Bone Health and Osteoporosis:
A Guide for Asian Women Aged 50 and Older

January 2012

When you think about your health, you probably do not think about your bones. But keeping your bones healthy and reducing your risk of fractures by preventing osteoporosis is very important throughout life and especially as you get older. Here is some important information to help you.

Risk Factors

Factors that increase your chances of having osteoporosis and fractures include:

  • being Asian
  • being female
  • being older (50+ years)
  • low body weight
  • menopause or surgery to remove both ovaries before menopause (resulting in lower levels of the hormone estrogen)
  • history of fracture as an adult
  • close relative with history of fracture as an adult
  • long-term low calcium intake
  • inadequate physical activity
  • current cigarette smoking
  • alcoholism
  • use of certain medications such as corticosteroids and anticonvulsants
  • history of anorexia nervosa.

What Is Osteoporosis?

Osteoporosis is a disease that makes bones fragile and more likely to break. There are no symptoms to warn you. The first sign is usually a fracture that occurs after your bones have already become fragile. Fractures occur most often in the hip, spine, and wrist. Spinal fractures cause stooped posture, loss of height, and chronic back pain. Hip fractures, the most serious consequence of osteoporosis, can result in permanent disability and even death.

You can take steps to protect your bones in your older years. These include a good diet with plenty of calcium and vitamin D, a regular exercise program, a healthy lifestyle, and, sometimes, medication.

Calcium and Vitamin D

You need calcium to help maintain healthy, strong bones throughout your life. Adults up to age 50 need 1,000 mg (milligrams) of calcium every day. Women over age 50 and men over age 70 should increase their intake to 1,200 mg daily.

Many Asian diets are low in calcium. Examples of foods that contain calcium in different amounts include:

  • almonds
  • bok choy
  • broccoli
  • calcium-fortified orange juice
  • calcium-fortified rice
  • calcium-fortified soy milk
  • canned salmon with bones
  • canned sardines with bones
  • milk, yogurt, cheese, ice cream
  • napa cabbage
  • oysters
  • sesame seeds
  • soybeans
  • tofu
  • turnip leaves.

Many Asian Americans have trouble digesting milk products. This is called lactose intolerance. If you are lactose intolerant, here are some things you can do:

  • Eat dairy foods in small amounts spread out over the day.
  • Eat more nondairy, calcium-rich foods.
  • Take calcium supplements.
  • Use lactase pills, which make milk products more digestible.

Vitamin D helps your body absorb calcium. You need 600 IU (International Units) of vitamin D every day. Men and women over age 70 should increase their uptake to 800 IU daily. People can get enough vitamin D from such sources as:

  • egg yolks
  • saltwater fish
  • fortified dairy products
  • vitamin and mineral supplements.

Exercise

Physical activity is also important to prevent osteoporosis and reduce falls that can result in fractures. Weight-bearing activities can help you maintain strong bones. Examples include:

  • walking
  • climbing stairs
  • dancing
  • weight training.

Other kinds of exercise will help you increase your flexibility and improve your balance to prevent falls. Examples include:

  • tai chi
  • bike riding
  • swimming.

Talk to your doctor about an exercise program that is safe for you. If you have low bone density or osteoporosis, you should protect your spine by avoiding exercises and activities that flex, bend, or twist your spine.

A Healthy Lifestyle

Smoking and drinking too much alcohol are bad for bones. To protect your bones, do not smoke, and if you drink alcoholic beverages, do so in moderation.

Bone Density Testing

If you are at high risk for osteoporosis, you may want to ask your doctor if a bone density test is right for you. This test will help your doctor decide if you need medication to reduce your risk of fractures.

Bone density tests are quick and painless. You usually do not need to get undressed. The most widely recognized test is called a dual-energy x-ray absorptiometry or DXA test, which measures bone density at the hip and spine. If you are age 65 or older, Medicare may pay for your test. Ask your doctor for more information.

Treatment of Osteoporosis

If bone density testing indicates that you have low bone density or osteoporosis, your doctor may prescribe treatment that includes calcium and vitamin D, exercise, and medication. Medications approved by the Food and Drug Administration (FDA) include: bisphosphonates; estrogen agonists/antagonists (also called selective estrogen receptor modulators or SERMS); parathyroid hormone; calcitonin; estrogen therapy; hormone therapy; and a recently approved RANK ligand (RANKL) inhibitor.

These medications provide a variety of choices. Your doctor can help you find the one that is best for you.

The National Institutes of Health Osteoporosis and Related Bone Diseases ~
National Resource Center acknowledges the assistance of the National
Osteoporosis Foundation in the preparation of this publication.

For Your Information

This publication contains information about medications used to treat the health condition discussed here. When this publication was produced, we included the most up-to-date (accurate) information available. Occasionally, new information on medication is released.

For updates and for any questions about any medications you are taking, please contact:

U.S. Food and Drug Administration

Website: http://www.fda.gov/
Toll free: 888–INFO–FDA (888–463–6332)

For updates and questions about statistics, please contact:

Centers for Disease Control and Prevention's National Center for Health Statistics

Website: http://www.cdc.gov/nchs
Toll free: 800-232-4636

NIH Osteoporosis and Related Bone Diseases ~ National Resource Center

2 AMS Circle
Bethesda,  MD 20892-3676
Phone: 202-223-0344
Toll Free: 800-624-BONE (2663)
TTY: 202-466-4315
Fax: 202-293-2356
Email: NIHBoneInfo@mail.nih.gov
Website: http://www.bones.nih.gov

The NIH Osteoporosis and Related Bone Diseases ~ National Resource Center provides patients, health professionals, and the public with an important link to resources and information on metabolic bone diseases. The mission of NIH ORBD~NRC is to expand awareness and enhance knowledge and understanding of the prevention, early detection, and treatment of these diseases as well as strategies for coping with them.

The NIH Osteoporosis and Related Bone Diseases ~ National Resource Center is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases with contributions from:

The National Institutes of Health (NIH) is a component of the U.S. Department of Health and Human Services (DHHS).

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