Lifestyle Modification
Nutrition
Calcium (Ca) and Vitamin D
- Prevention of osteoporosis
- Lifelong intake of adequate Ca is associated with higher peak bone mass which reduces the risk of osteoporosis/fracture in later life
- Recommended Ca intake for patients >50 years of age: 500-1200 mg/day
- The main sources of Ca are from dairy products; vegetables (eg broccoli, cabbage) are also a good source
- Vitamin D helps in intestinal Ca absorption and bone mineralization
- Recommended vitamin D intake for patients ≥50 years of age: 800-1000 IU/day
- Higher doses may be needed in patients with malabsorption, obesity, older individuals, transplant patients
- The main sources of vitamin D are from sun exposure (>15 minutes/day), fortified milk, cereals, egg yolks, salt water fish and liver
- Treatment of osteoporosis
- Ca and vitamin D supplements may be administered as adjunct to other drug therapies in the treatment of osteoporosis
- Helps to increase bone mineral density (BMD) and may reduce fracture risk in postmenopausal women with osteoporosis
- Glucocorticoid-induced osteoporosis (GIOP)
- Recommended in secondary prevention and treatment
- Has been shown to reduce bone loss
Good General Nutrition
- Excessive dieting and low body weight is associated with increased risk of fracture
- Recommend body mass index (BMI) ≥19 kg/m2
- Maintenance of adequate energy and protein intake is important as well as consuming a balanced diet
Exercise
- Regular weight-bearing exercises and muscle strengthening exercises can improve agility, strength, posture and balance, which may help to prevent falls
- Jogging, brisk walking, tai chi, weight training
- Type of exercise will depend on age of patient and physical ability
- May modestly increase bone density
Avoid Cigarette Smoking and Excessive Alcohol Consumption
- Both associated with increased risk of osteoporotic fractures and should be avoided
- Alcohol intake may be limited to <2 units/day
- Caffeinated drinks should be limited to <1-2 servings per day (240-360 mL/serving)