What do you know about Osteoporosis?
It’s a question that should concern all women, men too, as we are all at risk of this condition. Our bones like many other tissues in the body are constantly changing as we grow, mature and age. They go through remodelling, some bits of bone breaks down (osteoclasts) or resorb, other bits form new bone (osteoblasts).
In our 50s (or earlier if you have an early menopause or are low in testosterone for men) the rate of new bone being made slows right down and more is reabsorbed than is made - this creates an imbalance.
Porous bone pretty much describes osteoporosis, because that lovely dense bone you had when growing up is no longer so dense and your risk of fractures after even a slight fall is increased.
“A healthy, balanced diet combined with regular exercise and smart lifestyle choices—such as not smoking and [practising] moderate alcohol intake—helps set the foundation for strong bones as you age,” says Judy Stenmark, CEO of the International Osteoporosis Foundation. “For those at high risk of fracture due to osteoporosis, a bone-healthy diet also supports falls prevention and enhances the benefits of therapy. Stenmark adds that calcium should come primarily through food sources. “Supplements may be beneficial if adequate calcium intake cannot be met through the diet, especially where certain medical conditions exist,” she points out. “Anyone with concerns should speak to their doctor who can advise appropriately.”
BUT WHAT DOES THAT MEAN TO YOU?
I’ve realised how little many of us know about bone health and how it affects us. Especially now with an ageing population and more sedentary lives. It’s really very important that we educate ourselves and particularly young women – although men can get osteoporosis too – about bone health.
HOW DOES BONE FORM?
Between 0 and 30 you are pretty much just making bone. It grows when you are little and in your twenties its gets more dense.
From 30 to 40 its fairly steady BUT from 35 years old onwards you start to slowly and naturally LOSE bone. The rate you lose it begins to increase.
50 onwards – this is where we can be more affected by bone loss. For women post menopause you can lose up to 20% of your bone density in the first 5 to 7 years following menopause because you have lost your oestrogen and that is a major help in keeping your bones strong.
At 65 we catch up with men, their testosterone levels drop more gradually, as by the age of 65 we are both about at the same place.
WHAT IS A BONE BANK?
In a nutshell what you do/did in your teens and twenties will denote how good your bone health is in later life. So squander it at your peril.
All that you eat, your activity levels, heavy drinking, smoking, drugs- all your lifestyle choices will have an impact, good or bad on your bones.
WHY? because a poor diet, alcohol, and the like will take calcium from your bones to bring your body back to 'neutral'. Do that all the time and your bones will never reach their best peak bone density by the time you reach 30.
Sit on the sofa for hours, checking social media, watching box sets, avoiding exercise will also mean your bones will suffer - bones like a bit of stress from exercise, that's how they get stronger and more dense.
WHY DO WOMEN GET OSTEOPOROSIS MORE SO THAN MEN?
Because we go through the menopause. Our sex hormones are pretty important when it comes to bone health.
Low oestrogen and low testosterone can affect our bone density.
Early menopause puts a woman at risk of osteoporosis because you are losing your oestrogen earlier than you should naturally and that's when HRT helps protect bone health.
By the age of 65 men and women are about even in terms of their bone density, however we have a greater loss following the menopause whereas men have a more gradual steady decline of testosterone.
BUT...there are things you can do to help stay stronger longer. Lots of things. It's not all doom and gloom here.
To reduce your risk of osteoporosis, these are common sense tips you can follow.
Get enough calcium. The recommended daily amount for women age 50 and older is 1,200 milligrams (mg), while men should consume 1,000 mg daily up to age 70, and 1,200 mg daily after age 71.
Aim to get as much of your calcium as possible via dietary sources (e.g., milk and dairy products, fortified cereals and juices, leafy green vegetables, and canned fish).
Take a calcium/vitamin D supplement to help make up for any dietary shortfall.
Participate in weight-bearing exercises regularly. Examples include weight training and walking, which help to build bone.
Avoid alcohol or drink it in moderation only. Alcohol can inhibit the absorption of calcium. The current recommendation for older adults is no more than one alcoholic beverage daily.
Stop smoking. Cigarette-smoking is known to raise the risk for osteoporosis.
Go to the National Osteoporosis Society website, they have fantastic resources pages and lots of excellent advice on diet, supplements, the best ones to take and how to take them. It's the very best source of advice and help dealing with this disease.
BONE DENSITY SCANS
HOW DOES KNOWING YOUR BONE DENSITY HELP?
Knowledge is power. When you know what your current T scores are, you can make decisions about your lifestyle and improve it, depending on what you find. If you hit the NICE guidelines (see below) then you could qualify for a DEXA scan via your GP. Or you can self refer to a clinic - I had one done in London at the Orion Imaging Clinic which was very easy to organise, a simple pre scan form to fill in as there are some contra indications for having a Dexa scan. So they just want to make sure you don’t head down there only to discover you can’t have one. It’s £65 through them and done at the height of COVID restrictions and I was very impressed with it.
1.1Consider assessment of fracture risk:
In all women aged 65 years and over and all men aged 75 years and over
in women aged under 65 years and men aged under 75 years in the presence of risk factors, for example:
previous fragility fracture
current use or frequent recent use of oral or systemic glucocorticoids
history of falls
family history of hip fracture
other causes of secondary osteoporosis[7]
low body mass index (BMI) (less than 18.5 kg/m2)
smoking
alcohol intake of more than 14 units per week for men and women.
The Royal Osteoporosis website is a mine of information about all things linked to bone health. There are a variety of publications and leaflets you can download or send off for to help you improve your diet and support your future bone health.
These are comments from clients who have had their bone density tests done and this is what they say.
Would definitely recommend! The scan itself is painless and only takes a few minutes but the information given at the time and the instructions for future preservation will last a lifetime!
As a 44 year old female that has made movement, diet and exercise a priority over my lifetime so far, I decided I'd love to affirm that my hard work over the years had paid off, so booked in for the bone density test. The test was so quick and easy, the process slick and professional. The results, not quite what I was expecting!! How lucky I have been to discover I have Osteopenia. With no family history, no obvious risk factors, coupled with my lifestyle, I would never have thought I could be affected by low bone density at such a young age. It has made me reassess how I exercise, how much alcohol I consume and the balance of key nutrients in my diet. Without this test, I would have been oblivious and there is no doubt I would have ended up with Osteoporosis. I am now working to reverse the condition. A 30 minute appointment has changed my life. Thank you.
A firm believer in prevention is better than cure, I can highly recommend this scan.
I am a fit active 71 year old have exercised in some respect all of my life. I now suffer mildly from Arthritis. My mother had Osteoporosis so thought it a very good idea to get checked. The whole experience was quick and pain free. I was pleased that I hadn't followed my Mother's diagnosis but do have Osteopenia, thanks to working with karen I know that I could do things to improve this even at my age. Thanks for the chance to turn my bone health around.
A bone density scan was something I only thought would be available via my GP so was really pleased to be able to have one. Fortunately I am ‘normal’ for my age but I now intend on making some lifestyle changes to stay this way for as long as possible.