OSTEOPOROSIS – I HAVE A BONE TO PICK WITH YOU

10 November 2020

You’ve probably heard of osteoporosis, a condition that causes your bones to become thinner and weaker than normal. As a result your bones can break more easily from a minor bump or fall.  Make no bones about it (no pun intended), osteoporosis is a condition that we’d all rather avoid.

Osteoporosis affects two thirds of women and a third of men over 60 years of age. While it’s most common in older people, some younger people do develop osteoporosis due to medical conditions, or through taking prescribed medications that cause osteoporosis as a side effect.

What causes Osteoporosis?

You might ask, how do our bones get to this state of weakness and thinning?

Here’s the science part: our bones are made up of two types of living tissue, the thick outer shell known as the cortex (cortical bone) and a strong inner honeycomb mesh known as Trabeculae. These enable our bones to be strong, light weight and to some extent flexible. These properties allow our skeleton to support us in our everyday life (thank you, skeleton!) and endure the demands that we impose on our bodies.

During the early and middle part of our lives old bone is broken down (resorption) and new bone is made (formation), so the bones within our bodies remain strong. Bones are at their most dense in our early 20’s.  As we get older, resorption (bone breakdown) increases and formation of bone decreases - so as a result, our total bone density declines and our bones become more fragile.

It’s most common to sustain a fracture of the spine, wrist, or hips but depending on the severity of osteoporosis, it can also affect bones that normally shouldn’t fracture - like the femur (thigh bone).  Fracturing a bone whilst doing daily routines like getting out of your chair and standing is a sure sign of osteoporosis, and loss of height and highlighted curvature of the spine caused by shattering of bone are also indications.

There are two types of Osteoporosis:

Post-menopausal Osteoporosis
The most common type, where a decrease in oestrogen and an increase in bone resorption combine to make our bones more fragile.
 
Senile Osteoporosis
It’s believed that in later life osteoblasts (the cells that form new bone) lose the ability to reform, while the osteoclasts (the cells that absorb bone tissue) keep going without a care in the world.
The interesting thing about osteoporosis is that you may not know that you have it until it’s too late, unless you book yourself in for a Dexa scan. Dexa stands for Dual-Energy X-ray Absorptiometry, and it’s a painless procedure used to measure bone density.

Common factors that increase loss of bone mass and risk of osteoporosis are:

●       Low oestrogen (which usually occurs after menopause)

●       Low calcium

●       Alcohol consumption (more than the required daily intake – easy there Grandma & Grandpa!!)

●       Smoking

●       Drugs like glucocorticoids, which decrease calcium absorption from the gut

●       Physical inactivity

Medical conditions that are prone to contract osteoporosis include:

●       Turners Syndrome

●       Crohn’s Disease

●       Vitamin D Deficiency

●       Rheumatoid arthritis

●       Low sex hormone levels (testosterone)

●       Early menopause (before 45 years)

●       Being underweight

And some of us, unfortunately, just inherit it.

How can we reduce the likelihood of Osteoporosis?

To reduce and prevent the likelihood of fractures in our bones as we get older, there are four main prevention factors to consider:

●       Nutrition

●       Staying active

●       Injury prevention

●       Looking after yourself

 

Nutrition

To maintain strong bone tissue as we get older, your intake of Calcium and Vitamin D will help decrease the onset of osteoporosis. There’s fierce debate around how much Calcium should be taken daily: some sources suggest 500mg/day (that’s two servings of dairy products), while the experts recommend 1000mg/day. For the average Joe Bloggs, finding the right recommendations can be quite confusing and consuming 1000mg/day is quite a lot. Taking supplements will help you to reach the higher end of that daily intake - but having said that, taking 500mg/day is enough.

The best source of Vitamin D is the sun! You can consume Vitamin D through supplements, but nothing’s better than getting outside and exposing your skin for 30 minutes to the sun’s rays. It also gives you that ‘feel good’ factor.

Staying Active

Exercise helps to maintain bone density and strengthen muscles in your body; especially in your legs, which help you to maintain your balance and prevent falls. Weight-bearing exercises such as walking and jogging are a good start, and exercises using weights are even better as we are creating a greater force to fight with gravity.

Try to be active for 30 minutes each day. If that sounds challenging, remember that it’s only a tiny fraction of the 1440 minutes in each day… so get out there!

Looking after yourself

When it comes to looking after yourself, it’s all about leading a healthy and balanced life. Eat well, exercise regularly, eat foods high in calcium, limit alcohol, and spend 30 minutes outside every day – in fact if you exercise outside you can kill two birds with one stone! If you smoke, try to give up.

Injury prevention

As you get older, make your home safe from hazards and reduce the risk of falling. Ensure rooms are not cluttered, use supportive frames on stairwells, have good lighting in every room, keep the house warm in winter and don’t move heavy furniture by yourself.

 

In conclusion, while osteoporosis is primarily known as an ‘old person’s condition’ our younger selves shouldn’t take our bone density for granted. Osteoporosis can impose itself on anyone - BUT by reducing and preventing the likelihood of osteoporosis, we’re setting ourselves up for a great life in our twilight years: a life which is healthy, fulfilled and unbreakable.

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References

https://osteoporosis.org.nz/resources/health-professionals/clinical-standards-for-fls/

https://www.healthnavigator.org.nz/health-a-z/o/osteoporosis/

https://www.health.govt.nz/your-health/conditions-and-treatments/diseases-and-illnesses/osteoporosis

https://www.eu-patient.eu/Members/The-EPF-Members/Full-Membership/International-Osteoporosis-Foundation-IOF/