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October 3, 2016. OK, the toe bone’s connected to the foot bone and the foot bone’s connected to the leg bone. But the health of each and every bone is connected to how you eat and exercise. It’s Monday, so let’s consider the exercise part. Tomorrow we’ll move on to the eating part.

What works
Weight-bearing exercise contributes mightily to bone density and strength as well as to muscle mass and strength. If your bone density’s on the way down – this begins after age 35 if you don’t counter it with exercise and diet – you’re on the way to osteopenia and its severe form, osteoporosis. If you get there, you’re at a significantly higher risk for hip, spine, wrist and rib fractures.

Like muscle, bone is living tissue that responds to exercise by becoming stronger… The best exercise for your bones is the weight-bearing kind, which forces you to work against gravity. Some examples of weight-bearing exercises include weight training, walking, hiking, jogging, climbing stairs, tennis, and dancing.” National Institutes of Health

Why it works
Full disclosure: your toe bone’s really not connected to your foot bone. I like that old gospel tune as much as you do and I’m not here to diss the word of the Lord, but I have to tell you: bones don’t connect to bones. Muscles and ligaments are connected to bones. So when you exercise, your muscles pull on the bones. They put pressure on the bones. Just like the muscles, the bones respond by getting stronger.

What works best?
Depends on your current state of bone health. There’s some evidence that relatively high-intensity, high-impact exercise is the most effective way to build and maintain bone strength. “Adolescents and adults who participate in endurance sports, such as running, and non-weight-bearing sports, such as biking and swimming, often have lower bone mineral density (BMD) than athletes participating in ball and power sports …“, according to this study published in Current Sports Medicine Report. Do 10 or 20 squats every day. Push-ups. Fast dancing, especially when you jump around a lot. Hiking on hill and mountain terrain varies the speed and stress on muscle and bone because your physical activity varies according to the ups and downs – and how steep they are.

But if you have osteoporosis, high-impact is the last thing you want. Stretching exercises have been shown to increase range of motion and decrease pain. Don’t do serious weight bearing stuff. Do spinal balance, neck circles, quadriceps stretches. They’re all weight bearing, but gently and slightly. No impact.

What doesn’t work?
Doing nothing. Don’t just sit there.

Your bones on drugs
Take a walk instead. “Although weight training and vigorous exercise have long been touted as the most effective activities for preventing osteoporosis, recent data suggest that moderate weight-bearing exercise like walking may also help reduce risk. In the Nurses’ Health Study, women who walked for at least four hours a week had a 40 percent reduction in the risk of hip fractures. Among postmenopausal women, walking for at least eight hours a week (or the equivalent amount of another activity) provided the same level of protection against fractures as hormones did, while also lowering the risk of heart disease, diabetes, and stroke. Nurses Health Study News

Where to walk
Outdoors. Because the sun’s the best source of Vitamin D, the hormone needed for calcium absorption and bone-building. Of the 300,000 men and women over 65 who fracture a hip this year, 10 – 20% will die within a year. And 50% won’t regain their mobility; 25% will move to nursing homes. The Journal of the American Medical Association reports this in a study that shows Vitamin D supplementation to dramatically reduce the incidence of hip fracture.

The study showed the benefit resulted from the daily supplement of 700 – 800 IU of Vitamin D and suggested that the addition of a 700-milligram calcium supplement may be necessary. How does this compare with free sunlight? Well, if you’re a 20-year old, three or four weekly “sensible” sun exposures get you the equivalent of 20,000 IU. If you’re 70, you can still convert that amount of solar energy to 3,000 – 5,000 IU. So get out there.

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