By: Paul Xiong and Igor Klibanov
As we all know, osteoporosis is no laughing matter. All it takes is a simple fracture that can change or threaten your life. You may have or be concerned about developing osteoporosis and are afraid of its consequences, like:
- Fracturing your hip or thigh
- Being dependent on loved ones, caregivers, or family members
- Being unable to move around and do the things you love and enjoy, like gardening, hiking, skiing, playing with your grandkids
You’ve looked for ways to improve your condition, and you’ve probably read a lot of books and articles that provide conflicting information on osteoporosis.
You might’ve tried things like:
But without any success. Yes, these are all common courses of action, but the devil is in the details. This is because the information you saw may have the wrong exercises to do or because it didn’t correctly specify what and how much to consume.
In this article, you can expect to find out:
- What is osteoporosis
- The underlying causes of osteoporosis
- Risk factors that are completely out of your control
- Semi-controllable factors that you’re able to manage
- And the proper steps to reverse osteoporosis
But, before we begin, allow me to introduce myself!
My name is Igor Klibanov. I am the proud author of 8 books on exercise and nutrition, including the Amazon best-seller, Osteoporosis Reversal Secrets. I am also a certified personal trainer that specializes in helping clients with osteoporosis strengthen their bones, and decrease their risk of fractures.
So, without further ado, let’s get started with our first topic:
What is Osteoporosis and What Are Its Causes?
We know that bone is a living tissue that’s constantly breaking down and being rebuilt, and the speed of those processes changes due to many factors we’ll get into later. Osteoporosis occurs when the bone broken down is faster than the speed of bone tissue rebuilding.
Osteoporosis is a condition in which bones deteriorate, becoming less dense, porous, and more brittle. Because of their reduced bone mass and strength, they’re so brittle that even minor impacts or bumps can result in a fracture.
The wrist, spine, shoulder, and hip are the most common fracture locations.
Many people are unaware if they do have osteoporosis since there are no symptoms until you break a bone or get kyphosis (when your spine is bent and more rounded at the top than normal) becomes apparent. Only in the later stages, you may also notice:
- Back pain, caused by a fractured or compressed vertebra
- Height loss over time
- A stooped or hunched posture
- As well as bones that break far more easily than expected
Therefore, osteoporosis is often described as a silent threat.
But, you don’t always have to wait for these symptoms to appear because you can take a bone mineral density test. This form of x-ray (technically a DEXA scan), that uses extremely small amounts of radiation to tell you how strong your bones of the spine, hips, or other areas are, whether you have osteoporosis or osteopenia, and your risk of fracturing a bone.
Osteoporosis affects both men and women of all races, but older, postmenopausal Asian women are most vulnerable.
This brings me to my next topic:
The Uncontrollable Risk Factors of Osteoporosis
There are a variety of factors, both controllable and uncontrollable, that increase your risk of osteoporosis. The condition is affected by several circumstances that can’t be avoided or changed, but we’ll mention them for the sake of completeness. These include:
- Your sex
- Your age
- Your ethnicity and race
- Your family history
- And your body frame size
Like I said before, women, particularly postmenopausal women, are more likely to suffer from osteoporosis compared to men. This is because women have lower peak bone mass and smaller bones than men, however, men are still at risk, especially after the age of 70.
Speaking of age, the older you get, the faster bone loss occurs and the slower your growth of new bone becomes. Over time, your bones become weaker, and your risk of osteoporosis increases.
Your bone mass increases as your body builds new bones faster than it breaks down existing ones. The process of regenerating old bones slows after the early 20s, and most people attain their peak bone mass around age 25-30 for men and 20-25 for women.
Ethnicity and race are other important factors influencing the likelihood of osteoporosis. People of East Asian or Caucasian descent have the highest risk, while people of African Descent have a lower risk.
There’s also a genetic component to osteoporosis. If you have a family history of osteoporosis, you have a greater risk of getting it too (but it’s not inevitable, and there are definitely things you can do about it. Genetics aren’t destiny).
The final factor that increases the risk is your body frame size. Smaller body frames tend to be more vulnerable since they may have less bone mass to draw from as they age. Conversely, individuals with a larger body frame size have more bone mass to draw from, making them less prone to developing osteoporosis than thin-boned individuals.
After learning all the risk factors of osteoporosis that are out of your control, you might be wondering, what are some other factors that are manageable?
Semi-Controllable Risk Factors
Aside from the points stated above, some factors are somewhat manageable, but not things you can completely change. These mostly include health factors, such like:
- Corticosteroids and other medications
- Medical conditions
- And hormone levels
Long-term use or high doses of medications like corticosteroids disrupts the bone-rebuilding process, leading to rapid bone loss.
The most common medications implicated in bone loss are:
- Seizure medications
- Acid reflux medications
- Anti-epileptic drugs or medicine
- Cancer medications
- Transplant rejection or immunosuppressants
- And prednisone
But keep in mind that not all people who take medications lose bone, or lose bone at the same rate. It would be best to ask your doctor or a pharmacist to help you with this.
