Improving bone health.

As we age, our bones naturally get weaker. People with cystic fibrosis (CF) are at an even greater risk for developing weakened bones because they have low bone minerals, calcium, phosphorus, magnesium and fluoride, which build bones. Keeping your bones strong and healthy is a vital part of growth and overall well-being.

Almost 15 percent of people with CF have some form of bone disease. The two most common bone diseases are:

• Osteopenia: When you have low bone mineral density. This makes your bones weaker and increases the risk of developing osteoporosis.
• Osteoporosis: When your bone mineral density is very low, with more porous bones. This weakened bone is brittle and more likely to fracture.

You may be at a higher risk of having bone disease if you have:

• Decreased absorption of fat-soluble vitamins due to pancreatic insufficiency
• Low levels of vitamin D
• Low levels of calcium, possibly due to malabsorption
• Low production of sex hormones
• Low body weight
• Chronic lung infections
• Low levels of physical activity, especially weight-bearing exercise
• Long-term steroid use
• Tobacco, alcohol and caffeine use
• Cystic fibrosis-related diabetes (CFRD)

There are actions you can take to improve the health of your bones.

• Get screened. Your CVS Specialty CF CareTeam can help schedule an easy test, called a dual-energy x-ray absorptiometry (DEXA) scan, with your CF center. This scan uses an x-ray to check bone density. All children and adults with CF should be screened every one to five years. If a risk of osteoporosis is detected, screening may occur more often.
• Take medications for your bones as prescribed by your doctor. In some cases, your doctor may prescribe a medication from a group called bisphosphonates to help improve bone mineral density. Careful monitoring by your CF CareTeam or doctor may be needed.
• Get enough calcium. Calcium plays a big part in forming bones and keeping them strong. Children and teens need the most calcium because bones grow faster during this time. In general, people with CF who are nine years old and older should get 1300-1500 mg of calcium a day. It’s best to get your calcium from foods, but you may need to take a calcium supplement, too. Ask your CF CareTeam or dietitian about other foods high in calcium.
  
  Foods that are high in calcium include:
  • Yogurt
  • Cheese
  • Milk
  • Fortified soy milk
  • Tofu
  • Salmon
  • Collards
  • Spinach
  • Soybeans
  • Fortified oatmeal
• Exercise. Weight bearing and resistance exercise like walking, jogging and weight lifting are not only good forms of exercise, but can help you build bone strength as well.

With advances in treatment, people with CF are living longer and healthier lives. Good bone health is just one piece of your complete CF care puzzle. Work with your CF CareTeam and CF treatment center to learn more about bone health and to help keep your bones healthy and strong.