Follow the guide to do these 5 points, "diet + exercise" to prevent osteoporosis

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Osteoporosis is a degenerative disease characterized by low bone mass, bone microstructure destruction, increased bone fragility, easy to lead to fractures, early can have no obvious symptoms, however, with the progression of the disease, bone mass continues to lose, bone pain, spinal deformation, and even osteoporotic fractures and other serious life-threatening consequences, which is one of the main causes of death and disability in elderly patients.

Osteoporosis can be prevented and treated

In general, bone mass peaks at age 35 and begins to be lost with age, so osteoporosis is common in older adults and postmenopausal women
.
There are also some conditions that belong to secondary osteoporosis, such as extreme lack of activity and exercise, unhealthy lifestyle, etc.
can also cause osteoporosis, and people with diabetes, hyperthyroidism or hormone therapy, and family history of fragile fractures are also susceptible to disease
.

Although osteoporosis occurs quietly and can lead to serious consequences, it is completely preventable and treatable
.

Risk factors for osteoporosis are divided into uncontrollable factors and controllable factors, the latter including unhealthy lifestyle (nutritional imbalance, smoking, low activity, etc.
), diseases, drugs, etc
.
Therefore, the prevention of osteoporosis includes two major aspects: bone health basic supplements, drug prevention and lifestyle adjustment, involving the following 5 points:

1.
Supplement calcium and vitamin D

Calcium combined with vitamin D is the basic drug for daily prevention and treatment of osteoporosis, which can run through the whole
course of the disease.

Calcium intake is beneficial to obtain ideal bone peak, slow bone loss, improve bone mineralization and maintain bone health, therefore, the recommended daily calcium intake for adults is 800 mg, and the daily calcium intake for people aged 50 and above is 1000~1200 mg
.

How to supplement calcium reasonably?

➤Calcium carbonate has high calcium content, high absorption rate, and is easily soluble in gastric acid
.

➤Calcium citrate has low calcium content, but good water solubility, small gastrointestinal adverse reactions, citric acid may reduce the occurrence of kidney stones, suitable for gastric acid deficiency and patients
with the risk of kidney stones.

➤ Do not overdose
on calcium supplementation.
Pay attention to diet conditioning, eat more fresh vegetables, fruits, cereals rich in plant fiber, etc.
, drink water reasonably to increase stool volume, you can exercise more, help promote intestinal defecation, relieve constipation
.

➤ Studies have found that calcium supplementation prevents the risk of kidney stones by reducing the availability of oxalic acid in the
intestine and its urinary excretion.
However, calcium supplementation, if taken between meals or before bedtime, may increase the risk of
kidney stone formation.

Vitamin D can increase intestinal calcium absorption, promote bone mineralization, and maintain muscle strength
.
The recommended intake of vitamin D for adults is 400 lU (10ug)/d; Elderly people aged 65 and above often have vitamin D deficiency due to lack of sunlight and intake and absorption disorders, and the recommended intake is 600lU (15ug)/d; When vitamin D is used for the prevention and treatment of osteoporosis, the dose can be 800~1200lU/d, and the maximum intake can be tolerated as 2000lU (50ug)/d
.

Precautions for vitamin D supplementation:

➤ Evidence shows that improper vitamin D supplementation will trigger the risk of hypercalcemia and kidney stones, so patients with kidney stones should be used with caution, preferably under the guidance of a doctor
.

➤In addition, the risk of poisoning and hypercalcemia caused by physiological dose supplementation of ordinary vitamin D is very small, and generally does not increase the risk of
kidney stones, renal calcium salt, and renal function damage.

➤Therefore, routine monitoring of blood calcium and urine calcium
is not required.
Guidelines do not recommend the use of active vitamin D to correct vitamin D deficiency, and do not recommend a single high-dose regular vitamin D supplementation
for 1 year.

2.
Supplement zinc, phosphorus, magnesium and other nutrients

Studies have shown that magnesium, zinc, copper, or manganese play an important role
in collagen and other protein synthesis, forming bone structure to maintain bone mass, bone metabolism, and bone turnover.
These trace elements are supplemented with calcium and vitamin D better than calcium and vitamin D
alone.

