Wednesday, January 2, 2008

Standing Tall

Ask Glen!

Q. Glen, I seem to be shrinking! I am over 40. Can this be true?

A. Starting at about age 40, people typically lose about half an inch each decade, and the decline usually accelerates after the 70th birthday. The Baltimore Longitudinal Study of Aging is a well-known investigation that included roughly 2,000 people. The men in the study lost, on average, about two inches of height between ages 30 and 80, and the women, about three.


Osteoporosis. As we get older, our bones become less dense, more brittle, and therefore more likely to fracture. This loss of bone tissue is called osteoporosis. Older women are particularly susceptible because of the drop-off in estrogen levels during menopause. Estrogen blocks resorption, the process by which calcium is released from bone into the bloodstream.

When a hip or wrist bone weakened by osteoporosis breaks, it’s usually the kind of crack we have in mind when we picture a broken bone. But fractures of osteoporotic vertebrae, those knobby bones that make up our spine, are different. The bone crumples like a cardboard box that has had too much weight put on it. Most of these vertebral fractures don’t cause any pain or other symptoms and are discovered incidentally in a chest or abdominal x-ray.

Bad posture. Some doctors and researchers believe that vertebral fractures have been overrated as a cause of height loss and kyphosis (pronounced kie-FOE-sis), the medical term for being hunched over. Dr. Harold Rosen, an osteoporosis expert at Harvard-affiliated Beth Israel Deaconess Medical Center in Boston, points to studies that have shown that only about 30% of kyphosis can be explained by vertebral fractures. It’s hard to say what’s behind the other 70%, but a big share of it may simply be bad posture.

An exercise for improving your posture

Lie flat on your stomach and relax your shoulders and back (top). By lifting your shoulders off the ground, you’ll strengthen the muscles in your back, which can help improve posture (bottom).


For many people, losing a little bit of height is no big deal. Compared with the other challenges of getting older it can be pretty trivial. On the other hand, severe kyphosis can cause all sorts of problems. It may affect your breathing because the lungs don’t have enough room to expand. You may also be more likely to fall and break a hip or another bone because your center of gravity is shifted forward. And, no surprise, neck and back pain are often a problem.

Bent backs


Improving your posture. You can do some simple exercises that will strengthen certain back muscles so you can stand up a little bit straighter. Sit-ups or crunches, a modified sit-up that involves contracting your stomach muscles, will strengthen your abdomen.

For overall muscle control as well as posture and balance improvement, many people swear by yoga or tai chi, a form of Chinese martial arts that has been described as moving yoga.

You can do these preventive exercises on your own if you are healthy. But if you’re older, have osteoporosis, or both, it’s a good idea to talk to a doctor before you get started on an exercise program. The wrong exercises could do more harm than good.

Strengthening your bones. The other way to limit height loss is to counteract the effect of osteoporosis on bone — and on the vertebrae in particular. The single best way to do that is to stay as active as you can. Innumerable studies have shown that weight-bearing exercise stimulates the creation of bone tissue.

Getting enough calcium and vitamin D is also important. How much is enough? If you’re older than 50, the recommendation for daily calcium intake as of 2005 is 1,200 milligrams.

Doctors are changing their minds about vitamin D as the evidence of its benefits piles up. Those benefits seem to go well beyond just increased bone strength and may include improved balance. The recommended daily amount is 400 IU (International Units) for people ages 51 to 70, and 600 IU for those 71 and over. Some Harvard experts now believe that we may need at least 1,000 IU daily to protect ourselves against osteoporotic fractures.

A middle-of-the-road approach is to start taking a multivitamin. Most contain 400 IU of vitamin D. Milk, vitamin-fortified breakfast cereals, and coldwater fish (mackerel, salmon, sardines) can add another couple of hundred IU to your daily total. Your skin makes vitamin D when sunlight hits it, so stepping outside for a little bit on a sunny day is another way to get more of the vitamin into your system. When you do, feel good and stand tall.


Yours in good health

Any questions?

Ask Glen!

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