Strategies to prevent and treat osteoporosis in people with asthma are not significantly different from those used to treat people who do not have asthma.
Nutrition: A well-balanced diet rich in calcium and vitamin D is important for healthy bones. Good sources of calcium include low-fat dairy products; dark green, leafy vegetables; and calcium-fortified foods and beverages. Supplements can help ensure that the calcium requirement is met each day, especially in those with a proven milk allergy. The Institute of Medicine recommends a daily calcium intake of 1,000 mg each day for men and women, increasing to 1,200 mg daily for those age 50 and older.
Vitamin D plays an important role in calcium absorption and bone health. It is synthesized in the skin through exposure to sunlight. Food sources of vitamin D include egg yolks, saltwater fish, and liver. Many people obtain enough vitamin D by getting about 15 minutes of sunlight exposure each day or from eating fortified foods. Other individuals—especially those who are older or housebound, live in northern climates, or use sunscreen—may require vitamin D supplements to achieve the recommended intake of 400 to 600 International Units (IU) each day.
Exercise: Like muscle, bone is living tissue that responds to exercise by becoming stronger. The best kind of activity for your bones is weight-bearing exercise that forces you to work against gravity. Some examples include walking, climbing stairs, weight training, and dancing. Regular exercise, such as walking, may help prevent bone loss and provide many other health benefits.
People who experience exercise induced asthma should exercise in an environmentally controlled facility and participate in activities that fall within their limitations. They may also use medication when necessary to enable them to exercise.
Healthy lifestyle: Smoking is bad for bones as well as the heart and lungs. Women who smoke tend to go through menopause earlier, triggering earlier bone loss. In addition, people who smoke may absorb less calcium from their diets. Alcohol also can affect bone health negatively. Those who drink heavily are more prone to bone loss and fracture because of both poor nutrition and an increased risk of falling.
Reducing exposure to asthma triggers, such as irritants and allergens, can help lessen a person’s reliance on glucocorticoid medication. Avoiding people with colds and other respiratory infections and minimizing emotional stress can also be important.
Bone density test: A bone mineral density (BMD) test measures bone density at various sites of the body. This safe and painless test can detect osteoporosis before a fracture occurs and can predict one’s chances of future fracture. People with asthma, particularly those receiving glucocorticoid therapy for 2 months or more, should talk to their doctors about whether they might be candidates for a BMD test.
Medication: Like asthma, osteoporosis is a disease with no cure. However, there are medications available to prevent and treat osteoporosis, including: bisphosphonates; estrogen agonists/antagonists (also called selective estrogen receptor modulators or SERMS); parathyroid hormone; estrogen therapy; hormone therapy; and a recently approved RANK ligand (RANKL) inhibitor.
Because of their effectiveness in controlling asthma with fewer side effects, inhaled glucocorticoids are preferred to oral forms of the medication. Bone loss t...
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