This week, Sally takes a look at osteoporosis and offers some tips and advice on keeping your bones strong and healthy!
Did you know that almost one in two women and one in five men over the age of 50 will break a bone, mainly due to poor bone health such as osteoporosis? Don’t want to be part of that worrying statistic? Then read on.
Firstly, what is osteoporosis?
Osteoporosis is also known as thinning of your bones. Our bones are made up of a protein (collagen) as well as calcium and other minerals. Together, these form the structure of the bone – a thick outer shell, surrounding a honeycomb-like inner. Osteoporosis occurs when the outer shell or the struts of the honeycomb become thinned. Unfortunately, our bones get thinner naturally as we become older – in fact, by the age of 75, up to half of women will have osteoporosis… essentially, the thinning of our bones causes them to become fragile and, as a result, break more easily.
What problems can it cause?
Osteoporosis in itself does not cause any problems but it can increase the chance of breaking (fracturing) a bone. About 1 in 3 women break their hip at some time in their lives – and we have all seen older people become shorter and stooped due to partial collapse of weak bones in their spines. Broken arms or wrists from minor falls can also occur from osteoporosis and may give an early warning of further fractures to come. Although these fractures often heal without problem, repeated fractures can lead to other problems – with some people losing their confidence and even independence as a result. Not something to look forward to in later life!
What causes osteoporosis?
Aside from the normal ageing process, a few things can increase our risk of osteoporosis:
• Menopause – Falling oestrogen levels are the biggest contributor to osteoporosis – which is why women are more susceptible.
• Low hormone levels for other reasons – For women, removal of ovaries, anorexia nervosa or taking drugs for breast cancer may affect hormone levels and increase risk. In men, low levels of testosterone after surgery or treatment for some cancers can also increase the risk.
• Genetics – If one of your parents has broken a hip, you are more likely to have a fracture yourself.
• Race – Black Afro Caribbeans tend to have bigger, stronger bones so are at lower risk than those of Caucasian or Asian origin.
• Low body weight – If you have low BMI, i.e below 19kg/m2, you are at greater risk of developing osteoporosis and fractures.
• Illness – Other health conditions such as Crohn’s or coeliac disease (which affect how well you absorb your food and nutrients), or rheumatoid arthritis, hyperthyroidism or hyperparathyroidism can also increase our risk.
• Medication – Certain drugs such as steroids, drugs for epilepsy or mental health problems may also cause bone thinning if taken for long periods of time.
What can we do?
The good news is that the sort of things we need to do to reduce the risk of osteoporosis are simply habits we need to get into to help our health in many ways. The key is to build up your ‘bone bank’…invest in making sure your bone is as strong and dense as possible so that the natural ageing process has less effect. How?
• Healthy eating – Ensure you have a balanced diet containing plenty of vitamins, minerals and other nutrients that your bones need. Aim to eat plenty of fruit and veg, wholegrain, unprocessed carbohydrates, milk and dairy products, and protein such as meat, fish, eggs, pulses, nuts and seeds.
• Calcium – Have plenty of calcium, which is essential for strong teeth and bones. Whilst a varied diet should provide enough calcium, some may benefit from supplements. Recommended dose is 700mg per day, or 1,000mg a day for those with established osteoporosis – but don’t overdo it as too much calcium can cause other problems.
• Vitamin D – Vitamin D is essential to help your body absorb calcium. We make vitamin D ourselves when our skin is exposed to sunlight – and so over 1/3 of us are vitamin D deficient in the winter months. We can get vitamin D from our diet if we eat plenty of oily fish, but in winter, supplements may be beneficial.
• Get moving – The more force we put through our bones, the stronger they become. Try to incorporate 30 minutes of activity like jogging, skipping, aerobics, tennis, and dancing five times a week into your life. Nordic walking or similar is great for a lower impact, but still effective, exercise that helps upper body too. Not only will it be good for your bones but also for your general health, weight and well-being.
• Stop smoking – Yet another reason to bin the evil fags is the fact that smoking poisons the cells that are trying to replace the old bone structure with fresh and strong bone – so your bones become weaker and weaker.
• Steady on the alcohol – Drinking above recommended limits significantly increases the risk of breaking bones…and not just because you are less steady on your feet, but because your bones are much weaker too.
I am worried I may be at risk of osteoporosis – what should I do?
You may want to check your risk using this recognised scoring system. If you are still concerned, the first thing to do is address all possible lifestyle issues – which may be sufficient in themselves to prevent you breaking a bone in the future. However, if you think you are at particularly high risk, or have had a previous low-impact fracture, then talk to your GP. He or she can assess you further and may refer you for a DEXA scan which measures the density of your bone and therefore helps determine your risk of having fractures in the future.
Is there any treatment?
Don’t worry – it’s not all doom and gloom, as there are lots of things that be done to help! The lifestyle measures are very important – but if you are at high risk, then your doctor may recommend physiotherapy and medication to strengthen bones and joints as they can reduce fracture risk by about 50%. Replacement of different hormones may be appropriate in some cases and vitamin D and calcium supplements are also useful.
For more information and support, check out the National Osteoporosis Society website.