Tips to Keep Your Bones Fracture-Free

1. Be sure you get enough calcium and other essential nutrients to keep your bones strong.
Because calcium is a major component of bone, it's very important that you get enough of this valuable mineral every day. The National Academy of Sciences and the National Osteoporosis Foundation recommend 1,000 to 1,200 milligrams of calcium per day for both men and women.

It's easy to fit calcium in your diet, either in a meal or just a snack. Not only is calcium found in dairy products (milk, yogurt, cheese and ice cream), it's also in fish that is eaten with its bones (canned sardines and salmon), beans, tofu prepared with calcium sulfate, nuts, green leafy vegetables, oranges and raisins. You can also try calcium-fortified foods such as orange juice, snack bars, pasta, cereals and soy drinks.

If you don't like to drink milk or are lactose intolerant, or just don't think you're getting enough calcium in the foods you eat, ask your health care professional about taking a calcium/vitamin D supplement, either in tablet, chewable or powder form.

Along with calcium, you need 400 to 800 IU of vitamin D daily because it helps your body absorb calcium. Sunshine is a good source of vitamin D. Aside from taking in the rays, eating certain fish and seafood, such as salmon, halibut, tuna, oysters and shrimp, will give you plenty of vitamin D.

Recently, the vital bone-building role of the mineral magnesium has come to light. About half of your body's magnesium supply is in your bones, and research has shown that a deficiency in magnesium actually affects calcium metabolism. Calcium and magnesium should be taken in a 2:1 ratio. Look for supplements that contain calcium, magnesium and vitamin D.

2. Make time for physical activity every day.
Being physically active builds strong bones and muscles which, of course, help prevent fractures. In addition, it improves your balance, which will help prevent you from falling. Activity that puts some stress on your bones is particularly beneficial. Take as little as 30 minutes every day to get physical. No matter what your age, you will reap the benefits and see the results of exercise. There are five types of exercises that should be part of your bone-health workout: weight-bearing aerobics (vigorous walking, step aerobics, rowing or jogging), high-impact (racquet sports, jump rope or basketball), strength-training (weight training), balance (tai chi, yoga or even dancing) and flexibility. Any type is good for your bones; you don't have to do the same exercises every day-you can mix and match.

Be sure to check with your heath care professional to get the go-ahead to start an exercise routine and to see which exercises or activities from these categories are appropriate for you. Exercising to music or with a friend can be fun and motivating. You might want to join a dance class at your local community center or dancing school. And remember to do some gentle stretching exercises before and after your workout.

3. Pay attention to your weight and your height.
Bone health is affected if you are underweight or overweight. If you are thin, your bones may have less mass; in other words, they may be weak, which makes you more prone to fracture. If you are underweight (too thin), you are at increased risk for fracture because of three factors: you may be producing less estrogen, and estrogen is essential for keeping bones strong; the workout that your bones get from day-to-day movement as well as planned exercise is not as vigorous because of less weight-bearing; and consumption of fewer calories than a woman of normal weight may mean that you are not getting enough bone-building nutrients in your diet.

Being overweight is never considered healthy; however, the extra weight actually stimulates your bones, and over time they grow stronger. Fat cells produce a type of estrogen, which can be beneficial to bone growth but may put you at increased risk for developing some types of cancer.

Maintaining a healthy weight is your best bet. How can you tell how much you should weigh? If your body mass index (BMI; body weight relative to height) is between 18.5 and 24.9, your weight is fine for you. You can calculate your BMI simply by dividing your weight in pounds by your height in inches squared and multiply that figure by 705. If your BMI is below 19, talk to your health care professional about achieving a healthy weight. Try to weigh yourself on a regular basis, and at the same time of day since your weight varies throughout the day. For the record, have your weight recorded at least once a year as a method of monitoring loss of bone density.

Whether you need to gain or lose weight, it's very important do so in a healthy way. Rapid weight loss (from fad diets or fasting) or repeated weight loss and gain (so-called "yo-yo" dieting) can cause you to lose not only fat, but bone and muscle too. Always try to alter your weight gradually and continue bone-protecting exercises and physical activity.

Any loss of height is cause for concern. It can be a sign that you have had at least one spinal fracture, and you possibly were not even aware of it. Have your height measured the next time you visit your health care professional. Don't assume that you're the same height you've always been. While you're at it, look in the mirror to check your posture. If you look crooked, leaning, or stooped over, bring it to the attention of your health care professional as soon as possible. It might not just be bad posture; you need to be evaluated for osteoporosis and treated, if necessary, to prevent future fractures.

As with weight, you should measure your height on a regular basis (at least once a year starting at age 35). Check it at the same time during the day because gravity and spinal disk hydration cause your height to fluctuate over a 24-hour period. The truest measure of height is when you wake up in the morning, before your body has moved around much.

4. Don't Fall!
Weak bones break more easily, and for that reason you should raise your awareness about fall prevention. Broken bones, including osteoporosis-related fractures, are often caused by falls. Falls usually occur because we either trip over something or lose our balance.

Research has shown that our sense of balance starts to change in our mid-forties, not in old age, as we used to think. Balance involves several factors including vision, flexibility, inner-ear equilibrium, and sense of space. There are some simple tasks you can do to test your balance such as standing at least 10 seconds on one foot or with one foot behind the other. Try them first with eyes open and then with eyes closed. Your health care professional can help determine your level of balance by observing you do these and other, more challenging tasks.

Work at improving your balance by doing some form of balance exercise (tai chi, yoga, dancing, among others), wearing proper shoes (with good support and soles that are not slippery), having your vision checked (and corrected if necessary) and even having your hearing checked. If you know that balance is an issue for you, you might want to install handrails in the bathroom and other places in the house. Also in the bathroom, make sure you have non-skid mats wherever you stand with wet feet, either in the shower or tub, or on the floor.

Fall prevention should also focus on making your home fall-proof by removing things that you could stumble over. These items can anything from wires that run across floors, slippery rugs or even just plain clutter. Make sure you have enough bright light so you can always see where you are going. There is also evidence that vitamin D may help muscle strength and balance.

5. Evaluate your risk factors and lifestyle and start a bone health program.
Be proactive and see your health care professional for a fracture risk evaluation. Together you can determine your risk for developing osteoporosis or other bone conditions. Topics covered will include your age and race; weight, height and bone structure; menopausal/menstrual status; family history of broken bones or osteoporosis; level of physical activity (or inactivity); any medications you are taking, especially any that affect bone; nutrition (including calcium and other mineral intake); the bone-damaging effects of alcohol, smoking and caffeine; and any diseases or conditions you have. You will most likely have a bone density test if osteoporosis is suspected or to get a baseline on your bone mass and strength. You may need to start taking bone-enhancing medications, or, you may need to change medication[s] you may be taking already for such conditions as thyroid disorders or arthritis because some of them weaken bone.

Once your bone health program is up and running, you should follow-up with your health care professional on a regular basis to check bone vital signs such as height, posture and weight changes, and monitor your overall risk factor profile.

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