Bone mineral density loss can be a complication of having HIV. This means people living with HIV (PLHIV Person (or people) Living with HIV. This term is now preferred over the older PLWHA.) are at a greater risk of experiencing a bone fracture. Bone loss has been associated with the duration of HIV infection, immune reconstitution on treatment, and treatment with specific anti-HIV drugs which may also affect bone metabolism.
Other interactions are also at play which affect bone fragility in PLHIV such as increasing age (where HIV may also increase the rate of ageing), low body mass index
Whilst the HIV treatment-related and other medical causes of bone loss are best left to discussion between you and your doctor, there are things you can do yourself to prevent bone loss and maintain bone density.
One of the biggest factors for improving bone density is exercise. It is also important to try to quit smoking, limit alcohol (to two drinks per day), eat nutritious foods and get 15 minutes of daily sun exposure to increase your vitamin D levels.
‘So how does exercise help my bones?’ Well, bone density (just like muscle tone) is not static or constant – bone is constantly being built-up and broken down in a cycle process called ‘bone turnover’. Weightbearing exercise and resistance HIV which has mutated and is less susceptible to the effects of one or more anti-HIV drugs is said to be resistant. exercise put a mechanical stress on the bones to bring this cycle into greater balance. When more bone is being lost than can be built back up again — in conditions such as osteoporosis (porous bones) and osteopenia (thinning bones) — this type of exercise can greatly assist to improve bone density.
There are many ways to provide weight and resistance during exercise right in your own home. It’s not necessary to do the heavy iron weights at the gym, especially when you are first starting out.
It’s not always the amount of weight that is important, it’s the degree of resistance.
Whilst lifting heavier weights improves and enhances bone health more than lifting light weights, lighter weights can be moved more rapidly, which is more stimulating to bone than slow movements.
Weights are but one way of providing resistance to create a tension or load upon your bones, but resistance can be achieved in all sorts of ways other than weights.
Water is a form of resistance (although not a strong resistance), so swimming or aqua-aerobics can have some bone-building benefits.
Increasing the amount of resistance will also increase the bone-building benefit.
This can be achieved by using paddles on the ankles and wrist during water-based exercise.
Cycling is another way to apply a resistance load onto bones, although similar principles apply to level of resistance and the benefits gained, e.g., rolling down hills won’t build your bones, but harder cycling up hills will. The more resistance applied, the greater the benefit.
Ankle and wrist lightweights and cuffs (available in most sports stores) can be strapped to your ankles and/or wrists, providing a weight resistance as you exercise. Whether you walk, run, cycle, hike or dance — or whatever you might do for exercise activity — ankle and wrist weights will assist bone health. The old phrase ‘take a weight off your feet’ doesn’t apply to bone health — but putting a weight on your feet does!
Many exercises that strengthen bone can be done at home on your own, or with a partner:
Breathe throughout the exercise, don’t hold your breath as you push.
You don’t have to use heavy weights to build some muscle, since muscle can also be developed with lower weights and resistance exercises, especially muscle tone and shape (rather than muscle size).
Remember: before any exercise it’s important to warm-up by doing gentle muscle stretching, especially during winter when the body is cold. The more rigorous your exercise regimen the more you need to warm-up before exertion during exercise. Otherwise you may tear a muscle or ligament.
It’s also important to warmdown after exercise and this is a similar process of gentle stretching. The warm-up should be about 10-15 minutes and can include running on the spot to get your heart rate up too. The warm-down should be about the same time period, maybe a little less, but decreasing in intensity until your body temperature and heart rate lowers back to normal again.
It’s important to get expert information and professional exercise advice and instruction from a trained fitness instructor or exercise specialist (including physiotherapists). However, as a start the following guidelines are generally recommended for exercise for bone health:
It’s also important to consult your doctor before starting an exercise program, just in case there are special reasons you should only do certain exercises or none at all, due to another current health complaint or issue.
A good song to listen to while you’re exercising is The
Delta Rhythm Boys’ “the hip bone’s connected to your
thigh bone, the thigh bone’s connected to your knee bone. . .”
Or pick your own music!
Young B et.al Increased rates of bone fracture among HIV infected persons in the HIV Outpatient Study (HOPS) compared with the US general population, 2000-2006. Clin Infect Dis 2011 April 15; 52:1061