Your risk of developing osteoporosis may also be higher if you have certain medical problems, including:
- Kidney or liver disease
- Rheumatoid arthritis
and also malabsorption conditions like:
- Celiac disease
- And inflammatory bowel disease
These medical conditions are by no means easy to overcome, and figuring out how to improve your medical condition will help with or prevent osteoporosis.
Managing your hormone levels is also a big part of osteoporosis. The hormones to address would be:
- Sex hormones, like estrogen and testosterone
- Thyroid hormones or thyroxine
- Parathyroid hormones
- And cortisol
The first step would be to test all of those hormones. If the tests show that you’re in the optimal range, give yourself a pat on the back – there’s not much else to do. But if the hormones are either above or below the range where they should be, seek out your doctor’s advice on how to address them.
Sex hormones act in multiple ways to maintain a strong skeleton, and lowered hormone levels tend to weaken bones.
For example, a common treatment for prostate cancer is to take testosterone-lowering medications. Yes, the benefit is that they decrease the risk of cancer, but the drawback is that they also reduce bone strength. The same is true for women with a history of breast cancer; they’re often given estrogen-lowering medications. They prevent the cancer from returning, but the downside is that they also reduce bone strength.
Your hormone levels are part of the reason why women are more likely to develop osteoporosis. Women already have lower testosterone levels than men, and experiencing menopause further reduces estrogen levels.
Another hormone, the thyroid hormone (primarily responsible for the regulation of metabolism), can cause much bone loss if there’s too much. This can occur if your thyroid is overactive or if you take too much thyroid hormone medication to treat an underactive thyroid.
Other overactive glands like the parathyroid and adrenal glands have also been linked to osteoporosis. The overactive glands secrete an excessive amount of their hormones (parathyroid hormone and cortisol), which makes the bones weaker, have low bone density, and an increased risk of fractures.
Taking medications to boost your hormone levels is sometimes used to treat osteoporosis.
Now you can understand why these factors, hormones and medical conditions, are difficult to change but still manageable for your condition.
Not to worry because there are still factors you do have full control over, which is my next topic:
What are the Fully Controllable Risk Factors for Osteoporosis?
Unlike the other risk factors mentioned above, you have complete control over these. The big 2 would be your:
- Exercise habits
- And overall nutrition
People who spend a lot of time sitting (considered a sedentary lifestyle) are more prone to developing osteoporosis than those who are more active.
The reason behind this is that activities such as jumping and strength training and other weight-bearing exercises promote increased bone density and strength. The impact put on your bones makes them stronger and has a significant impact on bone density.
Compared to other activities like swimming and cycling, where zero impact is happening, those high-impact movements are far more beneficial to your bones. Couch potatoes, in fact, have higher bone density than elite swimmers and cyclists, but this isn’t a reason to become one and avoid exercising. They’re still beneficial to your heart… but not to your bones.
Later in the article, I’ll go into the specific workouts you should focus on.
Moving onto your overall nutrition, the two most important nutritional factors for bone strength are protein and vitamin K.
But, before we start things off, let’s address one of the main misconceptions about osteoporosis, which is that low calcium intake is surprisingly not actually a risk factor. Calcium increases bone density but does not reduce fractures.
Study after study after study shows that high calcium diets are no better than low calcium diets when it comes to fracture risk. One particular study divided women into 4 groups:
- Group 1 consumed less than 400 mg of calcium a day
- Group 2 consumed 400-800 mg
- Group 3 consumed 800-1200 mg
- Group 4 consumed over 1200 mg a day.
Calcium increases bone density without reducing fracture risk.
With that out of the way, the single most important nutritional factor for osteoporosis is by far protein intake.
Protein makes up approximately 50% of bone volume and one-third of bone mass. It stands to reason that if you eat a low-protein diet, you won’t have the “raw material” to build bones.
A study conducted on 125 postmenopausal women divided them into 4 groups:
- Group 1 had a protein consumption of less than 16% of their total calories
- Group 2 had a protein consumption of 16-18% of their total calories
- Group 3 had a protein consumption of 18-20% of their total calories
- Group 4 had a protein consumption of over 20% of their total calories
- Groups 1 and 2 experienced 16 hip fractures over the duration of the study
- Group 3 experienced 7 hip fractures over the duration of the study
- Group 4 experienced 5 hip fractures over the duration of the study
The second most important dietary factor is vitamin K, specifically, vitamin K2. Vitamin K2 is most effective when you already have osteoporosis, and it increases in effectiveness the more severe your condition is. Those without osteoporosis would see very little difference in bone density if they got vitamin K2 compared to those that didn’t at all.
Now finally, the part you’re probably here for:
What are the Steps to Prevent Osteoporosis?
