Coach on Call. Thank you for your interest in Being Active to Prevent or Treat Osteoporosis. I hope you find this tip sheet helpful.

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1 It was great to talk with you. Thank you for your interest in. I hope you find this tip sheet helpful. Please give me a call if you have more questions about this or other topics. As your UPMC Health Plan health coach, I m ready to help in any way I can. What Is Osteoporosis? Some bone loss with age is normal. Bones are living tissues. Every day, old bone is broken down and new bone is created. When you are young, bone is created faster than it is broken down. You build up what is called bone mass. Bone mass reaches its peak at about age 30. After that point, bone is broken down faster than it is created. Osteoporosis goes beyond normal bone loss. Your bones become porous, weak, and brittle. So weak that in severe cases, even mild stresses like coughing can cause a fracture. Osteoporosis is: More likely if you: Are a woman, especially after menopause, or a man with low testosterone levels. Are Caucasian or of Asian descent. Have a small body frame. Have a parent, brother, or sister with osteoporosis. Take certain drugs that weaken bones. Have had stomach or weight loss surgery. Have anorexia, bulimia, celiac disease, Cushing s disease, or Crohn s disease. Often not identified or treated. About 80% of those who are at high risk for osteoporosis or have already had at least one fracture due to it are not aware of it or treated for it. Very common. About half of Americans aged 50 and older have either osteoporosis or low bone mass. Serious. It can lead to chronic pain, long-term disability, and death. For example, within the first year after a hip fracture, most individuals are dependent on others or in a nursing home. Almost one in five die. A healthier life is life on is the on line the for you! line for you! CMN (a) UPMC_16_1237 Copyright 2015 UPMC Health Plan Inc. All rights reserved. TRT OSTEO FL 15WP0900 (MCG) 12/11/15 PDF

2 Page 2 of 7 This tip sheet focuses on how being active is good for your bones. For bone health, it is also important to: Eat a healthy diet with enough calcium. Get enough vitamin D. If you smoke, quit. Avoid secondhand smoke. Avoid heavy drinking. Avoid cola soft drinks. Avoid under-nutrition. Examples are severe weight-loss diets and eating disorders. Talk with your doctor about the medicines you take. Some may increase bone loss. For more about the above healthy habits, talk with your doctor and health coach. UPMC has many tools and resources to help you, including a tip sheet entitled Living Well to Protect Your Bones. How Being Active Helps Your Bones Research has shown that: Being active as a child and teenager increases peak bone mass. Being active and fit throughout life lowers the risk of osteoporosis. It also helps prevent fractures and other injuries related to falls. The risk of having a hip fracture is lower in: Both men and women who are active. Those who spend less time sitting. Those who play sports. Those who do household chores. Strengthening low back and belly muscles can lower the risk of spinal fractures and curving of the spine. In women after menopause, therapeutic exercise can maintain or increase bone mineral density. In older adults who are frail, doing activities that improve balance may help prevent falls. It may also slow bone loss in early postmenopausal women. In older adults who have had hip replacement surgery due to hip fracture, intensive exercise training can improve strength and function. Follow your doctor s advice!

3 Page 3 of 7 Special Concerns if You Already Have Osteoporosis or Are at High Risk Do you have osteoporosis? Are you at high risk for it? You may think that exercise will increase your chances of breaking a bone. The opposite is true. A good exercise plan can help you prevent falls and the broken bones that come from falls. It does this by making your bones and muscles stronger and improving your balance and flexibility. Talk to your doctor about designing an exercise plan that is right for you. Your doctor will consider your: Risk of fracture. Range of motion. Fitness. Gait. Balance. Any chronic conditions that affect how able you are to exercise, such as obesity, high blood pressure, and heart disease. The National Osteoporosis Foundation recommends that your doctor refer you to a specially trained physical therapist. The therapist can tailor an exercise program to your needs and update it over time. Make an Exercise Plan For most healthy people, a good exercise plan includes the following. Talk with your doctor or a physical therapist about how to adjust this plan to fit your unique needs.

