Falls are the leading cause of injury in adults age 65 and older. There are many precautions older adults can take to reduce the risk of falling—tidying the home and removing clutter, adding grab bars in the bathroom, wearing supportive shoes with rubber soles. But another important measure: Keeping your bones strong and healthy.
Healthy bones look something like a sponge. If you look at bone tissue under a microscope, you’ll see a dense network of small holes, but the overall effect is one of solidness. Through the early 20s, people build bone mass—that is, we add to the calcium in our bones faster than we use it. Over time, our bodies store less calcium. We typically don’t replenish the calcium in our bones as quickly as we use it. As our bones lose mass and density, the small holes increase in size. Under a microscope, these bones have the delicate look of a spider’s web. Such fragile bones don’t provide adequate support—in fact, sometimes just standing is enough for bones to break!
Are you at risk for low bone density? As many as 40 million adults in the US have or are at risk for osteoporosis, a disease that has been linked to 1.5 million fractures per year in the US alone. Many of the factors that affect your risk of developing osteoporosis are beyond your control. These include age, sex, race, build, and family history.
If you are female, age 50 or older, white or Asian, have a small frame, or have a parent or sibling with osteoporosis, it is especially important to address the factors you can control. In addition, certain diseases increase risk—Parkinson’s is one. And because those with Parkinson’s are also at high risk for falling, these individuals face an increased risk for broken bones.
Fortunately, some of the risk factors for osteoporosis are controllable. You can slow the rate of bone loss by not smoking and limiting alcohol. Other factors include:
Activities where your body works against gravity to keep you upright, such as walking, yoga, t’ai chi, or even dancing counts. These also increase flexibility, coordination, and balance, which can help prevent falling.
Getting enough calcium is critical, especially for women. In the first decade after menopause, women lose three to five percent of their bone mass per year! This is why adequate calcium is especially important for women over age 50. Calcium also plays a role in reducing blood pressure and lowering the risk of hypertension, and it may protect against heart disease and some cancers. Adults over 50 should aim for 1,200 mg of calcium per day.
Foods that are high in calcium include:
Calcium isn’t the only nutrient in the strong-bone equation. Another important nutrient when it comes to reducing the risk of falls: Vitamin D. This vitamin helps your body absorb calcium. Without enough vitamin D, bones can become thin and brittle. Adults over 50 should aim for 600 IU of vitamin D every day (those over age 70 need 800 IU vitamin D).
Very few foods contain vitamin D naturally. Foods like cold cereal and dairy products may be fortified with it, but it’s important to check labels. Dietary sources of vitamin D include:
Even with fortified foods, it can be difficult to get enough vitamin D from your diet. The best source: Sunlight! Your skin actually makes vitamin D when it’s exposed to sunlight. The sun needs to shine directly onto skin, without sunscreen. Now, you have to be careful when getting vitamin D from sunlight because unprotected sun exposure leads to an increased risk of skin cancers. Dermatologists recommend use of sunscreens to block dangerous UV rays, but they also unfortunately prevent the body from absorbing vitamin D. Consult your doctor, but the July 2010 issue of the Harvard Health Letter proposes a reasonable guideline: short periods of exposure to sunlight a few times a week, with liberal use of sunscreen if you’re going to be outside for more than 15 minutes.
If you are homebound or don’t get outside in direct sun, or during the winter when the sun’s rays aren’t as strong, you may need to talk to your doctor about your risk for vitamin D deficiency. If you take vitamin D supplements, be sure to take them with food, and ask your doctor or pharmacist about any potential interactions with medications.