How did you do on the Bone Health IQ Test in last week's blog (5/13)? If it raised your awareness of your personal risk for developing osteoporosis, you get a gold star! Here are the answers to the questions:

1. Primary risk factors for osteoporosis include gender and age.

True: Being female and of older age are two top risk factors.

2. Osteoporosis is an inevitable part of the aging process. All women in their 80s have this disease.

False: While it true that osteoporosis becomes more common with age, it is not true that every older person gets it. About half of women in their 80s have it.

3. Prolonged low estrogen levels – such as those seen in young women who exercise or diet excessively and in postmenopausal women – may cause irreversible bone loss.

True: In women, the sex hormone estrogen protects bones. Low estrogen at an early age is just as damaging to the bones as low estrogen after menopause. You may never be able to recoup the lost bone.

4) Sedentary individuals in general have less bone mass than exercising individuals.

True: People who are bedridden, are inactive or do not exercise are at high risk for osteoporosis.

5. It’s normal to lose height with age, so don't be alarmed if you're shrinking.

False: Loss of height of more than one inch is cause for concern. Vertebral fractures can cause height loss and when there is no pain, you may not be aware that you have them.

6. Thin women with small frames are less likely to develop fractures from osteoporosis because their bones are not stressed by excess weight.

False: Small, thin bones are more fragile and vulnerable to fracture.

7. Peak bone mass, which is achieved by age 30, is a significant determinant for risk of fracture over the lifetime.

True: Peak bone mass is the point at which you have the greatest amount of bone you'll ever have. From this time on, you begin to lose bone very gradually. More "bone in the bank" means better protection once bone loss begins.

8. You should have a bone density test if you are 50 or older and have broken a bone in a minor injury.

True: You can't feel your bones growing weaker. Often, breaking a bone is the first clue that you have osteoporosis.

9. Calcium and appropriate exercise are both important for bone health. If you are calcium deficient, you can compensate by exercising harder.

False: Calcium and exercise have an additive effect on bone. Exercise stimulates new bone growth and calcium mineralizes the new bone.

10. If you are diagnosed with osteoporosis, you should immediately begin doing vigorous exercise, pushing yourself to your point of tolerance.

False: If you’ve been diagnosed, you want to protect the spine and avoid falls. Switch to low impact activities (walking, elliptical, cross country ski, etc.) and lift lighter weights with higher repetitions. Balance training is important for fall prevention.

LISTEN LIVE: Joan Pagano on Rehabilitative Medicine Show with host Dr. Jonathan Whiteson

DATE: Monday, May 20
TIME: 7-8 am ET
LOCATION: Sirius XM Radio Channel.81

CALL-IN NUMBER: 877-NYU-DOCS

Angelina Jolie made headlines with her brave announcement of having a preventive double mastectomy to preserve her health. Studies show that exercise can also help prevent breast cancer, lower a chance of recurrence and serve as a form of treatment during recovery.

Tune in to hear Joan Pagano's live interview on exercise and breast cancer. Get answers to your questions from a seasoned fitness professional with 20 years experience working with breast cancer survivors.

• How much exercise do you need to protect against breast cancer?
• What types of exercise can you do during/after breast cancer treatment?
• Safety guidelines for stretching and strengthening after a mastectomy/reconstruction.

Call in with questions/comments: 877-NYU-DOCS

A study conducted by the National Osteoporosis Foundation revealed that most women over the age of 45 fail to recognize their personal risk for developing osteoporosis, the disease of "porous bones." Even though the majority of women have at least two risk factors for the disease by this age, they do not perceive themselves to be personally at risk.

In order to bridge the gap between perception and reality, take this True/False quiz to boost your bone health IQ. The answers will appear next week in this blog.

1. Primary risk factors for osteoporosis include gender and age.
2. Osteoporosis is an inevitable part of the aging process. All women in their 80s have this disease.
3. Prolonged low estrogen levels – such as those seen in young women who exercise or diet excessively and in postmenopausal women – may cause irreversible bone loss.
4. Sedentary individuals in general have less bone mass than exercising individuals.
5. It’s normal to lose height with age, so don't be alarmed if you're shrinking.
6. Thin women with small frames are less likely to develop fractures from osteoporosis because their bones are not stressed by excess weight.
7. Peak bone mass, which is achieved by age 30, is a significant determinant for risk of fracture over the lifetime.
8. You should have a bone density test if you are 50 or older and have broken a bone in a minor injury.
9. Calcium and appropriate exercise are both important for bone health. If you are calcium deficient, you can compensate by exercising harder.
10. If you are diagnosed with osteoporosis, you should immediately begin doing vigorous exercise, pushing yourself to your point of tolerance.

Tune in next week for the answers!

Recent studies offer encouraging news for those of us afraid of losing our mental edge with age.

Research shows that exercise – any exercise – has a profound effect on overall cognitive function. Beyond merely stemming memory loss, exercise targets different aspects of cognition to improve recall.