3.
Eat a balanced diet

Prevention of osteoporosis cannot simply rely on calcium supplementation and other medications, and lifestyle adjustments are very important measures
.

First of all, it is necessary to eat a balanced diet and balance nutrition, and each meal should consume the necessary nutrients, such as protein, vitamins and fiber
.

➤ Dietary diversity: an average daily intake of more than 12 kinds of food, more than 25 kinds per week, including cereals, potatoes, vegetables and fruits, livestock, poultry, fish, eggs, milk, soybeans and nuts and other foods, mainly cereals
.

➤Ensure cereal potato intake: 250~400g of cereal and potato food per day, including 50~150g of whole grains and miscellaneous beans, 50~100g of potatoes; Vegetables 300~500g, dark vegetables should account for 1/2; fresh fruits 200~350g
.

➤Ensure protein intake: fish and poultry are preferred every day, with a weekly intake of 280~525 g of fish, 280~525g of livestock and poultry meat, 280~350g of eggs, and an average daily total intake of 120~200g; 1 egg per day, without discarding the yolk; Eat soy products often and nuts in moderation; Ensure the intake of milk and dairy products, the intake is equivalent to 300g (about 300ml) of liquid milk per day
.

➤ Increase intake of vitamin D-rich foods, such as fatty wild fish and sun-exposed mushrooms
.

In addition, pay attention to drinking plenty of water and control the intake
of sugar, salt and smoked foods.

4.
Exercise regularly

Regular exercise is one of the
basic measures to prevent and treat osteoporosis.
The activity of the muscles during exercise stimulates bone tissue, making bones
stronger.
Exercise also helps to enhance the body's five-dimensional "mobility" – strength, endurance, flexibility, balance and agility, thereby reducing the risk of
falls.

➤For the elderly or patients with osteoporosis, it is recommended to do at least 150~300min of moderate-intensity exercise (such as jogging, tai chi, etc.
) per week, or 75~150min of high-intensity aerobic exercise per week, or moderate-intensity and high-intensity combined aerobic exercise
with comparable effects.

➤ At the same time, encourage a combination of aerobic exercise, muscle strengthening and balance training activities
.

➤ It should be noted that whether it is outdoor or home activities, you should do what you can, and you should determine the degree of
physical activity according to your own health level.

5.
Adjust your living habits

Such as quitting smoking and limiting alcohol, avoiding sitting for a long time, ensuring adequate sun exposure, etc
.

Since the main source of vitamin D in the human body is 7-dehydrocholesterol in the skin produced by ultraviolet radiation in the sun, it is necessary to ensure sufficient sun exposure to meet the needs of
synthesizing vitamin D.

➤ When receiving sunlight, it is required to expose limbs, do not use sunscreen, do not partition glass, and do not use umbrellas;

➤ The time is ideal between 10:00~14:00, the irradiation time is 5~10min, and the frequency is 2~3 times a
week.

➤ Older adults and individuals with darker skin who need longer sun exposure
.

summary

In the process of preventing and treating osteoporosis, lifestyle modification and medication are equally important and require long-term adherence
.

Finally, for secondary osteoporosis related to diseases (such as diabetes, etc.
), the primary disease should be actively treated first, while paying attention to the two basic preventive measures of nutrition and exercise, and if necessary, using anti-osteoporotic drugs under the guidance of a doctor to actively prevent and treat
.

Source: Photogram

References:

1.
Guidelines for the diagnosis and treatment of primary osteoporosis(2017)[J].
Chinese Journal of Osteoporosis and Bone Mineral Diseases,2017,10(05):413-444.
)

2.
Expert consensus on nutrition and exercise management in patients with primary osteoporosis[J].
Chinese Journal of Osteoporosis and Bone Mineral Diseases,2020,13(05):396-410.
)

3.
CHEN Sheng, ZHOU Jianlie.
Prevention and treatment and supplementation of magnesium, zinc, copper and manganese in osteoporotic fractures[J].
Chinese Journal of Clinical Nutrition,2012,20(3):184-185.
)

4.
Medical Pulse.
Inventory of 10 "anti-osteoporosis therapeutic drugs": benefits and risks of standardized medication balance[EB/OL].
[2022-10-24].
https://news.
medlive.
cn/endocr/info-progress/show-193306_46.
html.