Health matters

Methods known for healthier bone

Conway McLean, DPM, Journal columnist

Our population is aging. The number of Americans aged 65 and older will more than double over the next 40 years, projected to reach 80 million by 2040.

Predictably, this equates to an increased incidence of hip fractures. Experts claim the number of hip fractures will nearly double worldwide by 2050. These common but serious injuries can be the result of numerous factors, but bone health is clearly an important one.

Bone health and aging well are hot topics in the media and innumerable potions and notions available. How do we stay healthy, mobile, strong? One well researched approach is to maintain fitness through exercise. Resistance training can be beneficial to health, especially as we age. Muscle strength declines by 15 percent per decade after age 50, and 30 percent per decade after age 70.

Yet, strength is intrinsic to daily function, especially in the very elderly. Most of the variance in walking speed in the elderly is related to leg strength, and increased strength has been shown to improve walking endurance and stair-climbing power. Many debilitating falls in the elderly could be prevented if more people in this age bracket were participating in fitness activities.

Research increasingly suggests that resistance training, more commonly referred to as weight training, when appropriately prescribed and supervised, has very positive effects on muscular strength and endurance, cardiovascular function, metabolism, coronary risk factors, and psychosocial well-being. Both aerobic endurance exercise and resistance training can promote substantial benefits in physical fitness and other quality-of-life, health-related factors.

The benefits are too numerous to mention here but includes others beyond the obvious improvement in muscular strength. Weight training also assists in the maintenance of your base metabolic rate and is particularly beneficial for improving cardiac function in the elderly. Additionally, resistance training appears to have substantial effects on glucose tolerance, and insulin sensitivity, and thus is particularly helpful for those with diabetes.

Broken bones, especially those from a fall, can be devastating consequence of reduced bone density in the elderly. A well designed weight training exercise program can have a tremendous impact on bone quality, increasing the density, the size, and mechanical strength, of your bones. Improving bone quality is one of the best ways to prevent the complications associated with osteoporosis, and resistance training is really the healthiest way to do that.

Physical activity has been shown to provide the mechanical stimuli or “loading” important for the maintenance and improvement of bone health, whereas physical inactivity has been implicated in bone loss and its associated health costs. Resistance training exercise can provide weight-bearing stimulus to bone, and yet research indicates that it seems to have a more profound effect than aerobic exercise. Over the past 10 years, nearly two dozen cross-sectional and longitudinal studies have shown a direct and positive relationship between the effects of resistance training and bone density.

However, it is extremely important to have the assistance of a physical therapist, or exercise specialist, to oversee such a program. This is especially true if you have no background, experience, or education in weight training. Proper form is critical to preventing injury, and having a program expressly designed for you if you have not been working, is also extremely important.

Nutrition must be mentioned, at least perfunctorily, in any discussion on health. Calcium is a mineral we are all familiar with and is a necessity for well-being. Our bones are made up primarily of calcium. But the process leading to bone production is a delicate balance of various hormones, blood flow, physical stress (in a scientific sort of way), and a host of other factors. Without sufficient levels, you can’t make new bone well, often reducing bone healing after any injury.

Vitamin D is also essential, a requirement for the process leading to bone deposition. Interestingly, it acts like a steroid hormone in many ways. D is important in regulating mood and helps to maintain healthy weight levels. Unfortunately, a deficiency of vitamin D is epidemic and is felt to be a part of numerous medical issues globally. If you aren’t taking a vitamin D supplement, chances are moderately good you are deficient.

Modern medicine has given us the ability to live dramatically longer lives, and the statistics bear this out. I routinely see patients in my office in their 90’s, and even centenarians are more common, where once they were an oddity. But how well we are able to live, our quality of life, is less certain. Make the most of your time here on earth; be able to enjoy it. Get some exercise and get happy!

EDITORS NOTE: Dr. Conway McLean is a podiatric physician now practicing foot and ankle medicine in the Upper Peninsula, having assumed the practice of Dr. Ken Tabor. McLean has lectured internationally on surgery and wound care, and is board certified in both, with a sub-specialty in foot orthotic therapy. Dr. McLean welcomes questions, comments and suggestions at drcmclean@penmed.com.


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