What can men do to improve their bone density?

From the Guidelines

Men can improve their bone density through a combination of regular weight-bearing exercise, adequate calcium and vitamin D intake, and healthy lifestyle choices, as recommended by the most recent evidence-based guideline for the management of osteoporosis in men 1. To achieve this, men should:

• Engage in weight-bearing exercises like walking, jogging, weightlifting, and resistance training for at least 30 minutes, 3-4 times weekly
• Consume 1,000-1,200 mg of calcium daily through dairy products, leafy greens, fortified foods, or supplements if needed
• Get 600-800 IU of vitamin D daily through sunlight exposure, fatty fish, fortified foods, or supplements
• Limit alcohol consumption to no more than two drinks daily and avoid smoking, as both can decrease bone density Some key points to consider:
• For men with low testosterone, hormone replacement therapy might be recommended by a doctor, as testosterone helps maintain bone mass 1
• Men with osteoporosis may be prescribed medications like bisphosphonates (alendronate, risedronate), which slow bone loss 1
• Regular bone density screenings are important, especially for men over 70 or those with risk factors like family history, long-term steroid use, or certain medical conditions 1 It is essential to note that these recommendations should be taken as a whole, and not in isolation, and that the assessment of fracture risk using FRAX is crucial in determining the appropriate treatment approach 1.

From the FDA Drug Label

1. 2 Treatment to Increase Bone Mass in Men with Osteoporosis Prolia is indicated for treatment to increase bone mass in men with osteoporosis at high risk for fracture, defined as a history of osteoporotic fracture, or multiple risk factors for fracture; or patients who have failed or are intolerant to other available osteoporosis therapy

2.3 Recommended Dosage All patients should receive calcium 1000 mg daily and at least 400 IU vitamin D daily

To improve bone density, men can consider the following:

• Calcium supplementation: 1000 mg daily
• Vitamin D supplementation: at least 400 IU daily
• Treatment with denosumab (Prolia): for men with osteoporosis at high risk for fracture, as indicated by a healthcare provider 2

From the Research

Improving Bone Density in Men

To improve bone density, men can consider the following options:

• Lifestyle changes, such as adequate calcium and vitamin D intake, and exercise programs 3
• Weight-bearing and resistance-training exercise to build bone and reduce bone breakdown 4
• A balanced diet with optimal protein and calcium intake, and vitamin D sufficiency 5
• Avoidance of smoking and excessive alcohol intake 4
• Fall prevention to reduce the risk of fractures 4

Nutrition and Bone Health

Adequate nutrition is essential for maintaining bone health:

• A balanced diet including minerals, protein, and fruit and vegetables can help prevent fragility fractures 5
• Dairy products are a valuable source of calcium and protein, and can help reduce hip fracture risk 5
• A Mediterranean diet or a prudent diet can also help reduce fracture risk 5

Treatment Options

Men with osteoporosis can consider the following treatment options:

• Bisphosphonates, which can increase bone mineral density (BMD) and reduce osteoporotic-related fractures 3, 6, 7
• Denosumab, teriparatide, and other anabolic agents, which can also increase BMD and reduce fracture risk 3, 6, 7
• Pharmacologic therapy, which should be based on safety, cost, convenience, and other patient-related factors 7