Importance of Non-Pharmacologic Interventions in Osteoporosis Management: A Case Series Finding Value in Nutrition and Exercise Counseling by a Fracture Liaison Service
Abstract
BACKGROUND: Bone mineral density (BMD) warrants attention given its role in secondary fracture prevention and pre-surgical optimization in orthopaedic surgery. While fracture liaison services (FLS) offer expertise in the management of osteoporosis medications that are known to increase BMD, these resources further coordinate the prescription of vitamin D supplementation and provide nutritional counseling to include adequate amounts of dietary calcium and protein, along with recommendations of intentional exercise to improve a patient's overall bone health and decrease fall risk. This case series describes patients who experienced increase in bone mineral density with these non-pharmacologic interventions.
METHODS: Retrospective review was performed to identify patients experiencing an increase in BMD on dual-energy x-ray absorptiometry (DXA) scan after presenting to the bone health clinic of a level one academic trauma center since January 2020. Patients prescribed an osteoporosis medication were excluded. Each patient's prior bone health history, comorbidities, prior injuries, DXA data, and laboratory values were recorded. Bone health interventions including nutrition optimization, to include adequate daily dietary intake of calcium and protein, intentional exercise, as well as vitamin D supplementation were noted.
RESULTS: 12 patients experienced an increase in bone mineral density with non-pharmacologic interventions. Average age of the series was 64.8 years (range 51-76…
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