4 Page 4 of 7 Type, Examples Key Features and Benefits How Much, How Often, Tips Aerobic Walking Jogging Swimming Biking Tennis Dancing Strength training Hand weights Push-ups, sit-ups, etc. Weight machines Resistance bands Digging or lifting in the garden Delivers oxygen-rich blood from your heart and lungs to your muscles. Makes your heart, lungs, and blood vessels stronger. Lowers your risk of type 2 diabetes, obesity, and heart disease. Note: Weight-bearing exercise such as walking, dancing, or tennis, also strengthens bones. Makes your muscles do more work than usual. Makes it easier to do daily tasks at home and work. Increases bone density. Helps you stay independent as you age. Slowly build up to at least 150 minutes per week of moderate activity like brisk walking. Or build up to at least 75 minutes per week of vigorous activity like jogging. Spread over at least three days a week. Do something you like. Do at least twice a week. Skip a day between exercises that work the same muscles. Include all major muscle groups. Use proper form to avoid injuries (consult a fitness trainer or physical therapist). Balance Walking backward, sideways, on your heels, on your toes Standing from a sitting position T ai chi or qigong Helps you walk without staggering, get up from a chair without falling, and climb stairs without tripping. Helps you stay independent as you age. Do at least three times a week.

5 Page 5 of 7 Type, Examples Key Features and Benefits How Much, How Often, Tips Flexibility Yoga Stretching Sit less and move more Walk around when on the phone and during TV commercials. Ride an exercise bike while you watch TV or DVDs. Allows your joints to move through their proper range of motion. Enables you walk, lift, and step normally and avoid pain and injury. Lowers your risk of early death from all causes. Lowers your risk of type 2 diabetes, obesity, and heart disease. Do at least twice a week, after your muscles are warmed up. Hold each stretch for seconds. Stretch as far as needed to feel a gentle stretch, never to the point of pain. Breathe throughout the stretch. Get a pedometer and build up to 10,000 steps or more a day. Take the stairs instead of an elevator. Play with your children or grandkids. Take a walk break after every 30 minutes at your desk or computer. Begin where you are and build up over time. Starting small and slowly building on success will help you progress! Talk to your doctor prior to beginning any new physical activity to determine whether it is appropriate for you.

6 Page 6 of 7 Take Action 1. In general, being active is quite safe. It is more harmful to your health to be inactive. But always talk with your doctor before you begin or increase any exercise program. Ask what exercises to focus on and which ones to avoid. 2. To avoid injury: Do not suddenly increase how often and how much exercise you do. Do so slowly, over time. Warm up before exercising. Do some simple stretches after your muscles are warm. Cool down after exercising. Drink plenty of water before, during, and after being active. Listen to your body. Stop if you feel any pain. 3. Make a plan to be active in the coming week, using all but the last column below. Do your best to follow it. In the last column, record the minutes you completed. Day Activity Where When Minutes Planned Minutes Completed Example: Tuesday Walk In the neighborhood 7 a.m. 20 Lift weights At home 8 p.m. 15 Sunday Monday Tuesday Wednesday Thursday Friday Saturday Sunday Total 4. Staying on the Path to Wellness Continue to make plans to be active, week-by-week, and record how well you follow them. Use a notebook, calendar, or date book or copy the table above. At the end of each week review how well you followed your plan. Use that to fine-tune your next plan for the coming week.

7 Page 7 of 7 The information in this tip sheet is for educational purposes only and is not intended or implied to be a substitute for professional medical advice. Before making changes, always talk to your doctor about what is right for you. Sources: Facts and Statistics. International Osteoporosis Foundation. Available at org/facts-statistics#category-14. Accessed July 9, Exercise for Strong Bones. National Osteoporosis Society. Available at exercise. Accessed July 9, Todd JA, Robinson RJ. Osteoporosis and Exercise: Review. Postgrad Med J Jun;79(932): Review. Available at pdf/v079p00320.pdf. Accessed July 9, 2015.