How does activity level, posture, and exercise affect osteoporosis?

People who are more active, specifically up on their feet for at least several hours per day, have a lower rate of progression of osteoporosis. People who perform a greater percent of their activities with their spine in extension (with the natural arch maintained) probably have a lower rate of progression of vertebral fractures. People who perform regular exercises involving weight bearing have a lower fracture rate as well. Thus, walking is a much better exercise for osteoporosis than swimming.

Recent studies have clearly demonstrated that just as the spine responds to activity level and weight bearing exercise, so does the wrist. People who do “loading exercises” for their arms are found to have significantly increased bone density when compared with those who do not. This would be expected to result in decreased risk of fractures, improved function, and decreased disability.

How does intake of calcium affect osteoporosis?

Although much research needs to be done, it seems clear that people with greater lifelong intake of calcium have a lower rate of osteoporosis and fractures. Calcium can be found in dairy products, in bony fish such as sardines, herring, and canned salmon; in tofu; and in leafy vegetables. Those whose intake is insufficient can supplement by taking calcium pills. TUMS are an inexpensive source of calcium and a number of mineral supplements provide ample calcium as well. Daily intake should be at least 1000 mg., possibly 1500 mg. in people at greater risk. Calcium intake is not itself without risk in people who are predisposed to form kidney stones; therefore, calcium supplementation should be discussed with a physician.

How does estrogen replacement therapy help?

Again, much research has yet to be done. However, it seems that people who take estrogen replacement have significantly fewer hip and wrist fractures in studies done over the past several years. Vertebral fractures are probably reduced as well, although studies have not focused on this problem. The advisability and timing of estrogen replacement therapy with respect to menopause should be discussed with one’s gynecologist or primary physician.