It’s never too soon (or too late) to start thinking about your bone health. Making the right diet and exercise choices now can protect against fractures later in life.
It’s easy to assume that osteoporosis only affects other (more fragile) people, but 1 in 2 women and 1 in 5 men over 50 in the UK will break a bone, mainly due to poor bone health. With around 3 million people suffering from osteoporosis (sometimes called brittle bone disease), the condition occurs when the strength of bones – declines, with the result that they become weaker and more likely to break under fairly minimal pressure, such as a fall.
The problem is that you probably won’t know your bone density has declined until you suffer a fracture. Breaks of the wrist, hip and spine are the most common and these can be debilitating, particularly if you’re also coping with other medical conditions or are elderly. A hip fracture, for example, can mean a long hospital stay and possible loss of independence.
Osteoporosis doesn’t happen overnight, though. In fact, the diet and exercise choices you make throughout your life will have a bearing on your risk once you hit middle age. So it’s important to think about your bone health at every age, and it’s also good to know it’s never too late to take action to improve it.
WHY DO OUR BONES DETERIORATE?
Specialist cells called osteoclasts break down the old, worn-out bone tissue, while other cells, known osteoblasts, build new tissue. Until your mid-30’s, the process is balanced -in other words, new bone tissue is laid down at about the same rate as the old tissue is broken down. So the amount of bone tissue you have remains steady and your bone density, or strength, is stable.
As you get older, however, bone starts to break down faster than it can be repaired and restored. Anyone can, of course, break a bone under extreme pressure, but it’s this reduction in bone strength that explains why it’s more common for people over the age of 50 to have a fracture more easily.
ARE YOU AT RISK?
Some of us are at higher risk of having a fracture as a result of osteoporosis, explains Julia Thomson, an osteoporosis nurse with National Osteoporosis Society. For example, in women, the process is accelerated in the years after the menopause, when the bone-protective effects of the hormone oestrogen are lost.
It’s a good idea to speak to your GP if you have any of the following risk factors:
- A family history of osteoporosis: If a parent or grandparent had a hip fracture – even when elderly – it can be a sign of osteoporosis and may mean you’re at greater risk. And shrinking in height isn’t just an inevitable consequence of ageing – it suggests vertebral compression fractures as a result of weak bones. So, if a parent or grandparent became smaller in old age, it could be a sign that you have a family history of osteoporosis.
- Use of certain medications: Aromatase inhibitors for breast cancer, proton pump inhibitor for heartburn and oral corticosteroids for asthma are all linked with a decline in bone density. Asthma inhalers aren’t as big an issue, however, because less medicine is absorbed into the system when taken through inhalers.
- A history of anorexia: Dieting and poor nutrition in childhood and adolescence can store up problems later. But the most serious risk factor is having had anorexia that actually caused your periods to stop, because you may have missed out on oestrogen for a time.
- Certain medical conditions: which are linked with an increased risk of osteoporosis. These include rheumatoid arthritis, hyperthyroidism, conditions that affect the absorption of nutrients such as coeliac disease or Crohn’s disease, and conditions that result in long periods of immobility. An early menopause or hysterectomy also means a reduction in oestrogen at an earlier age, which increases the risk.
- A history of exercising excessively: while weight-bearing exercise helps to keep bones strong (see later in the blog), excessive exercising can reduce hormone levels, which increases the risk.
YOUR BONE PROTECTION PLAN
Your diet and lifestyle play a key role in helping to ward off osteoporosis. Here’s how to give yourself the best chance
FOCUS ON CALCIUM
This mineral is a must for healthy bones. We all have individual calcium needs depending on our age, gender and life stage. For example, you need more when you’re breastfeeding. The nutrient reference value (NRV) for calcium, which you’ll see on food labels, is 800mg daily, so that’s what most of us should be aiming for. If you have a glass of milk, a small pot of yoghurt and a small matchbox-size piece of cheese, you’ll hit that target.
Don’t worry about missing out if your choose reduced-fat dairy products such as skimmed milk or reduced-fat cheese: they contain just as much calcium, if not a little more, than full-fat ones.
Sardines containing soft bones, dried fruit, nuts (especially almonds, seeds and broccoli are also good sources, along with white flour that’s fortified with calcium. Bear in mind, however, that calcium in dairy is more easily absorbed and used by our bodies than the calcium in other foods, so if you don’t eat dairy for any reason, speak to your GP or a dietitian about how to get enough in your diet.
