Better bones, better balance, better life

Philip J. Goscienski, M.D.

February 2006

The incidence of broken wrists and broken hips is growing faster than ever among our oldest citizens and there is no hint that it's going to slow down when today's kids reach the age of osteoporosis. In fact, it's going to get worse until America reverses its trend toward becoming a super-sedentary society.

Calcium alone won't cure osteoporosis and it does precious little to prevent it after the age of 30. In developing countries where calcium intake is barely a third of what is supposedly normal, hip fractures are not very common. The United States is blessed with an abundance of dairy products, calcium-fortified foods and a huge choice of calcium supplements but broken hips are a leading cause of disability in persons over the age of 60. One out of five of these victims will die within a year of the accident, enduring months of pain, discomfort and a deteriorating quality of life.

Osteoporosis is an exercise-deficiency disease but it's a rare practitioner who will give specific recommendations for physical activity to a patient at risk.

There are two reasons why exercise matters. The first is that a working muscle stresses the bone that anchors it, causing that bone to become thicker and stronger. Muscles that go unused for years allow the underlying bone to become thinner and weaker.

The second reason is related to balance. You don't fall over when you close your eyes because you have position sense, feedback from special nerve endings that are attached to every muscle cell. When muscle cells wither from lack of activity these specialized nerve endings stop working. That makes it difficult to maintain balance, especially when weak leg muscles can't lift the feet over small obstructions. Poor balance leads to falls. Bones that have become thin and fragile can't withstand a tumble that a young person would hardly notice.

For a person who is past the age of 65 and who already has osteoporosis a physician may prescribe one of several drugs that slow down or even reverse the loss of bone. Calcium does matter but so does a varied diet that provides magnesium, boron, omega-3 fatty acids, vitamins, protein and other bone-building nutrients.

More than half of our elderly population, especially those that live in northern latitudes, need more vitamin D than sunshine can provide. The current recommendation of 400 units of vitamin D per day is too low for persons over the age of 60. They should take at least 600 units per day and some experts in the field recommend as much as 1000 units daily.

What everyone needs is a program of daily, weight-bearing physical activity such as walking and resistance exercises that will slow down the loss of muscle and those nerve endings that provide balance.

Advanced age and chronic disease are not excuses to avoid exercise. A group of Boston seniors whose average age was more than 90 and who had an average of four chronic diseases showed remarkable improvement in strength and walking ability after only a few weeks of supervised physical activity. These elderly exercisers also gained bone strength, and how much calcium they took didn't make any difference

Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at