Bones play a critical role in full-body health. The skeleton is the framework of the body — protecting your organs, enabling movement and housing the bone marrow that makes blood cells, to name a few functions. As we age, maintaining bone health becomes even more important.
Suzanne Hecht, an associate professor in the University of Minnesota Medical School and director of the U of M Sports Medicine Fellowship, talks about what bone health means, some of the common issues that affect bone health and how you can keep your bones strong as you age.
Q: Why is bone health important?
Hecht: The skeleton, made up of your bones, provides the structure to the body and in conjunction with the muscles, tendons, ligaments and joints allows for movement. Bones have a dynamic structure and are always building up new bone and breaking down old bone, and the amount of new bone being produced declines as you get older. Poor bone health increases the risk of fractures and loss of function among other issues, particularly as we age.
Q: What are some of the common issues that impact bone health?
Hecht: Good nutrition — including an adequate intake of calories, calcium and vitamin D — supports our bone structure. Inadequate calcium intake is one of the most common issues that impacts bone health, as it is one of the main building blocks of the bone. Calcium intake deficiency is exceedingly common, with studies showing that 60-70% of children and adults qualify as having a calcium deficiency. Additionally, alcohol use, soda consumption and smoking can all negatively impact your health. Eating disorders such as anorexia and malabsorption syndromes also have well-known associations with poor bone health.
Exercise is another key factor in stimulating new bone formation and, unfortunately, most children and adults do not get the recommended daily amount of exercise.
Q: What factors affect your bone health as you age?
Hecht: Two critical factors that impact your bone as you age are genetics and chronic diseases. Genetic factors determine 80-90% of the peak bone mass — the highest amount of bone that your skeleton will accumulate, which typically occurs between 25-30 years of age — that can be attained in your lifetime. Around the age of 30, the bone begins to break down more than it builds up. This leads to an overall decrease in peak bone mass and gradually decreasing bone mineral density. The lower your peak bone mass, the faster you reach the thresholds of osteopenia and osteoporosis, conditions with which bones are weaker and more likely to break.
As you age, the risk of being diagnosed with chronic diseases also increases. Chronic diseases can directly impact your bone health and indirectly impact the skeleton due the effects of medications. Chronic medical conditions can also result in decreased mobility that weakens the bone.
Q: How can people improve and maintain bone health?
Hecht: Improving and maintaining good bone health is a lifelong commitment, and building up your peak bone mass while you’re young can pay lifelong dividends. At any stage of life, exercise and good nutrition will set you up for success. Exercise stimulates increased bone formation, particularly weight-bearing exercises, and we recommend activities that promote movement in various directions, jumping and weight-lifting. In addition to getting the correct caloric intake, make sure you are getting the recommended amounts of calcium and vitamin D in your diet.
Screening for low bone density is a critical step for diagnosing osteopenia and osteoporosis, and those with known risk factors may want to do so at a younger age. Risk factors may include a family history of osteoporosis or hip fractures, personal history of low impact fractures and chronic diseases and medications associated with low bone mineral density. It’s important to discuss your personal history with your medical team to help assess risk and work on a treatment plan if needed.
Q: How is your work at the University of Minnesota advancing knowledge and providing support for bone health?
Hecht: My work involves evaluating and caring for patients, ranging from young athletes to the elderly, with a wide range of bone issues. I often see patients prior to major orthopedic surgeries for bone health optimization to improve their outcomes. My main interest area is bone health in young athletes, which includes treating athletes with stress fractures, inadequate nutrition and chronic diseases. I am committed to promoting bone health gains and minimizing bone health loss during childhood in order to reduce future osteoporosis diagnoses and low impact fractures. Bone health education for clinicians, patients and the general public is also an important aspect of my work at the U of M. Everyone needs an awareness of bone health and to be alert to the negative impact of osteoporosis on health and function.
Suzanne Hecht is an associate professor in the University of Minnesota Medical School’s Program in Sports Medicine, a family and sports medicine physician with M Health Fairview and director of the U of M Sports Medicine Fellowship. She sees patients at the U of M Physicians Sports Medicine Clinic and has a Certificate of Added Qualifications in sports medicine and certification in clinical densitometry. Dr. Hecht also teaches residents in sports medicine workshops and provides training room and sideline care to U of M athletes as well as the USA Gymnastics and U.S. Figure Skating teams.
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