"National Osteoporosis Foundation 
How Can I Prevent Osteoporosis?"

Building strong bones, especially before the age of 30, can be the best defense against developing osteoporosis, and a healthy lifestyle can be critically important for keeping bones strong.

There are several steps you can take to prevent osteoporosis:

Estrogen and Alendronate

Both estrogen and alendronate are approved by the Food and Drug Administration (FDA) for the prevention of osteoporosis. Experts recommended estrogen replacement therapy (ERT) for women
at high risk for osteoporosis, especially if their ovaries were removed before age 50. ERT should also be considered by women who have experienced natural menopause and have multiple osteoporosis risk factors, such as an early menopause, a blood relative with osteoporosis, or below normal bone mass on a bone density test.

There are risks as well as benefits associated with estrogen use, including increased risk of uterine and breast cancer. The risk of cancer of the uterus can be offset by the addition of another
hormone, progesterone, to the estrogen therapy. With long-term use of estrogen (more than 10 years), there may be an increased risk of developing breast cancer. As with all drugs, the decision to use estrogen should be made after discussing the benefits and risks and your own situation with your physician.

Alendronate, a medication from the class of drugs called bisphosphonates, is approved in a 5 mg dose for the prevention of osteoporosis. In clinical trials, alendronate slowed or stopped bone loss, increased bone density, And reduced fracture risk. Side effects are uncommon but may include irritation of the esophagus, abdominal or musculoskeletal pain, nausea, and heartburn. To derive the most benefit from alendronate, the following guidelines must be followed: take alendronate on an empty stomach with 8 oz. of water first thing in the morning, remain upright for at least 30 minutes after taking it, and have nothing to eat or drink during this time.

Diet

Making sure you get an adequate amount of calcium may help in protecting you against osteoporosis. Recent studies indicate that many adults get only half or less of their daily calcium requirement. An 8-ounce glass of whole or skim milk, 1 1/2 ounces of cheddar cheese, 2 cups of cottage cheese, and 1 cup of yogurt each contain an estimated 300 mg of calcium -- nearly one-third of the
recommended daily allowance before menopause. As you increase your calcium intake, try to eat foods that are low in fat. Keep track of your daily calcium intake for a week and discuss this record with your doctor. If your diet doesn’t contain enough of this vital nutrient, supplement your intake with calcium tablets. Ask your doctor or pharmacist to recommend a supplement that is well absorbed by your body. If you’re ill or if you’ve had kidney stones, talk to your doctor before taking any supplements.

You need normal levels of vitamin D to absorb calcium. Your body manufactures this vitamin as a result of exposure to sunlight, and it is also available in vitamin-enriched milk products. Too much vitamin D is harmful, so don’t decide to take supplements without first consulting your doctor. However, you can safely take 400 units (the recommended daily allowance) in a multivitamin.

Exercise

Exercise can also be helpful in building and maintaining strong bones. Exercise that forces you to work against gravity -- so called weight-bearing exercises such as walking or jogging -- are beneficial. Other weight-bearing exercises include racquet sports, hiking, aerobic dance, and stair climbing. The benefits of exercise last only as long as you maintain the program. If you are at risk for osteoporosis, your doctor will most likely include exercise as part of your overall treatment program.