One study recruited women ages 70 to 80 who had mild cognitive impairment, making memory and thinking more muddled than would be expected at a given age. Seniors with this condition develop Alzheimer's disease at higher rates than normal. The women were divided into groups assigned to walking, weight lifting and stretching. After six months, the women who stretched scored worse on memory tests; but the women who exercised in both of the other two groups scored better. While the different types of exercise may have different effects in the brain, they both cause improvement in memory.

Another study examined the effect of exercise on patients with heart failure, because those patients are at high risk of memory loss and other thinking skills. Since the heart is not pumping enough blood to the body, the brain is not getting enough either. A cardiac rehab program that incorporated exercise reversed memory loss.

Finally, for those of us whose brains are simply fried by environmental stresses there's more good news from a study that looked at the cognitive impact of green spaces. A simple walk in the park refreshes the brain by providing relief from constant noise and hectic nerve-wracking demands of city living. The human brain's ability to stay calm and focused is limited and can be overwhelmed with external stimulation, causing it to become distracted, forgetful and mentally flighty. Natural environments engage the brain with effortless attention, allowing for reflection.

To stay mentally sharp, schedule time out for a walk in the park! It's productive therapy for your best thinking.

Calcium supplements are in the news because of conflicting results of several major studies and recommendations by the US Preventive Services Task Force. The varying conclusions of researchers showed inconsistent findings, putting into question the benefits of supplements containing calcium to prevent bone loss.

The studies' conclusions ranged widely, finding that calcium pills:

• Increase the risk of heart attack by as much as 30%
• Decrease the risk of hip fracture by 35% in post-menopausal women with no increase in heart attack
• Increase the risk of heart attack by 20% in men (who smoke), but not in women (in men and women aged 50-71).
• Do not prevent bone fractures and may increase the risk of kidney stones

What do experts draw from this controversy? First, that better studies are needed to clarify the possible risks and benefits and to whom they may apply. Secondly, that the safest and most effective source of calcium is found in food choices, not supplements. And finally that exercise is key to bone health, specifically weight bearing and strength training exercises.

Like muscles, your bones get stronger when you make them work, training them to handle more stress or resistance. Exercise should maximize the load to the bones with a progressive (i.e. gradual intensification) program of weight bearing aerobic exercise and weight lifting. Assuming your joints are healthy, you should aim for:

• High impact aerobic exercise: defined as activities in which both feet are off the ground at the same time, as in running, jumping rope, and high-impact aerobic dance; also sports like basketball, volleyball and gymnastics.
• High intensity weight lifting: using the heaviest weights you can lift in good form for 8-12 repetitions with the last few reps being challenging.
• Balance and stabilization exercises: using a stability ball, BOSU and foam rollers, which recruit the muscles of the core body as you master unstable surfaces. Improving your balance reduces your risk of falling.

Remember: To protect your joints from injury, use good judgment regarding high impact exercise and high intensity weight lifting. Be sure to increase the workload gradually.

If you've already been diagnosed with osteoporosis, downshift into low impact exercise to avoid jarring the spine and other vulnerable joints. The National Osteoporosis Foundation maintains that the benefits of calcium supplements are likely to outweigh any risks in women over 50 who have osteoporosis, broken bones or significant risk factors for fractures.

Of course, this information should not take the place of guidance from your own physician or other medical professional. Always consult with your doctor before beginning an exercise program or becoming much more physically active.

Have you ever considered how fitness training could be beneficial to your skills as a driver? According to a new study, simple exercises can enhance your ability to drive, keep you safe on the road, and extend the years that you are able to drive.

The Hartford Center for Mature Market Excellence and the MIT AgeLab found some fascinating results in their research on the connection between daily exercise and driving. Drivers in the study reported benefiting from some of the most challenging physical aspects of driving:

• Greater ease in turning their heads to see blind spots when changing lanes or backing up;
• More rotation in their torsos to scan the driving environment when making right hand turns;
• Increased ability to get into their cars more rapidly.

The participants ranged in age from 60-74. They followed an exercise program for 15-20 minutes a day over eight-to 10 weeks which focused on four areas:

• Strength training to strengthen the legs for using the floor pedals and the upper body for controlling the steering wheel. Here's a great exercise to improve lower leg strength and flexibility.
• Range of motion for movements like turning your head and putting on your seat belt. Check out this video for simple limbering exercises that will help.
• Flexibility exercises to keep your movements fluid and more agile, able to get in and out of the car with greater ease and speed. These full-body stretches will help.
• Coordination exercises to improve integration of upper and lower body movements, such as when you have to simultaneously brake and turn. Combine upper and lower body moves in one exercise, think squat with a biceps curl or a side lunge with a shoulder raise.

If you include these types of exercises in your training program, you will surely have new confidence next time you need to parallel park!