Osteopenia diet and exercise

April 21, 2005 4:33 AM

I have just been diagnosed with osteopenia in my femur and lumbar spine. Any tips on increasing bone density? [unlike my bones, more is inside]

I am a 33 year old woman and after a particularly long and vigorous walk / jog, I ended up with an insufficiency fracture of my right femur. So I am concerned that my bone density has already decreased quite a bit. I have done some research, and all the advice is general: increase calcium intake and engage in weight-bearing exercise. So, to that end, I have some specific questions.

1. I know I must monitor my calcium intake every day, and increase consumption of yogurt, spinach, etc. Any other ideas for good foods to include? (I got some great yogurt tips from this thread.)

2. Also, can you suggest any good exercises to strengthen the bones, especially in my legs and back? Jogging and vigorous walking are not a good idea right now, since that is what I was doing when I injured myself.

posted by naturesgreatestmiracle to health & fitness (13 comments total)

I wouldn't want to recommend anything, it sounds like you should ask your doctor. I know that lifting weights has been shown to increase bone density but I really wouldn't recommend it if walking makes your bones break.
posted by Napierzaza at 4:49 AM on April 21, 2005

My insufficiency fracture didn't result in a "break" of my bone. Rather, it was on the edge of the femur and was more like a bruise in the bone.

Also, I am being treated by a doctor, but I was looking for easy foods to include (recipes?) and fun exercises and activities that aren't too impact-based.
posted by naturesgreatestmiracle at 5:00 AM on April 21, 2005

I understand that sardines are loaded with calcium. I like the ones in tomato sauce, on toast.
posted by Faint of Butt at 5:07 AM on April 21, 2005

I'm sure you already know that the lower the fat content in the dairy you eat, the higher the calcium you get from it. If you can handle dairy, I'd start adding as much non-fat dairy as you can, non-fat yoghurt, milk and cottage cheese are good places to start. Sardines and some other canned fish are high in calcium. Using an elliptical machine at the gym (or at home) would probably meet the weight-bearing exercise requirements you have, without any impact at all. But obviously check with your doctor first.
posted by biscotti at 5:28 AM on April 21, 2005

You want to get sufficient vitamin D which is necessary to absorb calcium. Just a few minutes of sun exposure without sunscreen a couple of times a week should do it. That method is currently hotly contested by dermatologists, with probably most of them against it. Others argue that you actually need much more vitamin D than the USRDA, and that the best way to get it without taking supplements is through sunshine.
posted by caddis at 7:13 AM on April 21, 2005

How about swimming? If you remember to have a strong kick, you could work a lot of muscles. You can also use paddles and fins to increase resistance and build more muscle (checking with your doctor first, of course).
posted by eckeric at 8:20 AM on April 21, 2005

Swimming is not a weight bearing exercise. You have to stress the bones by putting your weight on them to induce bone growth. The elliptical machine sounds good to me. You also might try just plain walking, not jogging, nor power walking, just walking at a reasonable pace. Of course, swimming will burn more calories and make you stronger than walking will; it just won't really build bone density.
posted by caddis at 8:37 AM on April 21, 2005

Ah, thanks caddis, that is good to know. after reading your post, I found this: So where does swimming fit in? Unfortunately swimming does not place any significant stress on the bones. Study after study comparing swimmers with other athletes, shows swimmers to have similar bone density to couch potatoes. Even the increase in muscle mass, and the concomitant pull on the bones, is not enough to stimulate a significant increase in bone density.

Bummer
posted by eckeric at 9:31 AM on April 21, 2005

Unfortunately, for some of us the calcium intake and exercise are not enough to maintain bone density. Given your situation, though, at least some time spent taking actual calcium supplements (the citrate form is considered the more absorbable and the ones that combine magnesium and vitamin D get you the other factors you need in the right proportions) rather than trying to recoup on just food is worth giving some thought to. Keep in mind that you can use only about 500mg of calcium at one go and that it takes a fairly acid environment for absorption. Oxalates and aluminum-containing antacids are the enemies of calcium and caffeine, although cleared in some studies, still is under suspicion for accelerating calcium loss from the system. More details here and here.

Beyond that, however, unless you were totally calcium-deficient before, it's worth pressing your doctor for a workup on the reason for your bones' failure to maintain density. The ovarian hormones, thyroid hormone, parathyroid hormone and some metabolic diseases all play into bone maintenance or have been linked with bone density loss and have other consequences as well. So it might be worthwhile making sure there's not some related damage going on for which the density loss is a symptom.

I second the eliptical as being weight-bearing with the least amount of actual thumping and bumping injury production. Lifting, if done if a very controlled manner and working up at a modest rate, can avoid the fracture risk, but it probably requires specific coaching. Any chance you could get a physical therapy consult on this? They would be more able to guide you in non-damaging skeletal challenges.
posted by salt at 9:43 AM on April 21, 2005

Thanks for all your comments!
posted by naturesgreatestmiracle at 2:18 PM on April 21, 2005

My girlfriend is also on the quest to increase bone density after a relatively low impact fall left her with a shattered tibia and fibula.

Sardines, as have already been mentioned, and other bony fish such as salmon are good. A quarter cup of sesame seeds has as much calcium as a cup of milk. Calcium fortified orange juice and soy milk are good alternatives for the lactose intolerant.

When comparing calium sources, carbonate and phosphate are cheaper and contain more elemental calcium, but citrate, citrate malate and bisglycinocalcium are more easily aborbed by the body.
posted by Monk at 3:05 PM on April 21, 2005

There's some orange juice with added calcium
posted by leapingsheep at 3:16 PM on April 21, 2005

According to what I was taught in medical school, you are too old to increase your bone density by dietary changes. Women are best able to do this in the second and third decades of life. After this, they start losing bone density no matter how much calcium and vitamin D they ingest.

Bisphosphonate drugs and calcitonin are supposed to help with this in older women, but you really ought to bring this up with a doctor.
posted by ikkyu2 at 7:15 PM on April 21, 2005