You might already have some ideas on what to do, but you might still be confused. Don’t worry, because this section will help guide you on what you should do to reverse your osteoporosis.
The main things you want to do are:
- Vitamin D & vitamin K2
As mentioned before, protein makes up about half of your bone density, making it a really important factor to keep in check. People with osteoporosis should have between 20-30% of their daily calories coming from protein. This appears to be consistent with overall protein recommendations, even for individuals without osteoporosis.
Folks over 60 have worse absorption than those under 60, therefore requiring about 50% more protein. Aside from your age, you also want to consider your activity level and weight to determine the amount of protein you should consume. This study recommends 0.8 grams/kg of protein (or more depending on your activity level), if you’re sedentary. Eat 50% more if you’re over 60. But you’re not sedentary. You’ll now be participating in strength training, right? Right 😉
And people who do strength training need more than people who don’t do strength training. How much do you need if you’re strength training? If you’re under 60, you need about 1.6-1.8 grams/kg/day. If you’re over 60, you need 30-50% more than that, or about 2.1-2.7 grams/kg/day.
If you don’t feel like doing the math, enter your email at www.OsteoporosisReversal.com and you’ll receive a link to a special calculator that will help you get the required protein.
Of course, you need your protein sources so I compiled a large list of foods you want to eat. The following foods each have over 30 grams of protein per serving:
- Low-fat dairy
- Protein powders
- And egg whites
Simply put, the best protein sources are meat, fish, and seafood.
Next is a list of foods that have between 10-25 grams of protein per cup:
- Greek yogurt
- Protein bars
- Peanut butter
- Hemp seeds
- And oats/oatmeal
Vitamin D helps bone health by increasing the body’s ability to absorb calcium. The majority of people require at least 600 international units (IU) of Vitamin D each day. After the age of 70, the requirement increases to 800 IU per day.
Sunlight can provide some vitamin D, but it may not be a useful source, depending on where you live, and whether you frequently use sunscreen or avoid the sun due to the danger of skin cancer.
Alternatives in food include cod liver oil, trout, and salmon. Many types of milk and cereal have been fortified with vitamin D. If none of those work, your best bet is to use supplements.
Note that having excessively high level of vitamin D does not make it better. Excessive intake of vitamin D will cause more harm than good. In one study where men with normal vitamin D levels were given doses so high that their blood levels of vitamin D were above the reference range, they lost bone density. So it’s not a case of “more is better.” It’s a case of “the right amount.”
In terms of vitamin K2 consumption, you’ll need at least 15 mcg/day.
Here are some foods rich in vitamin K2:
- Egg yolk: 67 mcg per 100 grams
- Eel: 63 mcg per 100 grams
- Most cheeses: 10-55 mcg per 100 grams
- Beef liver: 11 mcg per 100 grams
- Chicken: 10 mcg per 100 grams
Again, supplements are also an option to get enough calcium and vitamin D, and you want to aim for adequate amounts that aren’t deficient or excessive.
Exercise can play a big role in improving your condition because it helps you strengthen your bones and slow bone loss. It is never too late to start exercising, and consistency is what matters most.
The best exercises are ones that involve jumping and strength training.
Although jumping is very beneficial, it also carries a risk with it. So we want to jump in ways where you get the benefits without the risks. The way to do that is to do strength training exclusively for 3-9 months before getting into jumping.
Once you’re ready for jumping, you want to do exercises that have a ground reaction force 4 times greater than your body weight. Some examples would be:
You should aim for 40-100 jumps per session.
Unlike jumping, walking, jogging, running, and dancing don’t produce enough force to be effective for your bones. Not to say they’re not beneficial for other reasons. Just not for your bones.
For a more specific workout plan, try the following exercises for 3-4 sets of 8-12 reps:
You can also alternate between another routine consisting of:
Try to schedule these exercises 2-3 days per week. Before you begin, make sure to start slow and not too intensely, to avoid injuries. It’s also important that you take breaks in between to let your body recover.
You might also want to consider balance-enhancing activities like the one I talk about in my article on balance exercises, which can help prevent falls but aren’t necessary.
If you’re looking for specific exercises that suit you or direct guidance, fill out the application form on our home page to discuss your options.
Osteoporosis – The Bottom Line
So, to sum everything up, there are 3 causes of osteoporosis:
- Risk factors that you can’t control
- Risk factors that you can manage
- Risk factors that you can fully control
Calcium intake does not help osteoporosis and is actually a myth. Milk, calcium supplements, and anything of that sort will not benefit you in terms of your fracture risk (it won’t harm you either, though), so don’t worry about getting enough calcium.
Try to manage your medical conditions the best you can, and make sure you don’t have low levels of hormones.
Healthy lifestyle choices such as a proper diet (namely, adequate protein and vitamin K) and exercise will lead to healthy bones, increase bone density, and reduce the risk of fractures.
If you want some personalized help with that, just fill out the application form on our home page.