3 million people have it in the UK, causing 500,000 fractures per year. Many of these fractures could be prevented.
So what is osteoporosis? Basically our bone has a core of a sponge-like mineral matrix that is built from roughly 15% water 65% bone mineral and the rest is collagen.
In osteoporosis the holes in the sponge become larger causing the bone to weaken. The bone becomes ‘thinner’, although because it is often without symptoms it has become known as the ‘silent’ disease.
So how do you help to prevent osteoporosis?
Many cases of osteoporosis come from our modern life styles. With projections showing an increase in cases in the future we need to be educating the young and helping the elderly now. The good news is that we can.
By improving the sponge (cancellous) bone we reduce our likelyhood of getting osteoporosis and even to reduce its severity should it be diagnosed.
Our bones are at their densest aged 25 to 30 years, so it is important to ensure we help children and young people develop good bone density.
In children and young people the two most important elements are diet and exercise.
A healthy diet in children should be rich in calcium and vitamin D (particularly in winter). Vitamin D can be found in oily fish, red meat, liver, egg yolk and fortified cereals, or supplements.
Children are advised to do at least 60 minutes of vigorous exercise a day (swim, dance and skateboarding are a few examples), reduce periods of prolonged sitting and do strength exercises. This can include weights, football and gymnastics.
Once we reach peak bone density aged 25-30 years old we need to keep it good for as long as possible.
We divide the risk factors for developing weak bones into modifiable risks (things we can help) and non-modifiable risks. Concentrating on the modifiable risks is very positive and beneficial at any age.
Modifiable Risks
Obviously diet and exercises are a key part of this. Adults need to be targeting at least 2 1/2 hours of moderate exercise (brisk walking) a week. Research has shown that vigorous but non-weight bearing exercise such as swimming will not help bone density.
We also need to keep an eye on the bad habits that sneak in! The most important ones are smoking and alcohol, and being underweight also poses a significant risk.
Early menopause and hormone changes can cause alterations in bone density that your GP or gynaecologist will be able to help you with. The key is to get clear, early and good advice.
Non-Modifiable Risks
These are circumstances beyond our immediate control such as age, sex, body type, genetics and certain types of illness which can predispose us to osteoporosis. However, some common illnesses such as thyroid problems can be treated extremely well by your GP.
One of the first steps to understanding your osteoporosis risk is by talking to a healthcare professional and discussing your health and concerns. They may choose to use a risk calculator such as Frax. Depending on the outcome this would be followed by advice and possible referral for bone density scanning known as a DEXA scan or other tests. This is a fast, cheap, painless and effective diagnostic test.
Diagnosis may be, normal, osteopenia or osteoporosis. Osteopenia is a stage between normal bone density and osteoporosis. Osteopenia can be reversed with good advice, diet and exercise.
Medically there are treatment options but correct diagnosis is crucial. Primary osteoporosis is predominantly triggered by the ageing process whilst secondary osteoporosis can be caused by a disease, medications or lifestyle choices. So treat the cause and the osteoporosis!
Medications that can be used to treat risk of bone fractures include HRT or bisphosphonates (for men and women). These are prescription only drugs and your doctor should discuss them with you if they feel they are appropriate to consider. Oestrogen helps to protect bone density so do make sure you discuss this issue openly and freely with your GP or gynaecologist, especially if you reach an early menopause. Your healthcare professional will understand the issues you are facing in the context of your general health and any other illness or risk factors you may have.
But do get enough calcium. 99% of calcium is in our bones and teeth and we lose some every day in our sweat, hair and urine. We absorb about 15-20% of the calcium we eat, but vitamin D will help us absorb it.
How much calcium do we need? The NHS recommends those aged 19-64 need 700mg of calcium per day (beware different countries have adopted different guidelines.) This should be obtainable from a healthy diet, particularly milk, cheese and dairy, green leafy vegetables (except spinach), soya drinks with added calcium and bread made with fortified flour.
There are also a multitude of supplements designed to help to fortify our bone strength. There are arguments for and against taking these and any decision is best made taking giving consideration to your entire health and discussing it with your medical team.
Plan ahead, exercise smart, eat smart, discuss your concerns with your healthcare professional, and you can enjoy better bone health.
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