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With the possible exception of breast cancer, no health specter looms larger in
the minds of women—and especially women athletes—than that of osteoporosis, or
thinning of the bones. The word conjures up images of aging women hunched over
with the characteristic “dowager’s hump,” shuffling along slowly or relegated
to a wheelchair. It’s a frightening picture and it’s made worse by the
statistics—one out of every two women will be affected by osteoporosis at some
time in her life. The disease affects men, too—of Americans with osteoporosis,
20% are male.
The Ageless Malady
Even young women are at risk for osteoporosis. In older women, osteoporosis is
often related to declining estrogen levels but in younger athletic women, it
usually accompanies sporadic periods (fewer than three per year) and eating
disorders like bulimia or anorexia. 26 million women are at risk for fracture
in the U. S. alone.
Frightened? There’s no need because with the proper diet and exercise, you can
maintain healthy bones all your life. Here’s what you need to know to help
prevent osteoporosis.
When Does Osteoporosis Strike?
Under normal circumstances, bone density peaks at 35 years of age. So osteoporosis
can best be avoided by maximizing bone density during the bone-building years
before age 35, then retaining as much of that bone material as possible in subsequent
years. The disease usually begins in the late 30’s and escalates as you age, leading
to a greater risk of fractures. In fact, post-menopausal women have a fracture rate
that’s anywhere from twice to five times the rate of younger women.
What Causes Osteoporosis?
There are three culprits: estrogen deficiency, inadequate calcium intake and inadequate
physical activity. Let’s look at each:
Estrogen deficiency can be avoided by eating enough to maintain a healthy level of
body fat. As you age, it’s important to see your physician for estrogen replacement
therapy (ERT). This is especially crucial in women approaching menopause who are
experiencing declining levels of estrogen and sporadic periods. Although they may
not want ERT due to the side-effects like swollen breasts, it’s best to consult
a physician to see if ERT is indicated. It’s better to put up with minor
side-effects rather than compromise bone health. As for the slightly increased risk of
breast cancer when taking estrogen, your physician can discuss this issue with you
and tell you how to avoid it.
Many women don’t get enough calcium because they don’t drink milk, and they avoid
products like cheese associated with high fat intake. But calcium is vital to bone
health—it’s the building block for your skeleton. One way to get enough calcium is
to take a supplement. I recommend 1.5 to 2.0 grams of calcium per day compared to
the RDA of only 600 mg.
Still, food is the best way to make sure you’re consuming enough calcium, so include
tofu (made with calcium sulfate), dairy products like milk,
yogurt and cheese (choose the non- or low-fat versions), leafy green vegetables
(like broccoli and kale) and salmon with the bones. You don’t need to gorge on
these goodies—just one 8-ounce glass of milk contains 300 mg of calcium.
Finally, exercise is important because it stresses the bones, making them become
stronger. Weight-bearing activities like running, walking, weight training and rope
skipping are preferable to swimming and cycling. While female varsity athletes
generally have higher bone densities than non-athletic women, they also have a
higher risk of amenorrhea than non-athletes. Studies show that amenorrheic athletes
have a lower bone-mineral density than those with regular menses. So it’s important
not to train so hard, and let body fat dip so low, that the regular menstrual cycle
is interrupted.
What to Avoid
In addition to keeping estrogen levels high, getting plenty of exercise and adequate
calcium in your diet, it’s important to know what to avoid.
- Caffeine, smoking and excess alcohol consumption.
Caffeine inhibits the absorption of several minerals
including calcium. Women who drink more than a couple of cups of coffee per day
and have low calcium intakes run the risk of developing osteoporosis. Smoking and
drinking excessive amounts of alcohol are also culprits.
- A high protein diet. The currently popular high
protein diets lead to dehydration because to metabolize the excess protein, the body
eliminates its waste product, urea, in the urine. High water losses through urination
mean that you’re urinating away calcium. Some experts suggest that over a period
of time, you could eliminate enough calcium to put you at risk for
osteoporosis.
- Striving for an extremely low percent of body fat. Extreme caloric
restriction, combined with high levels of training, can deplete body fat to unsafe
levels. At a certain point, the body slows production of estrogen, similar to what
happens during menopause, and periods cease. This condition, called amenorrhea, can
lead to osteoporosis.
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