REMEMBER VITAMIN D
This vitamin is vital as it helps the body absorb and use calcium. It’s hard to get enough vitamin D from diet alone because there are only a few foods that naturally contain it. These include oily fish, such as salmon, fresh tuna. trout, mackerel and sardines, and eggs.
The best way to get more vitamin D is by safe exposure to the sun. Most of the vitamin D we get is made when the skin is exposed to ultraviolet-B (UVB) rays from sunlight in the summer. Unfortunately, in autumn and winter, the sun’s rays aren’t strong enough in the UK to make vitamin D. So it’s no surprise that national surveys show the levels in our blood (in all age groups) are highest from July to September and lowest from January to March.
To get enough vitamin D from the sun, you don’t need to sunbathe, though. For most fair-skinned people, exposing the hands and face for about 15 minutes a few times a week during spring and summer is sufficient – darker skins may need a little longer. Make sure you never go red or burn, to avoid increasing your risk of asking cancer.
A good way to top up, especially in winter, is to consume vitamin D-fortified foods, such as cereals and yoghurts, or consider taking a supplement. The Department of Health recommends a daily 10mcg supplement each day for certain groups, including pregnant and breastfeeding women, people who spend most of their time indoors (elderly people in care homes, for instance) and people who cover their skin when outside.
WALK, JOG OR DANCE
Exercise is also crucial. Activities that involve jumping are particularly good for boosting strength – jogging, brisk walking. dancing, rebounding and Zumba is all bone-friendly options. Experts also recommend resistance training which helps blood flow to your bones. One study in The Journal of Sports Medicine and Physical Fitness found low-weight, high-repetition resistance training classes increase bone density.
WATCH YOUR BMI
Your BMI should ideally be between 20 and 25 (calculate BMI here). If it’s too low you’ll have less bone tissue overall, which makes osteoporosis more likely. Carrying too much weight, on the other hand, puts undue strain on your bones. A study from Harvard Medical School in Boston found some overweight people actually carry fat inside their bones, which makes them weaker. It also revealed that fat around the middle indicates a higher risk.
YOUR BONE BLACKLIST
Too much salt: leads to a loss of calcium in your urine.
Excess caffeine: can also lead to loss of calcium in the urine. Regularly drinking phosphoric-acid-containing fizzy drinks (such as Coke) uses calcium to neutralise their acidity.
Nicotine: is toxic to bone cells – bone breaks down faster in people who smoke.
Excessive amounts of vitamin A: that’s more than 1.5mg daily over many years – increases the risk of bone problems. If you take supplements that contain vitamin A make sure your combined intake from food (such as liver) and supplements isn’t more than 1.5mg.
An excessive intake of alcohol: increases your risk of osteoporosis so don’t go over the recommended limit of 14 units per week.
WHAT A SCAN CAN REVEAL
If you’re concerned about your bone density for any reason, speak to your GP, who’ll do an assessment to work out whether you’d benefit from a scan.
The gold standard is a DXA scan. It uses X-rays to look at 4 vertebrae in your spine and 1 in your hips to assess how far above or below average your bone mineral density is. The scan generates. what’s known as a T-score for osteoporosis?
If necessary, you’ll be offered medication to lower your risk of fractures as well as advice about any changes you need to make.
EASY WAYS TO GET MORE CALCIUM
1. Add reduced-fat dairy products. such as milk, yoghurt and cheese, to your diet – grate a little cheese over pasta and stir fat-free fromage frais into curries.
2. Throw tofu and nuts into stir-fries.
3. Snack on dried fruit and nuts such as figs, almonds and brazil nuts.
4. Whiz fruit with skimmed milk, or a calcium-enriched milk alternative.
5. Eat heaps more broccoli, spinach and kale – green, leafy veg tend to contain more calcium than others.
6. Top stir-fries and salads with sesame seeds.
7. Stir chickpeas, beans or lentils not dishes such as soups and casseroles
8. Mash up and eat the small bones in canned sardines
9. Reach for a pot of low-fat fruit yoghurt or fat-free greek yoghurt with some berries next time you a sweet craving.
10. Top porridge with low-fat yoghurt and sunflowers seeds.
PS: I’d love to know what you thought of the tips, a good tip to look at would be especially are you at risk, hit me up in the comment section or alternatively drop me a message. I answer every email, just ask.
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