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Men and Osteoporosis

Building stronger bones to reduce risk

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Women are more likely to develop osteoporosis and get it earlier. But because men are underdiagnosed and undertreated, their outcomes are often worse. That’s why it’s so important for men to adopt these bone-healthy strategies.

Osteoporosis has generally been considered a women’s disease. Yet 20 percent of men will suffer a broken bone from osteoporosis. By 2050, the number of male sufferers over the age of 70 is expected to double. The good news: lifestyle changes including diet, use of supplements, and properly designed exercise programs could decrease that prediction.

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The bare bones

Our bones are in a constant process of regeneration. As we age, our body resorbs old bone faster than it can form new bone, and bone mass is lost. Osteoporosis occurs when that loss becomes pronounced enough to affect the strength of the bones, leading to fractures.

The more bone mass we develop when young, the less likely we are to develop osteoporosis because we have greater total bone mass to draw upon. However, other factors can increase our risk.

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Boning up on risks

Some risk factors are genetic; others are related to lifestyle.

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Gender and age

Fewer men develop osteoporosis and at a later age.

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Ethnic background

Caucasians and Asians are at greatest risk.

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Family history

Having a parent or sibling with osteoporosis increases risk.

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Body frame size

Smaller body frames have less bone mass in reserve.

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Sex hormones

As hormones decrease, osteoporosis risk increases. Because men experience gradual hormonal reduction, their bones are protected longer. However, some prostate cancer treatments reduce testosterone levels, leading to earlier onset.

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Glandular problems

Overactive thyroid, parathyroid, or adrenal glands can all contribute to osteoporosis risk.

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Dietary factors

Consistently low calcium intake, anorexia, and gastrointestinal surgery (stomach reduction, removal of part of the intestine), which decreases the body’s ability to absorb calcium, can put men at risk of osteoporosis.

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Medical conditions

Chronic diseases that affect the kidneys, lungs, stomach, and intestines or that alter hormones increase osteoporosis risk.

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Medications

Corticosteroids and medications for seizures, gastric reflux, cancer, and transplant rejection may interfere with bone rebuilding and are associated with osteoporosis.

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Lifestyle habits

Being inactive, consuming more than two alcoholic drinks daily, and smoking all weaken bones.

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Stress

Pamela Frank, ND, whose own father was diagnosed with osteoporosis in his 60s, would add stress to this list.

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More than skin deep

Osteoporosis is sometimes called “the silent thief” because early stages of bone loss don’t advertise themselves. By the time symptoms appear, bones have been seriously weakened, and fragility fractures occur in which bones break easily. While falls and resulting broken bones are the main sign, others include

  • back pain when vertebrae in the spine fracture or collapse
  • decreased height over time
  • increasingly stooped posture
  • unexpected bone fractures

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Breaking it down

Bone fractures, particularly in the spine or hip, are the most serious complications of osteoporosis. Hip fractures can result in disability and sometimes death from postoperative complications, especially in older adults.

Yet the effects of osteoporosis are often underestimated, especially for men, who are less likely to see a doctor or be screened. Even when presenting with a broken bone, men may be treated for the fracture but not the underlying disease, leaving them at risk for further osteoporotic fractures. In one study, 90 percent of men with fragility fractures remained undiagnosed and untreated for osteoporosis.

The numbers? One in five men will suffer a broken bone due to osteoporosis. Of the approximately 30,000 hip fractures in Canada annually, more than one-quarter occur in men. Compared to women, more men will require care in a long-term facility or die as a result. Vertebral fractures are even less likely to be detected and treated.

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Good for the bones

We can help prevent osteoporosis by taking good care of our bodies.

Simple things we can do include

  • eating a healthy whole foods diet
  • getting regular physical activity
  • quitting smoking
  • limiting alcohol consumption

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From our mouths to our bones

What we put in our mouths shows up on our bones. Several micronutrients have been identified as important for good bone health. Some foods, however, have the opposite effect and can leach much-needed minerals, such as calcium, from our bones or reduce our ability to absorb it.

