By Dr Martie Conradie, MBChB (UP)
Bones. Such a neglected part of our bodies!
When younger, you are much more concerned with your skin and muscles, but as age creeps up, you start realising how important bones are.
Osteoporosis is a disorder of bone which commonly affects women. It is estimated that after the age of 50, one in two women and up to one in four men will break a bone due to osteoporosis. You do not want that one to be you…
There is good news however, you can do a lot to prevent and to treat osteoporosis.
Before looking at these conditions, here are a few facts about bone:
Osteoporosis occurs when the formation of new bone cannot keep up with the loss of old bone. The term “osteoporosis” comes from Latin, meaning “porous bones”. The small spaces in the bone tissue become larger, resulting in less dense bone which makes it weaker and more fragile.
Osteopenia is the term used when you just have a lower bone density than expected. Your bones are not weakened as much as with osteoporosis and treating it can slow down the progression of bone loss.
The amount of bone mass that you have built up while young, can influence how likely you are to develop osteoporosis. The higher your peak was, the more bone you can lose before it becomes significant.
The risk factors that you cannot change include:
The factors that you can do something about, include:
So, those of you who are still young, change the risk factors you can, to increase that peak.
Osteoporosis can worsen if it is not appropriately treated. Bones will get weaker and thinner which will increase the risk of a fracture. It had even been reported that a strong sneeze had resulted in a fracture in a woman with severe osteoporosis!
Bone fractures are a serious complication, and the hip is commonly affected. Hip fractures can result in disability or death. Up to twenty percent of people with a hip fracture die within the first year (often related to pneumonia or blood clots), and nearly 50% are never able to regain their full functional ability.
To diagnose osteoporosis, your doctor will ask you about your medical history, do a physical exam and run some tests of your blood or urine to check for conditions resulting in bone loss.
Your bone mineral density can also be measured, most commonly by dual energy X-ray absorptiometry (DEXA) of the lower back and femur. DEXA uses X-rays to measure the density of bones.
It should be done on all women who are 65 years or older, all men 70 years or older, and on all people with clinical risk factors, especially if they have had a fracture after the age of 40 years.
Osteoporosis and osteopenia can be treated by general practitioners or specialists.
There is no cure, but medications are available to help to slow the breakdown of bone or to stimulate the growth of new bone. Some include: bisphosphonates, oestrogen (which is referred to as hormone therapy) or testosterone (for men). These therapies and their side effects should be discussed in detail before it is started, since many of them increase the risk of cancer, while some cannot be used with other chronic medication.
A comprehensive osteoporosis management program should be followed which includes proper nutrition, exercise and preventing falls.
You and every person can benefit from following these tips to ensure good bone health and it is never too late to start protecting your bones.
Calcium – The amount you need changes during your lifetime with the greatest need in childhood, adolescence, pregnancy and while breastfeeding. Your body also becomes less efficient at absorbing calcium as you age.
Vitamin D – It is required to ensure that calcium is absorbed and to help maintain good bone health. After the age of 70 the intake should be increased.
If you are indoors a lot or cannot spend a lot of time in the sun, a supplement is advised, but should preferably be under advisement from your doctor.
Protein – Low protein intake is associated with an increased hip fracture risk. It is important for maintenance of body tissues, including muscles which support your skeleton.
Food sources should include a variety to ensure all the different amino acids, that your body needs as building blocks, are provided.
Vitamin C – It enhances the absorption of calcium and is often advised to be consumed together.
Sources include fresh fruits, vegetables, and good supplements are available.
Magnesium – It is a mineral which is part of the process of forming healthy bones and it helps to keep calcium inside the bones and prevents it from ending up in your blood vessels or other tissue. Your ability to absorb it decreases with age.
Eating a variety of healthy foods, such as nuts, whole grain bread and dark green vegetables, will usually provide enough.
Good supplements are available, and it is often part of a multivitamin or CalMag. Diarrhoea can occur if you take too much magnesium.
Zinc – It helps the bones stay strong and promotes healing of tissues.
Sources include oysters, avocados, blackberries and dairy products. Many types of cereals or breads are fortified with it, and good supplements are available.
Vitamin K – It helps to prevent excess bone loss and is found in food such as spinach, kale, peas and green beans. Supplementation with vitamin K should only be done if advised by a doctor, since it can be dangerous at high levels and interacts with medication such as warfarin.
You do not have to train for a marathon, but every little bit helps.
Weight-bearing and resistance exercises are what bones really need because it stimulates new bone formation. Your body realises that stronger bones are needed to do these exercises. Combine it with strength training and balance exercises, since these strengthen the muscles which support bones and reduce the risk of falls.
There are exercises that, although healthy for other body systems, will not really strengthen your bones, like swimming.
For people with osteoporosis, preventing falls are of utmost importance.
Some practical tips are:
In your life, you will be exposed to many unhealthy substances, but do whatever possible to avoid those that you are able to. May you all have healthy bones which never fracture, and if they do, may they heal well.
For those interested in reading more about osteoporosis or diets advised for good bone health, the following links can take you to reliable sources:
And for recipes that are good for bone health: