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Exercise
Exercise encourages muscle and bone growth. Weight bearing exercises such as walking, jogging, and climbing stairs help build bone strength. Aerobic exercise, such as swimming and biking, improve heart and lung function and help clear mucus from the lungs. Resistance exercises, such as using free weights or machines at the gym, encourage muscle and bone to strengthen together. Many sports incorporate both weight bearing and resistance exercises.Nutritional Supplements
Maintaining good nutritional status is important to combat bone loss. Calcium and vitamin D supplements are especially important. Calcium supplements, at least 1000 mg per day, should be in the form of calcium carbonate. Vitamin D supplements may be contained in the calcium formulation. All CF patients need extra vitamin D so that they receive at least 400 IU per day. Vitamin D levels should be checked through blood tests annually.
Sunlight
Exposure to sunlight helps maintain adequate levels of the active form of vitamin D in the body. All it takes is 15 minutes a day. Bisphosphonates
The bisphosphonates (alendronate, ibandronate, risedronate) are a group of medications that work by influencing bone remodeling. Bone remodeling usually involves a continuous cycle of two stages---bone breakdown, or reabsorption, and new bone formation. Bisphosphonates minimize bone reabsorption while continuing bone formation. Bisphosphonates are available in daily and weekly formulations. These medications typically need to be taken first thing in the morning on an empty stomach with an 8-ounce glass of water. After the medication is taken, the patient should remain upright for 30 minutes to an hour.
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