If you have been diagnosed with Osteopenia, there are ways to avoid a later diagnosis of Osteoporosis. Osteopenia is a condition characterized by “a diminished amount of bone tissue” (Taber's Cyclopedic Medical Dictionary). Osteoporosis primarily affects women and is the leading cause of pathological bone fractures. According to Monahan, Drake and Neighbors, osteopenia is normal bone loss associated with aging, with “peak bone mass occurring at age 35”. Risk factors for Osteoporosis include inactivity, anorexia, calcium deficiency, amenorrhea, and postmenopausal status. We may unwittingly invite Osteoporosis by dutifully taking our medications such as “tetracyclines, corticosteroids, aluminum containing antacids, anticonvulsants (seizure medications), diuretics (water pills), and thyroid medications” (Monahan etal). Monahan, Drake and Neighbors further describe secondary osteoporosis as the result of hyperthyroidism and Cushing’s Disease. A diagnosis of Osteopenia can be an awakening for the sedentary: immediate action will be required to prevent Osteoporosis.

There are ways to counter the effects of the aforementioned osteoporosis risk factors. According to Paul Sorace, M.S., RCEP (sm), CCS, Clinical Exercise Physiologist, “A complete exercise program, along with a proper diet, can prevent Osteopenia from becoming osteoporosis. The goal of the exercise program should be to increase bone density and improve balance to promote fall prevention.”

For pre-menopausal women, a bone healthy diet includes 1000 mg of calcium per day, as recommended by the National Institutes of Health (Personal Trainer Manual, American Council on Exercise, 1996). The NIH adds that in the absence of estrogen therapy, calcium intake for postmenopausal women is 1500 mg/day. Strikingly, the Health and Nutrition Examination Survey found that “50 percent of all females age 15 and older consume less than 75% of the RDA of calcium”. According to Essentials of Nutrition and Diet Therapy author Sue Williams, calcium rich foods include yogurt (355 mg per 8 ounces), skim milk (302 mg calcium per 8 ounces), figs (269 mg calcium per 10 figs), almonds (148mg per 1 ounce), and collards (148 mg per 1 cup).

Offering an alternative perspective on calcium intake, the People for the Ethical Treatment of Animals web site quotes a study from Harvard University in which 78,000 American women were followed for 12 years. PETA reports that Harvard researchers discovered “it is unlikely that high consumption of milk or other food sources of calcium during midlife will confer substantial protective effects against hip or forearm fractures”. This opposing viewpoint is emblematic of the lack of uniformity in many arenas of osteoporosis prevention research.

One thing is certain. The improvement of balance should be a major component in any Osteoporosis Prevention Program. Medline stresses the benefits of Tai chi and Yoga. Aerobics and Dance also cultivate balance, while furnishing excellent cardiovascular gains. People with Osteopenia should enjoy continuous aerobic activity three times a week for 20-30 minutes. Your exercise intensity should feel "somewhat hard". If you can’t chat with a friend while training, ease up until you could pass the talk-test.

Should people with Osteopenia use exercise machines for weight training? The American College of Sports Medicine explains that “it is difficult to increase bone mineral density of the hip using traditional weight machines in a seated position. This is because the forces at the hip will be reduced. It is better to use free weights or machines that require standing.” ACSM encourages the introduction of hand-held free weights to traditional lunges and squats for bone remodeling, balance, and coordination. Once you have gained proficiency, ACSM suggests wearing a weighted vest to increase intensity and further improve bone mineral density.

For optimal bone remodeling, it’s preferable to lift a heavier weight fewer times than to lift a lighter weight many times. This is because “mechanical force magnitude is more important than the number of repetitions” (ACSM, Guidelines for Exercise Testing and Prescription). However, when beginning a weight lifting routine, it is safest to work with a qualified professional. For the neophyte weightlifter, the inadvertent choice of a too-heavy weight can compromise the joints. Joint injury can sabotage your weight lifting routine, which in turn can lead to further bone demineralization.

Attention people with Osteopenia: don’t do “The Twist”, especially while holding weights. Other taboo exercises for the Osteopenic or Osteoporotic Crowd include crunches and typical sit-ups. These movements involve spinal flexion and “increase the likelihood of compression wedge fractures in the lumbar spine” (Paul Sorace, Clinical Exercise Physiologist). Those with Osteopenia should never pull on the neck. Instead, focus on exercises that stabilize the core while keeping the spine straight.

Osteopenic bones will be protected by weight lifting and impact exercise only as long as the exercise program regularly continues. You can not "save-up" the benefits of exercise. Training for a long time one or two days a month confers dubious benefit. Such a training schedule is akin to brushing your teeth for two hours on Sunday so you won’t have to brush them all next week. It just doesn’t work. This metaphor describes the reversibility principle of exercise, which states “In the adult skeleton, when the loading (weightlifting) is removed, the positive effect on bone is lost” (page 302, IBID). If you've been handed the word "osteopenia" to describe your bones, take the proactive approach. After a year of lifestyle changes including weight training, aerobic activity, and improved diet, you could request a bone mineral density test to assess your new improved status. Just remember that "An increase in bone mass of more than one percent over nine months is significant because the average rate of loss is 0.5-1% per year." (ACSM, Guidelines for Exercise Testing and Prescription).

Are Dumbbells for Dumbbells? Does weightlifting make you DENSE? Yes it does! And just where you want to be dense... in your bones.