What Can I Do to Improve My Bone Health?

A high-calorie, nutrient-dense diet and exercise leads to healthy, strong bones for people with cystic fibrosis. Good nutrition also means taking vitamin and mineral supplements and sometimes medication. 

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Exercise Regularly

Weight-bearing exercise and resistance exercise such as walking, jogging or lifting weights are great for bone health. Exercise early in life may build more bone. Your CF care team can help you build an exercise program.

In addition, avoid smoking, which hurts your lungs and bones and can cause osteoporosis.

Eat Right

Low weight and poor nutrition cause weak bones. It is important for children and teens with CF to gain and keep their weight up and eat healthy. Proteins, also known as amino acids, are the building blocks for all body tissues, even bones.

In addition to protein, the minerals calcium, zinc, magnesium, phosphorus and fluoride and vitamins A, D and K are essential to build and keep strong bones. Your CF care team may prescribe calcium or vitamin D supplements if you do not get enough through your diet and your levels are low.

People with CF should avoid alcohol and caffeine because they lower bone density.

Essential Bone Minerals

Calcium plays a big part in forming bones and keeping them strong. Children and teens need the most calcium because bones grow fast in those years. People with CF age 9 years and up should get 1,300 to 1,500 mg of calcium a day

Calcium can decrease how well some medicines work if taken together. Ask your CF care team which medicines can be taken with calcium.

It is best to get your calcium from foods. Milk, milk products (cheese, yogurt, ice cream), and calcium-fortified plant-based milks are great sources of calcium and calories. Other good calcium sources are foods made with dairy products, such as macaroni and cheese, puddings and custards, and creamed soups. Dark green vegetables, almonds and calcium-fortified orange juice and cereals have some calcium. If you cannot get enough calcium from foods, ask your CF dietitian about calcium supplements. Your body can absorb only about 500 mg of calcium at a time, so spread your calcium sources throughout the day.

In addition to calcium, it is important to maintain the right levels of magnesium and zinc. Low magnesium blocks the body's use of calcium, and low zinc levels can cause poor growth and slow puberty.

Most Important Vitamins

Vitamin D helps our bodies absorb calcium to make bone. Your body makes vitamin D from being in the sun. Being in the sun for 5-10 minutes, 2-3 times a week, can raise vitamin D levels. Be careful not to stay out in the sun too long to avoid sunburn.

Fortified milk and cereals, egg yolks, and fatty fish are good food sources of vitamin D, but people with CF don't easily absorb vitamin D from foods. They should take vitamins made just for people with CF like AquADEKs® or MVW®. These vitamins have water-soluble vitamin D, which is easier to absorb.

Vitamin D levels in the blood should be checked once a year and after taking extra vitamin D as prescribed. If the amount of vitamin D in your blood is low, you may need to take more.

Vitamin K is a fat-soluble vitamin needed for bone density. You can get vitamin K in CF-specific vitamins. Vitamin K also is made in the intestines by bacteria. Good food sources include leafy greens such as cabbage, broccoli, kale, and spinach.

Take Medication: Bisphosphonates

If you have osteoporosis, medicines called bisphosphonates strengthen bones. These medicines help bone-building cells work better. They can stop osteoporosis from getting worse or reverse it. They are not often given to kids under age 7. They should be used only in those with severe osteoporosis or known fractures from weak bones.

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