Can Your Bones Last a Lifetime

By Joel Fuhrman, M.D.

Contrary To Common Misconception, Osteoporosis Is Not a Natural Consequence Of Aging.

Just as with heart disease, a great many Americans expect osteoporosis to occur as a natural consequence of aging. There is nothing natural about having a heart attack. Neither is it natural to break a few bones from coughing, hugging, or bending over. It certainly is not natural for your spine to collapse, creating pain and loss of your health, and it is not natural for your back to become painful, rounded, and humped for the rest of your life. It is not natural to grow so weak and frail that you fall and suffer a hip fracture.

Unfortunately, natural or not, more than 300,000 hip fractures occur each year, and more than 10 million American women suffer from osteoporosis. The lifetime risk of a hip, spine, or forearm fracture is nearly 40 percent among 50-year-old Caucasian women and more than 13 percent among Caucasian men.

Osteoporosis happens because of a combination of nutritional factors that accelerate calcium loss in the urine, low stores of vitamin D, and lack of weight-bearing exercises and core body strength.

The Nutritional Causes of Bone Loss

Low intake of calcium is not the main factor resulting in osteoporosis. In spite of the world’s highest intake of calcium, American women have one of the highest hip fracture rates in the world. This is not merely due to inactivity and lack of hard physical labor. It is also due to factors that accelerate the loss of calcium in the urine. Controlling the factors that work together to leach calcium from the bones and increase calcium in the urine (by reducing and eliminating them) is much more important than taking extra calcium. Osteoporosis is so prevalent because the vast majority of Americans eat a diet that is low in vegetables and high in animal products, sugar, salt, and caffeine.

In order to adequately protect your bone stores of calcium, animal protein consumption must be limited to 15 ounces per week or less, and salt consumption should be under 1200mg per day. Caffeine, refined sweets, and vitamin A supplements should be eliminated.

Benefits of Vitamin D

Because vitamin D increases the absorption of calcium in the gastrointestinal tract and stimulates osteoblastic (bone-building cells) activity, vitamin D has been generating lots of interest lately in the medical literature. Borderline low levels of vitamin D have been found to be very common in the United States and Canada.

Medical studies show taking vitamin D is more effective than taking extra calcium for osteoporosis. In a recent 3-year prospective multi-center study, 622 women with osteoporosis, 50 to 79 years of age, who had one or more compression fractures of their spine, were randomly assigned to receive 25 mcg of calcitriol (900 IU vitamin D) or 1000 mg calcium for three years. In the third year, the vitamin D-supplemented group had 9 fractures per 100 women, and the calcium-treated group had 31.5.The difference in effect also was evident after two years.

The take-home message here is that curtailing habits that cause calcium wasting in the urine and monitoring vitamin D for adequate intake are more important than taking extra calcium. Attention to vitamin D status is most critical in those not getting regular sunshine. The most effective prescription for preventing and reversing osteoporosis involves diet-style modifications, extra vitamin D intake, and an effective exercise program.

Exercising Wisely To Strengthen Bones

Rather than letting your bones weaken as you age, you can strengthen them and keep them strong.

Our bones are composed of a porous network of calcified bridges called a trabecula network, which under an electron microscope looks like the inside of a sponge. This network of connecting bridges continually breaks and rebuilds with normal wear and tear as a result of activities of daily living.

When use and weight-bearing activities are increased, many of these bridges break, but then are rebuilt— thicker and stronger. In fact, they grow and thicken in response to the stresses placed on them. With little muscle stress on the joint, they lose density and become thin and fragile. The strength and density of bone over time is directly proportional to the muscle strength moving that fulcrum. Just as muscles build with regular exercise, the bone strengthens too, right along with the muscle. In fact, a good test for bone strength is muscle strength.

Unfortunately, most women in America and other modern countries have relatively sedentary lives. Even women who do regular exercise and walk are susceptible, since most popular exercises do not adequately stress the spine with enough stimuli for bone growth. Having a healthy, erect spine is extremely important for digestion and overall health. Activities that exercise and strengthen the spine include digging, shoveling, carrying toddlers, using rowing machines, and doing back extension exercises. Scientific studies also have demonstrated that wearing a weighted vest can have a powerful protective effect.1

Weighted Vests For Women

For years, I have been advising thin women to wear and exercise with a weighted vest. Weighted vests can be worn for hours each day and are the most effective prescription a doctor can order to prevent and even treat osteoporosis. The problem in the past has been finding the best vests that are designed for women and have the weights in the right place to strengthen the back bone and keep the spine erect. It is important that the weights are positioned predominantly in the back pack area so that the weight is felt on the shoulders in order to stimulate bone development in the spine.

Frustrated with the commercially available vests—bulky, stiff, unattractive, and cumbersome, with the weights around the waist instead of around the upper chest—Pamela Free (a member of designed a new vest that meets my specifications and offers the cushioning and comfort that women require. (These new vests are available from our online store.)

Women can start with just a little weight of 6-8 pounds and gradually increase the weight (up to ten percent of your body weight) to strengthen their bones, not only during exercise, but as they work, shop, bend, stand up, and move all day. Wearing a weighted vest has other benefits as well, such as burning more calories all day, increasing core strength, and stabilizing muscles, thus improving balance and decreasing the risk of falls.


1. Greendale GA, Salem GJ, Young JT, et al. A randomized trial of weighted vest use in ambulatory older adults: strength, performance, and quality of life outcomes. J Am Geriatr Soc 2000 48(3):305-11. Greendale, GA, Hirsh SH, Hahn TJ. The effect of a weighted vest on perceived health status and bone density in older persons. Qual Life Res 1993 2(2):141-52. Shaw JM, Snow CM. Weighted vest exercise improves indices of fall risk in older women. J Gerontol A Biol Sci Med Sci 1998 53(1):M53-8. Long-term exercise using weighted vests prevents hip bone loss in postmenopausal women. J Gerontol A Bio Sci Med 2000;55(9):M489-91.

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