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Johns Hopkins Bayview News - The Importance of Bone Health

Summer 2013

The Importance of Bone Health

By: Karen Tong
Date: June 3, 2013

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The health of your bones is increasingly important as you age. Older adults often have bone loss—low bone density that makes the bones weaker—which leads to an increased risk of fractures. It’s never too early to start thinking about bone health; maximizing your bone health during your younger years helps to lower fracture risk later in life.

The Johns Hopkins Metabolic Bone Center has resources to assist people of all ages in improving bone health. “Focus on overall good nutrition and getting the right amounts of calcium, vitamin D, protein and potassium,” suggests Deborah Sellmeyer, M.D., medical director of the Metabolic Bone Center. “Include weight-bearing exercise into your routines.”


Over a lifetime, exercise can strengthen bones. Strength training using weights or resistance, and balance training, such as tai chi, also are important. Walking and general activity while out and about helps, too. “Thirty to forty minutes of walking each day can really make a difference in the health of your bones,” says Dr. Sellmeyer. Improving balance and muscle strength through exercise can help prevent falls, which are the leading cause of bone fractures.


All vitamins and minerals play a role in bone health. Most important are calcium and vitamin D. The recommended daily allowance of vitamin D for adults age 51 to 70 is 600 IU. The recommended daily allowance of calcium is 1,200 mg for women age 51 to 70, and 1,000 mg for men. Adults over 70 should have 1,200 mg of calcium and 800 IU of vitamin D each day. A multivitamin often ensures that you get the calcium and vitamin D you need, and provides a wide array of other nutrients that can be lacking if your diet is not well rounded.

“Eating plenty of protein, but not too much, also is necessary to help build and repair bone and muscle,” adds Dr. Sellmeyer. Most people need to consume .4 grams of protein each day for each 1.1 pounds they weigh. So, a person weighing 150 pounds needs about 55 grams of protein daily.


In the March 2013 issue of the Journal of Bone and Mineral Research, Dr. Sellmeyer, along with Kendall Moseley, M.D., endocrinologist and others, published research results about the role of potassium citrate in bone health.

Dr. Sellmeyer explains, “Potassium citrate is used clinically for kidney stones because it lowers the amount of calcium in urine. We wanted to learn if potassium citrate would help the body keep and absorb more calcium, making stronger bones over time.” The study found that taking potassium citrate pills resulted in a net gain of calcium in the whole body.

Potassium citrate pills are available by prescription. But you also can get all the potassium you need by eating the right foods. Dr. Sellmeyer suggests eating six to nine servings of potassium-rich foods such as citrus fruits, tomatoes (not processed with salt), yams, dried fruit and potatoes each day. Unless you have kidney problems, it is generally safe to consume this much potassium.

Diagnosing Bone Health

Determining the likelihood of fracture and the density of your bones is an important step toward better bone health. One painless test helps diagnose bone density and fracture risk.

A dual-energy X-ray absorptiometry (DXA) scan is a bone mineral density test that measures how much calcium and other minerals are in your bones. Usually, the DXA scan measures bone density at the spine, hip and/or forearm. The results of the scan are compared to the average bone density value at the age of peak bone mass (late 20s). Bone density and risk factors for fracture are then entered into an online tool called FRAX®, which calculates your 10-year risk of any fracture, as well as your specific risk of hip fracture.

A DXA scan is a routine screening test for women over 65 and men over 70. Some adults under 65 may need this test earlier, depending on personal risk factors, such as:

  • a family history of fractures
  • having a fracture after age 45
  • weighing less than 125 pounds
  • smoking or consuming excessive alcohol
  • having rheumatoid arthritis
  • taking medications or having a medical condition that affect bones

To schedule a DXA bone density scan, call 410-550-BONE (2663).

To learn more about the Johns Hopkins Metabolic Bone Center, call 410-550-BONE (2663) or visit The Bone Center.

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