Improving bone health.

It’s important to keep your bones strong and healthy. This helps your growth and well-being. Bones naturally get weaker as we age.

People living with cystic fibrosis (CF) are at greater risk for weak bones. That’s because you often have low levels of bone minerals. These include calcium, phosphorus, magnesium and fluoride. You need these minerals to build strong bones. People with CF also may not be able to absorb nutrients well from their food. They may have chronic inflammation. They may take certain medications for a long time. All of these can make bones weaker.

About 30 percent of people with CF have some form of bone disease.^1,2 The two most common bone diseases are:

• Osteopenia: Low bone mineral density. Your bones are weaker. You’re at risk of getting osteoporosis.
• Osteoporosis: Very low bone mineral density. Your bones are more porous. Weakened bone is brittle. It’s more likely to fracture.

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

• Less absorption of fat-soluble vitamins. This may be due to pancreatic insufficiency.
• Low levels of vitamin D
• Low levels of calcium. It’s often from lower absorption of nutrients.
• Low levels of sex hormones
• Low body weight
• Chronic lung infections
• Lack of exercise, especially weight-bearing
• Long-term steroid use
• Tobacco, alcohol and caffeine use
• Cystic fibrosis-related diabetes (CFRD)

You can do things to help your bones stay healthy and strong.

• Get screened. Check your bone density with a test called dual-energy X-ray absorptiometry (DEXA) scan. All children and adults with CF should be screened every one to five years. People at higher risk of osteoporosis may need to screen more often.
• Take medications for your bones as prescribed by your doctor. Your CF CareTeam or doctor will watch you carefully.
• Get enough calcium. Calcium helps build bones and keep them strong. Children and teens need the most calcium. That’s because bones grow faster early in life. It’s best to get your calcium from food. But you may need to take a calcium supplement, too. Ask your CF CareTeam or dietitian about how much calcium you need in your diet. Talk about foods with more calcium. These include:
  • Yogurt
  • Cheese
  • Milk
  • Fortified soy milk
  • Tofu
  • Salmon
  • Collards
  • Spinach
  • Soybeans
  • Fortified oatmeal
• Exercise. Weight bearing and resistance exercise help build stronger bones. Do exercise like walking, jogging and weightlifting.

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.