Your Healthy Bones Action Plan

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Ages 19 to 24

What Happens: During these years you reach your lifetime peak bone mass. Childhood sets the stage -- you build about 60 percent of your skeleton then -- but the rest comes during adolescence and your 20s. That's when high levels of estrogen and two other hormones, growth hormone and insulin-like growth factor-1, increase bone density, helping you develop about 40 percent more bone than you had in your teens. You'll need it: "A peak bone density that's just 5 percent less than what it might have been can lead to a 40 percent increase in your risk of osteoporosis," says calcium researcher Dorothy Teegarden, PhD, professor of nutrition at Purdue University, in West Lafayette, Indiana.

Your Healthy Bone Regimen: Consume 1,000 milligrams (mg) of calcium per day -- slightly more than three 8-ounce glasses of skim milk -- and 200 International Units (IUs) of Vitamin D. (Milk is an excellent source of D, as well.) If you don't get enough from your regular diet, take a daily calcium/vitamin D supplement or a multivitamin containing these ingredients to make up the shortfall. To maximize bone growth you also need to do weight-bearing exercise that challenges your body's large muscle groups (shoulder muscles, back, and pelvic area). Good choices: strength training, running, walking, or step aerobics.

Strong Bone Strategies

  • Inventory your habits. Coffee, cola, and other caffeinated drinks inhibit calcium absorption slightly -- for every eight ounces of coffee you consume, your body fails to absorb 4 mg of calcium. That's a trivial amount when you're supposed to be consuming 1,000 mg of calcium a day. The main reason to monitor caffeine is that, if you sip a lot of black coffee or soda, you're less likely to drink milk. To spare your bones, limit caffeinated drinks to two to three 8-ounce servings a day, advises Nelson B. Watts, MD, director of the Bone Health and Osteoporosis Center at the University of Cincinnati College of Medicine. Sneak in an extra 40 mg of calcium a day by adding two tablespoons of milk to your coffee or tea, or indulging in cappuccino, latte, or milky chai (low-fat or fat-free milk will give you even more calcium per serving). If you smoke, your bones are yet another reason to quit -- the habit can weaken them. So can too much alcohol: Limit it to 6 ounces of wine, 12 ounces of beer, or 1 ounce of spirits per day.
  • Watch the salt. Sodium makes your body excrete more calcium than usual when you sweat or urinate. We need only about one teaspoon of salt per day; most of us get far more, primarily from packaged foods. Eat more fresh foods; switch to lower-sodium versions of packaged products.
  • See your doctor if your period stops. If you miss your period for three consecutive months or more -- and you're not pregnant or nursing -- get to a doctor. Amenorrhea can occur for many reasons, including an eating disorder or excessive physical activity. (Ballet dancers and athletes, for instance, may miss periods due to low body fat.) Whatever the cause of the problem, the consequences are the same: Estrogen levels drop, preventing bone-building cells from doing their job, a loss that can't be recouped later, says Michelle P. Warren, MD, director of the Center for Menopause, Hormonal Disorders and Women's Health at Columbia University Medical Center, in New York City.
  • Be scrupulous about calcium if you take birth control pills. The pill maintains a steady level of estrogen, preventing the surges of estrogen that can aid bone formation. To protect bone, make sure you meet your calcium quota. Dr. Teegarden recently found that young women on the pill who consumed 1,000 mg of calcium per day didn't lose bone in their hip or spine over the course of a year. By contrast women on the pill who got 800 mg or less lost up to 2 percent of their bone mass in these areas.

Continued on page 4:  Ages 25 to 39


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