How to keep your bones healthy

Dr. Teresa Sosenko, a rheumatologist with Illinois Bone & Joint Institute (IBJI), answered the following questions regarding maintaining healthy bones.

Q: What test can tell you about the health of your bones?

A: A bone density scan, called a DXA scan, helps you understand the health of your bones. DXA stands for Dual Energy X-ray Absortiometer, which is a low-dose imaging instrument that measures the density and strength of your bones and delivers a score called a T-score.

Q: What does the T-score tell you?

A: The way to truly diagnose osteoporosis is to look at the T-score. A patient will either be above or below values. Anything between -1 and -2.5 means low bone mass or osteopenia, and anything at or below -2.5 is considered osteoporosis.

Q: What's the difference between a bone scan and a DXA bone density scan?

A bone scan looks for fractures, cancer, infection or abnormalities in the bones, while the DXA bone density scan looks at bone mineral density to determine the strength of bones, identifies your risk of breaking a bone (fractures) and reveals if you have a condition called osteoporosis.

The denser the bones, the less likely you are to experience fractures.

Q: What if someone has osteoporosis?

A: Patients with osteoporosis need calcium and vitamin D supplementation. If you receive a diagnosis of osteoporosis, that's when you would need to discuss a bone-strengthening agent.

Q: How much calcium and vitamin D do we need for our bones?

A: The recommendation is to get 1,000 to 1,200 milligrams of calcium per day. Most people only get 500 to 600 with their diet. A standard vitamin D supplement dose is 600 to 1,000 IU, however, this often varies based on the patient's vitamin D level.

Q: What's in our bones?

A: Essential minerals are stored in our bones, along with nerves, blood vessels, and proteins. Two layers make up our bones. There is a dense and rigid cortical layer that supports our skeletal structure and a flexible trabecular layer that holds red bone marrow and produces red blood cells.

Q: What should you eat to keep your bones healthy?

A: Optimal bone health can be obtained by adding a variety of plant-based proteins (beans, legumes, nuts, seeds, natural soy) with high-quality animal proteins (eggs, salmon, lean meats).

Q: What foods should be avoided?

A: Avoid sugar, limit alcohol to one to two drinks per day, and avoid caffeine and highly processed foods. Excessive caffeine consumption results in a loss of calcium and magnesium, which predisposes you to a higher risk of fractures.

Q: What vitamins support good bone health?

A: Vitamins D and K support bone health because they help with the absorption and delivery of calcium in the body. Potassium and vitamin C are good and can be found in oranges, bananas, and grapefruit.

Q: What exercises help seniors to improve bone health?

A: Consider weightlifting exercises, jogging, walking or playing tennis to keep your bones healthy. Weight-bearing and muscle-strengthening exercises can be high- or low-impact.

Q: How do you know if you need a DXA bone density scan?

A: Anyone can get a bone density scan at any time, but you may have some conditions that put you at greater risk for low bone density. Here are a few indicators:

• Shorter than you used to be: If you've lost height - at least 1.5 inches (3.8 centimeters), according to the Mayo Clinic - you may have compression fractures in your spine. One of the main causes of this is osteoporosis, a condition that makes our bones porous, brittle, and at risk of fractures.

• Drug history: If you've taken drugs that interfere with bone health, such as prednisone, you may be at risk of developing osteoporosis.

• Fluctuating hormones: Drops in hormones - estrogen for women, testosterone for men - that occur naturally later in life can put you at greater risk of weakened bones.

• Cancer treatment: Since certain treatments for prostate cancer reduce testosterone levels and lowered sex hormones weaken bones, you may have a low bone-density score.

• Secondary bone loss: If you have an eating disorder, celiac disease, multiple myeloma, thyroid diseases, parathyroid disease, hypercalciuria or Type 1 diabetes, you may want to have a bone density test to determine how to address potential secondary bone loss caused by these conditions.

• The Illinois Bone and Joint Institute has rheumatologists at eight locations across the Chicago area. Learn more and schedule an appointment at ibji.com/rheumatology or call (847) 375-3000.