Osteoporosis and fracture prevention
In brief
Section titled “In brief”- Osteoporosis increases fracture risk and can lead to mobility loss
- Bone responds to loading above 3-4x body weight (Wolff’s principle)
- HiRIT: heavy strength training + impact training, 2-3x per week
- Optimal status of vitamin D, K2 and calcium is essential
- More than half of fractures occur from falling — fall prevention is crucial
Why prevention is important
Section titled “Why prevention is important”Osteoporosis increases fracture risk and can lead to:
- Mobility loss
- Dependency
- Reduced quality of life
Prevention focuses on four pillars:
- Loading — Stimulates bone building
- Nutrients — Building blocks for bone
- Hormones — Regulate bone breakdown and building
- Fall prevention — Prevents fractures
Mechanical loading (Wolff’s principle)
Section titled “Mechanical loading (Wolff’s principle)”Bone is living tissue that responds to loading above the daily threshold.
| Loading | Effect |
|---|---|
| 3-4x body weight | Stimulates bone building |
| 4-6x body weight | Jumps, very effective |
| 70-85% of 1RM | Heavy strength training |
Effective dosing
Section titled “Effective dosing”| Parameter | Recommendation |
|---|---|
| Impacts per session | 40-50 |
| Sessions per week | 2-3 |
| Impacts per week | 100-150 |
HiRIT: High Intensity Resistance and Impact Training
Section titled “HiRIT: High Intensity Resistance and Impact Training”HiRIT is the most researched program for bone building.
Schedule: 2 sessions per week
Section titled “Schedule: 2 sessions per week”Heavy strength training:
- Deadlift
- Squat
- Overhead press
- Bench press
- Chin-ups or rows
Impact training:
- Drop landings from 20-30 cm height
- 40-50 impacts per session
Results
Section titled “Results”- Improves hip and vertebral bone density
- No increased risk of stress fractures
- Safe when program is correctly executed
Fall prevention
Section titled “Fall prevention”More than half of fractures occur from falling.
Training approach
Section titled “Training approach”| Focus | Examples |
|---|---|
| Balance | Standing on one leg, tandem stance |
| Coordination | Tai chi, dance movements |
| Hip strength | Sideways stepping, squats |
| Ankle strength | Calf raises |
Living environment
Section titled “Living environment”- Remove loose rugs and cables
- Ensure good lighting
- Install handrails at stairs and bathroom
- Wear stable footwear
Vitamin D
Section titled “Vitamin D”Vitamin D is necessary for calcium absorption.
| Source | Note |
|---|---|
| UVB light | Main source, between 10:00-15:00 |
| Fatty fish | Salmon, mackerel, herring |
| Egg yolks | Especially from free-range eggs |
| Grass-fed butter | Also contains K2 |
| Fortified dairy | Milk, yogurt |
Supplementation is often needed for:
- Elderly
- Little sunlight
- Dark skin
- Indoor work
Vitamin K2
Section titled “Vitamin K2”Vitamin K2 supports transport of calcium to bone (and away from blood vessels).
| Source | K2 content |
|---|---|
| Natto | Very high (Japanese fermented soy) |
| Hard cheeses | Gouda, Edam |
| Egg yolks | Moderate |
| Grass-fed butter | Moderate |
| Liver | Moderate |
Calcium
Section titled “Calcium”| Source | Note |
|---|---|
| Cheese | Especially hard cheeses |
| Yogurt | Full-fat yogurt |
| Leafy greens | Kale, broccoli |
| Nuts | Almonds |
| Beans | White beans |
| Sardines with bones | Excellent source |
Target value: 1000-1200 mg per day
Hormones
Section titled “Hormones”| Hormone | Effect on bone |
|---|---|
| Estrogen | Decline accelerates bone loss in women |
| Testosterone | Deficiency in men increases risk |
Hormone therapy can be protective. Discuss this with your doctor.
What really works
Section titled “What really works”Veelgestelde vragen
Which training is best for bone building?
HiRIT (High Intensity Resistance and Impact Training) is the most researched program. This includes heavy strength training (deadlift, squat, overhead press) and impact training (drop landings from 20-30 cm). Aim for 100-150 impacts per week divided over 2-3 sessions.
Why is impact loading important for bones?
Bone responds to loading above the daily threshold (Wolff's principle). Loading of 3-4 times body weight stimulates bone building. Walking alone is insufficient; jumps and heavy strength training are more effective.
Which nutrients are important for strong bones?
Vitamin D (for calcium absorption), vitamin K2 (transports calcium to bone), and calcium (1000-1200 mg/day). Sources: fatty fish, egg yolks, hard cheese, leafy greens, sardines with bones.
How do I prevent fractures with osteoporosis?
More than half of fractures occur from falling. Train balance, coordination and hip/ankle strength. Optimize the living environment for safety. Combine this with impact training and optimal nutritional status.
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Medical Disclaimer: The information provided by Stichting Je Leefstijl Als Medicijn regarding lifestyle, diseases, and disorders should not be construed as medical advice. Under no circumstances do we advise people to alter their existing treatment. We recommend that people with chronic conditions seek advice regarding their treatment from qualified medical professionals.