Smart tips to help you prevent and treat osteoporosis

If you've ever tripped on a step and fractured a bone, you could chalk it up to clumsiness — but osteoporosis might also be to blame. Here are some tips to help you prevent and treat osteoporosis.

The biggest bone benefits come from weight-bearing exercise done in childhood and early adulthood, but you'll still reap some benefits if you start now.

• Walking or jogging, doing aerobics and lifting weights or using dumbbells all count.
• If you're dieting, exercise can also help offset bone loss that may result when you try to lose weight by cutting calories.

Here's another reason to eat your spinach — and your kale and collard greens: they're rich in vitamin K, which some studies show can cut the risk of bone fractures.

In addition to vitamin K and calcium, fruits and vegetables provide other nutrients important in maintaining bone health and preventing fractures, including vitamins A and C, potassium, magnesium and fluoride.

• If you eat at least five servings of fruit and vegetables a day (more is better), you're getting enough of most of these nutrients.

Calcium is no longer considered the "slam dunk" for preventing osteoporosis it was once thought to be.

• Researchers who reviewed data from 29 studies involving nearly 64,000 people (mostly post-menopausal women) found that taking calcium supplements alone or with vitamin D for three to five years reduced the risk of a fracture by about 12 percent on average.
• People who gained the most bone protection were those whose diets were low in calcium to begin with.
• Talk to your doctor about whether calcium supplements are right for you.

These hormone-like compounds found in soy don't seem to have any effect on bone density in premenopausal women, and the evidence is mixed in post-menopausal women.

• What's more, studies find that there's no way to get enough from your diet alone to affect bone density; you'd have to take supplemental soy protein or phytoestrogens, which experts recommend against.

Numerous drugs are available today for treating osteoporosis or its predecessor, osteopenia. A major analysis of the following three drug types found no clear "winner" in terms of preventing fractures. (Hormone replacement therapy, which reduces the risk of fractures after menopause, is no longer recommended as a front-line therapy because of possible health risks.)

• Parathyroid hormone (calcitonin): This hormone stimulates bone-building cells. Studies find it works best at preventing hip and other non-spinal fractures. Once given only by injection, it's now available as a nasal spray for women who are more than five years past menopause.
• Selective estrogen-receptor modulators (SERMs): Raloxifene (Evista) works like estrogen in the body, helping reduce bone loss. It not only works well for preventing fractures in women with osteoporosis but is also one of the few drugs also approved to prevent osteoporosis in post-menopausal women.
• Bisphosphonates: These drugs include alendronate (Fosamax), risedronate (Actonel), ibandronate (Boniva) and others. They bind to bone to prevent it from breaking down. The only bisphosphonate approved to prevent osteoporosis is Boniva. Side effects can include gastrointestinal problems and even damage to the esophagus. Some patients have reported severe muscle or bone pain while using these drugs, so be sure to talk with your doctor about the risks.

People don't always realize that a broken bone, or even loss of height (which can result from compression fractures in the spine), may be the first sign of osteoporosis. This condition, in which your bones lose density and becomes thin, is both preventable and reversible with treatment. Decrease your risk with these simple tips and remember to always consult your doctor before starting any new medications.