Prevention strategies for osteoporosis

  Interventions appropriate for the general population to maintain bone mass include the following: adequate calcium and vitamin D intake, lifelong weight bearing and muscle strength exercise, smoking cessation, alcohol abstinence, and fall injury prevention.  Adequate calcium and vitamin D intake Adequate calcium and vitamin D intake through the daily diet is safe and effective in reducing the risk of fracture. Controlled clinical trials have shown that supplementation with both calcium and vitamin D can reduce the risk of fracture. Low-fat balanced diets, fruits and vegetables provide calcium and a variety of nutrients. If dietary intake of calcium is not sufficient, daily calcium supplementation is recommended.  The Institute of Medicine recommends 1000 mg of calcium daily for men aged 50-70 years and 1200 mg of calcium daily for women over 50 years and men over 71 years. Calcium intake above these levels does not further increase bone mass. Some studies have suggested that calcium intakes above 1200-1500 mg per day may increase the risk of kidney stones, cardiovascular disease and stroke. However, the results of these studies are controversial and inconclusive.  The daily dietary intake of calcium can be calculated and is about 600-700 mg per day for adults over 50 years of age (possibly lower in the national population). Increasing dietary intake is the preferred approach, in addition to taking calcium supplements.  Vitamin D plays an important role in promoting calcium absorption, maintaining normal bone mass, improving muscle balance, and reducing the risk of falls. The Institute of Medicine recommends 800-1000 IU of vitamin D daily for adults over 50 years of age; the Institute of Medical Dietetics recommends 600 IU of vitamin D daily until age 70, increasing to 800 IU after age 70. Fortified milk, saltwater fish, animal liver, calcium supplements and multivitamin tablets are rich in vitamin D. Risk factors for vitamin D deficiency: poor digestion, intestinal disease, chronic renal insufficiency, other chronic diseases and sun exposure. insufficiency, other chronic diseases and insufficient sunlight exposure, etc. Vitamin D deficiency is more common in patients with osteoporosis, especially in the case of hip fractures. Vitamin D supplementation should be based on test results, and serum 25(OH)D should be maintained at 30 ng/ml (75 nmol/L). Some patients require higher intakes of vitamin D. The upper safe limit for the general population is 4000 IU/day.  Treatment of vitamin D deficiency requires 50,000 IU of vitamin D2 or vitamin D3 per week or 7,000 IU per day for 8-12 weeks until serum 25(OH)D reaches 30 ng/ml and 1500-2000 IU per day thereafter to maintain serum 25(OH)D at 30 ng/ml. Weight-bearing and muscle-strength exercise Routine weight-bearing and muscle-strength exercise to reduce the risk of risk of falls and fractures, while also increasing bone mass. The Institute of Medicine recommends physical activity for all age groups to prevent osteoporosis and maintain good health.  Once exercise is discontinued, the resulting benefits are lost. Weight-bearing exercises include walking, jogging, Tai Chi, stair climbing, and dancing. Muscle exercises include yoga, weight lifting, etc. Patients with osteoporosis should follow their doctor’s instructions for more intense physical activity.  Quit smoking and alcohol Smoking is not only harmful to health but also damages bone quality. The Institute of Medicine recommends quitting smoking as part of the prevention of osteoporosis. Moderate alcohol consumption can increase bone mass and reduce the risk of fractures in women after menopause. However, drinking more than two drinks a day for women and three drinks a day for men may damage bone health, increase the risk of falls, and have the potential to develop into alcoholism.