Foods to avoid

  • colas and other carbonated soft drinks containing phosphoric acid
  • caffeinated drinks such as coffee and high-caffeine soda
  • processed foods high in sodium, including
  • processed meats (deli meats, hot dogs)
  • fast foods (pizza, burgers, tacos, fries)
  • regular canned soups, vegetables, vegetable juices
  • baked products (breads, breakfast cereals)
Read labels and choose foods low in phosphoric acid, caffeine, and sodium.

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Calcium

Calcium is the building block for bones and teeth. It’s also vital for our muscles and nerves. If calcium intake is low, our bodies demineralize bone to support those other functions.

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eat

  • dairy products
  • dark green leafy vegetables (collard, turnip, dandelion, mustard greens, kale, broccoli)
  • canned sardines or salmon with bones
  • calcium-fortified foods and beverages

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Magnesium

This mineral is a critical component of our skeleton and is often missing from our diet. Some researchers suggest a magnesium deficiency could impair bone mineralization and be a risk factor for osteoporosis.

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eat

  • legumes
  • nuts
  • seeds
  • fish
  • whole grains

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Vitamin D

This vitamin’s primary function is to maintain calcium and phosphorus absorption to support bone mineralization.

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eat

  • milk
  • vitamin D-fortified soy or rice beverages, juice
  • fatty varieties of fish (salmon, mackerel, tuna)
  • egg yolks

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B vitamins

The B vitamins help keep blood levels of homocysteine low, which may lower the risk of osteoporotic fractures.

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eat

  • folate: broccoli, spinach, chickpeas, beans, lentils, fortified flour, pasta, cornmeal products
  • B6: meat, fish, poultry, nuts and seeds, lentils, potatoes, bananas, soy products
  • B12: eggs, milk, cheese, milk products, meat, fish, shellfish, poultry, fortified soy and rice beverages, soy-based meat substitutes

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Vitamin K

Its major function is to help modify protein so it can bind calcium.

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eat

  • dark green leafy vegetables (kale, collard greens, spinach, Brussels sprouts)

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Protein

Because bones are about 50 percent protein, they need a steady stream of protein for repair and maintenance. Protein’s bone-building ability works best when combined with fruits, vegetables, and calcium-rich foods.

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eat

  • fish, poultry, or meat
  • dairy products
  • eggs
  • soy products (edamame, tofu, tempeh) supplemented with other calcium-rich foods

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Omega-3 fatty acids

Preliminary research suggests these fatty acids may have bone-boosting benefits.

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eat

  • fish and fish oil
  • flaxseed and flaxseed oil

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Building it up

The earlier we start exercising, the better, but it’s never too late. Regular exercise can increase bone mineral density in the spine and is essential to reducing falls, the leading cause of hip fractures among older adults.

The best exercise program combines different exercises to improve strength, balance, posture, and overall fitness.

  • Strength or resistance training strengthens muscles and bones in legs, arms, chest, shoulders, and back.
  • Weight-bearing aerobic physical activity, such as walking, jogging, stair climbing, rope skipping, and skiing, strengthens legs, hips, and lower spine.
  • Balance exercises, tai chi, and dancing improve balance and coordination, which help prevent falls and consequent fractures.
  • Posture awareness, combined with strength exercises targeting the back muscles, improves posture and reduces the risk of spine fractures.

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Strong bones may need a little help

As we age, our ability to absorb nutrients and minerals from food decreases, making it increasingly important to take supplements and herbs to give our bodies what they need.

When we think of strong bones, most of us think of calcium. But as Pamela Frank, ND, reminds us, “Bone health is about much more than just calcium. Magnesium; boron; manganese; and vitamins C, K, and D are all necessary.” Other supplements she recommends include copper and zinc citrate.

Other nutritional supplements that may help strengthen bones, though more research is needed, include

  • DHEA (dehydroepiandrosterone)
  • EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid)
  • folic acid
  • vitamins B6 and B12
  • silicon

Herbs that might be helpful, but which have not undergone clinical trials, include

  • black cohosh
  • horsetail
  • red clover

Note: Always consult a health care practitioner before taking herbal or nutritional supplements.

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