Bone Health: Understanding and preventing osteoporosis

Without healthy bones, you wouldn’t be able to stand, sit, walk, run, or dance. Yet most of us take our bone health for granted.

When you consider the importance of the skeletal system, taking extra care of your bone density is crucial.

What is osteoporosis?

Osteoporosis and low bone mass are currently estimated to be a major public health threat across the globe. Osteoporosis occurs when bones deteriorate, becoming weak and brittle. 

When we're young, our bones are made faster than they break down, so we have a high bone density. Around the age of 25 our bone mass levels off. Once we reach 35, our bone mass slowly starts to decline. Bones then become brittle, putting us at greater risk of bone fractures, breaks and compressions.

Spinal or vertebral fractures also have serious consequences, including loss of height, severe back pain, and deformity. "Compression" fractures are caused when weakened bones in the spine collapse, causing severe back pain. When several of these bones collapse we can experience loss of height or stooped posture, where the top of the back appears more rounded than normal.

Potential causes

Women are more prone to osteoporosis as their oestrogen levels diminish during the menopause. Oestrogen is a hormone that is essential for healthy bones.

There are some factors that can be controlled or prevented such as increasing physical activity, cutting down on alcohol and tobacco, and increasing sunlight exposure.

Warning signs

Osteoporosis is sometimes called the “silent thief,” because most people don't know they're affected until experiencing one of the following signs:

• Back pain.
• Loss of height and stooped posture caused by compression of vertebrae.
• Broken bones or fractures caused from minor accidents or falls that would not cause problems in someone without osteoporosis.

Danger zone

Though the disease can strike anyone at any age there are some factors that increase risk. You should be tested for osteoporosis if you:

• Are over 65.
• Have experienced a fracture after age 40.
• Come from a family with a history of osteoporosis.
• Are a post-menopausal woman.
• Have medical conditions associated with osteoporosis such as hyperthyroidism or rheumatoid arthritis - raise this with your GP.
• Experience low bone mass.
• Have a thin, small, or frail frame.
• Drink alcohol excessively, smoke or have a sedentary lifestyle.

Testing and treatments

Doctors use the Bone Mineral Density (BMD) test—a painless and accurate measure of bone mass—to look for osteoporosis. Not only will it tell you if you have osteoporosis, but it can also predict the likelihood you’ll develop the disease. Another common test is the heel ultrasound. Your heel is submerged in water and high frequency sound waves detect bone density. This test is quick and easy, and is usually followed by a BMD when low density is found.

Once you’ve been diagnosed with osteoporosis, you and your health care professional will need to work out the best course of action: one that suits your condition, lifestyle and that can help prevent further bone density loss.

Prevention

After age 35, you can't stop bone mass from decreasing, but you can minimise the loss. Follow these steps to keep your resolve and skeleton strong:

Eat well. A diet high in calcium and Vitamin D is vital to maintain healthy, strong bones. Vitamin D is found in cod liver oil, salmon, cheese, fortified beverages, and egg yolk. On the calcium front, research shows the average person aged 19-50 needs 1,000 mg of calcium a day while those over 50 need 1,500 mg. Food’s rich in calcium include milk, yogurt, and broccoli. If you are vegan, you can take supplements or fortified products with added vitamin D.

Exercise regularly. Anything that pits gravity against your body weight strengthens your bones. Weight-bearing exercises are the most beneficial so try walking, running, dancing, or lifting weights. By exercising you also attain better balance and muscle strength which decreases the risk of falling. Not only do you benefit your body, but also your mind: studies show exercise helps to relieve symptoms of depression and stress, which are believed to interfere with calcium absorption. Talk to your doctor about regular exercise that is right for you.

Butt out. Smoking increases bone loss. It prevents the bones from absorbing calcium and in women, slows the amount of oestrogen the body produces.

Avoid alcohol and caffeine. Caffeine and alcohol, like smoking, prevent the body from taking in calcium. Studies suggest alcohol also decreases bone formation. If you must consume alcohol or caffeine, keep your consumption to a minimum of no more than two drinks or cups of coffee a day.

Stress less. When you experience a great deal of stress—especially for prolonged periods of time—the body sucks calcium from your bones. Stress also increases harmful habits such as smoking, drinking alcohol and overloading on coffee, all of which reduce calcium stores. Once the calcium is gone, the body doesn't replace it. Learn to manage stress by creating healthy relationships, taking time for yourself and creating a realistic schedule to avoid hectic situations. Activities you enjoy such as cycling, gardening, or painting can also help you nourish you mind, body and soul.

Deal with depression. Studies show that people who experience depression lose excess bone mass. This may be because the stress hormone cortisol is more prevalent, or because of poor nutrition during depressed periods. If you suspect that you are experiencing depression, speak to a professional immediately. There are many treatment options available such as exercise, psychotherapy, and medication that can help you better cope with depression.

Manage pain. Chronic pain is common with osteoporosis after a fracture has healed. This pain interferes with normal life and ranges from bothersome to crippling. Learn to relax through breathing exercises, biofeedback—a therapy that teaches you to control body functions and relieve pain—meditation or gentle exercises like yoga. These can all help release tension and ease aches and pains.

Hormone therapy replacement (HRT) HRT at menopause replaces lost oestrogen. Given that oestrogen loss is a key factor in osteoporosis, HRT can help to prevent the condition. Oestrogen can also be used to reduce the number of fractures in people who are already suffering from osteoporosis. Consult your doctor for more information on HRT.

Seek support. Whether it’s sharing the ups and downs of osteoporosis, or swapping suggestions on how to manage your condition, support groups are a great place to find assistance.

Though osteoporosis can sneak up on you, arming yourself with knowledge and a healthy lifestyle is the best way to shut out the silent thief. Be aware of signs related to the condition, commit to getting proper nutrition and exercise and you’ll keep your frame standing strong and tall for years to come.

This information is provided to supplement the care provided by your GP or mental health professional, and is not to be used as a substitute for professional medical advice. Always seek the advice of your GP or another qualified health or mental health professional if you have questions about a medical condition or plan of treatment.