In the UK over 3 million people have osteoporosis. Over 500,000 have hospital treatment for fragility fractures related to osteoporosis. Our genes determine our height and skeleton type but our bone health is related to our lifestyle choices over many years. Reduction in bone mass is a normal part of the ageing process - but it does not have to be. Women are at greater risk than men. The reduction of oestrogen following menopause causes women to lose bone mass more quickly for the few years after menopause. Women who experience early menopause (before 45 years of age) or who have had their ovaries removed are at greater risk. Younger women, children and men may still have osteoporosis. In the UK over 1/3 women and 1/5 men will have a fragility fracture in their lifetime and at age 75-84 the 10 year risk for having a fragility fracture is 24% women and 14% men.
Osteopenia
is the stage of bone thinning before osteoporosis. Osteopenia does not necessarily lead to osteoporosis and your doctor may prescribe bone strengthening treatments to prevent further bone loss.
Osteoporosis
is a combination of bone mass and bone quality reduction. As bones weaken the risk of fracture increases. The first time people may suspect osteoporosis is following a pain caused by a bone fracture, which can be the result of a low impact injury. Fractures to the wrist, neck of femur (part of the thigh bone that forms the hip joint) and spine (vertebrae) are common. Ribs, pelvic bones and arms are also seen frequently. Older adults may have a forward bent over or stooped posture that can indicate fractures of the spine (vertebrae).
There are many factors that increase the risk of osteoporosis:
1. taking high-dose steroid tablets for more than 3 months
2 medical conditions – such as inflammatory conditions, such as rheumatoid arthritis, or malabsorption problem such as coeliac disease
3. family history of osteoporosis – particularly a hip fracture in a parent
4. long-term use of certain medicines that can affect bone strength or hormone levels, such as anti-oestrogen tablets that many women take after breast cancer
5. having or having had an eating disorder such as anorexia or bulimia
6. having a low body mass index (BMI)
7. not exercising regularly
8 heavy drinking
9. smoking
10. absent periods for 6 months or more caused by over exercising or over dieting
11. low testosterone levels in men
12. overactive thyroid gland
13. disorders of the adrenal glands, such as Cushing's syndrome
14. disorders of the pituitary gland
15. overactivity of the parathyroid glands
16. long periods of inactivity or bed rest
You can find out if you are at risk of osteoporosis by doing the Royal Osteoporosis Society's online test https://stopatone.theros.org.uk/
How to help your bones stay healthy
Diet -
ensure you have plenty of....
1. Calcium found in milk, cheese and other dairy foods, green leafy vegetables – such as curly kale, okra and spinach, soya drinks with added calcium, bread and anything made with fortified flour, fish where you eat the bones – such as sardines and pilchards
2. Vitamin D From about late March/early April to the end of September, most people should be able to get all the vitamin D they need from sunlight. The body creates vitamin D from direct sunlight on the skin when outdoors. However, between October and early March we do not get enough vitamin D from sunlight.
Vitamin D is also found in a small number of foods including oily fish – such as salmon, sardines, herring and mackerel, red meat, liver, egg yolks, fortified foods – such as some fat spreads and breakfast cereals. Another source of vitamin D is dietary supplements.
Exercise
The Royal Osteoporosis Society say that after a diagnosis of osteoporosis or if you have risk factors, you should do more exercise, rather than less. Being physically active and exercising helps you in so many ways, and is very unlikely to cause a broken bone. If you have spinal fractures or lots of other broken bones, you may need to modify some exercises to be on the safe side.There are three ways that exercise and safe movement help with bone health and osteoporosis:
Promote bone and muscle strength
Keep you steady
Care for your back
What types of exercise do I need to do for my bones?
Bones stay strong if you give them work to do. For exercise to be most effective at keeping bones strong you need to combine weight-bearing exercise with impact and muscle strengthening exercise. Variety is good for bones, which you can achieve with different movements, directions and speeds - in an activity like dancing for example. Short bursts of activity may be best, such as running followed by a jog, or jogging followed by a walk.
What is weight-bearing exercise with ‘impact’?
You are weight bearing when you are standing, with the weight of your whole body pulling down on your skeleton. Weight bearing exercise with impact involves being on your feet and adding an additional force or jolt through your skeleton – anything from walking to star jumps.
You can get weight bearing exercise with impact by taking part in some physical activity, sports or by doing specific exercises. Depending on what activity you do, the level of impact will vary. The following will help you to understand the difference between low,moderate and high impact exercise:
Low impact
Walks, Brisk walking Marching Stair climbing Gentle heel drops Stamping
Moderate impact
Highland dancing Jogging or running Team & racket sports Skipping & hopping Low level jumping Stamping
High Impact
Basketball Volleyball Track events Star jumps Tuck jumps High level jumps
More physical activity information from the Royal Society of Osteoporosis can be found on their website www.theros.org.uk