 1 cup broccoli or
navy beans has about 100 mg. Food is the best “natural” source of calcium.

• If your diet comes up short, add a calcium supplement.
Calcium carbonate (found in Tums, Caltrate or Viactiv, one of the newer “chocolate candy” chews) has the most elemental calcium per serving, but should be taken in between meals, preferably with a little yogurt or juice,
along with water, but not at the same time as multi-vitamin/mineral pills, because calcium can inhibit the absorption of other minerals. If you tend to be constipated or to produce low levels of stomach acid, then take calcium
citrate (as in Calcitrate) which is less binding and can be taken with meals. To reduce the risk of kidney stones, take your calcium in smaller doses throughout the day. If you are on Pepcid, Zantac, Tagamet or Prilosec, which all decrease stomach acid, take calcium lactate or citrate instead of carbonate. Calcium can form insoluble compounds with some medications, such as Tetracycline, making both less available. Avoid natural sources of calcium such as bone meal, dolomite or oyster shell, as they may be contaminated with arsenic, lead or other toxic metals.

• Get adequate Vitamin D, which is needed to absorb and activate calcium.
The adult RDA for Vitamin D is 400IU, and for the elderly or people who are immobile or confined, 600 to 800 IU is needed. However, excess D is toxic and can cause kidney and cardiovascular damage, and even promote loss of
bone. Most foods contain very little Vitamin D except for fortified milk, egg yolks, fatty fish and cod liver oil. Weight-bearing exercise 2-3 times a week is a bone-building miracle worker for people of all ages.

• Add two servings daily of isoflavone-rich soy products to your diet.
Ongoing studies show it to have bone-building properties.

• Check your medications.
Continued use of Prednisone (and all steroids including inhalers for asthma), Dilantin, Lasix, Synthroid, Cournadin or aluminum-based antacids may increase your risk of osteoporosis. Discuss this concern with your physician, and pay extra attention to calcium intake and bone-strengthening exercises.

• By age 50 request a baseline bone density test called a DEXA scan.
Monitor your bone density over time, especially women who cannot or choose not to take estrogen. For a more complete picture of bone status, get blood levels of osteocalcin, alkaline phosphatase and serum typelcollagen propeptid assessed.

• Ask your doctor about taking Fosamax (alendronate) or Miacalcin (calcitonin) if you already have osteoporosis or are at high risk for it.

Fosamax directly inhibits the cells responsible for breaking down bone. Miacalcin injection or nasal spray increases bone absorption of calcium.

• The newest osteoporosis drug, risedronate, which has been found to reduce hip, leg and spinal fractures in postmenopausal women that other treatments may fail to prevent.

In recent studies, risedronate also increased bone density by as much as five percent. FDA approval is being sought to sell the drug under the name Actonel. Check with your doctor.

Two other drugs have similar results for spinal, but not non-spinal, fractures. These are calcitonin, also marketed under the name Calcimar; and raloxifene, marketed as Evista.

Maintain the bone you already have. Quit smoking, cut back on excess protein, sodium and sugar, reduce in-take of alcohol, caffeine and cola drinks. Make water your favorite beverage. Get enough weight-bearing exercise, calcium and Vitamin D, along with other bone-building nutrients such as magnesium, Vitamin A and boron, all of which can be found in a whole foods diet or a good vitamin/mineral supplement.

Don’t let osteoporosis break your bones or your heart by reducing the length or quality of your life.