 | 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 1 gram 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 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 called reabsorption and new bone formation. Bisphosphonates work to minimize bone reabsorption while continuing bone formation. The effect is to prevent overall bone loss and to promote bone growth. Bisphosphonates are available in daily and weekly formulations. They 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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