Bone mass peaks in late adolescence. This makes living into your 90s a downhill spiral unless you take particularly good care of dem bones. Osteoporosis is a condition where the density of the bone, particularly of the hip and spine, reduces to such a degree that fractures and falls are likely. Breaking a bone when you’re a kid means having a cool plaster cast which your pals can pen jokes on and within six weeks, you’re back on your bike with the broken bone long forgotten. However, a fracture in your 70s onwards is a different kettle of fish, resulting in a much-diminished life often dependent on others, or even the cause of your demise. Osteoporosis affects 1 in 2 women and 1 in 3 men over the age of 60. Osteopenia is a reduction of bone density, which is not as severe as osteoporosis, but is still heading down that path.
- Osteoporosis is named the ‘silent killer’ as very often the first symptom you experience is a fall or fracture.
- Compression of the spine can result in a dowager’s hump or stooped upper back and is thought to be the cause of Notre Dame’s hunch.
- Pain can result from the compression of the vertebrae.
We tend to think of bones as inert still-life structures propping up the body. However, bones are constantly in micro-motion. Bone is made up of a protein lattice made from collagen. It is speckled with various minerals, including calcium and silicon, that serve to increase bones’ load-bearing capability. Bones hold 99 per cent of the body’s calcium and acts as a calcium storage facility, allowing calcium to freely move from bone to blood and vice versa, facilitating calcium to perform its other duties in the body including muscle contraction and nerve transmission.
What causes it?
- After menopause, with a sharp decline in oestrogen, bone density loss is at its most rapid.
- A family history of osteoporosis can increase your risk of osteoporosis.
- A sedentary lifestyle. Nowadays, there is not much physical work in the course of everyday life. Over the years, life has become easier on the body. Compare today’s computerised washing machines to those twin-tub contraptions that required hauling loads of wet sheets from tub to tub, followed by a tug-of-war with towels through the wringer.
- Heavy minerals from the environment such as lead, cadmium and aluminium contribute to osteoporosis as they compete with calcium to be absorbed into bone, making bone less strong. Unfortunately, once these bad minerals are incorporated into bone they are unlikely to leave.
- People with fair skin have a greater risk of osteoporosis than those of a darker hue.
- Illnesses including inflammatory bowel disease, coeliac disease and chronic diarrhoea usually result in malabsorption of minerals, and can therefore result in osteoporosis.
- A history of anorexia nervosa will increase your risk of osteoporosis. Anorexia combines a limited nutrient intake together with lowered oestrogen (often menstruation ceases during anorexia).
- Smoking decreases oestrogen production and increases calcium excretion.
- Certain medications including cortisone can increase bone loss.
What to do
Prevention is key. Once your bones are osteoporotic, it is much more difficult to treat. In fact, diet and supplements will, at best, keep levels the same. It is virtually impossible to reclaim bone unless you take medicine, which may have side effects. If you feel you might be at risk of osteoporosis, have a DEXA (dual energy x-ray absorptiometry) scan sooner than later. Reduced bone density, when diagnosed early enough, can be redressed by diet, exercise and supplements.
- Increase calcium-rich foods including spinach, broccoli, bok choy, cheese, milk, yoghurt, canned fish with edible bones, sardines, salmon, whitebait, tofu, almonds, tahini, sesame seeds, parsley, sprouts and dried figs.
- Decrease coffee and tea, avoid sugar and reduce salt as they all increase calcium excretion. Reducing salt not only means minimising the amount you add to your meals, but also reducing packaged, processed and takeaway food which are often studded with sodium.
- Animal protein decreases bone mineralisation. However, insufficient protein in the diet also decreases bone density. The answer is to increase plant proteins at the expense of animal protein. Plant protein can be found in legumes such as soy and lentils, as well as nuts and seeds.
- Dietary phytoestrogens may increase bone density, particularly after menopause. Such foods include soya sprouts, alfalfa, green beans, split peas, olives, soya beans, miso, tempeh, parsley, chickpeas, cherries, corn, oats, barley, rye, wheat, rice, pomegranate, hops, sesame seeds, linseed, buckwheat, millet, sage, fennel, celery, carrots, cabbage, rhubarb and garlic.
- Drink in moderation. A glass of alcohol a day decreases your risk of osteoporosis – more than 2 drinks increases your risk.
- An acid-forming diet can increase your risk of osteoporosis (see page 00).
- A calcium supplement is helpful, particularly if you are in the osteopaenic range of bone density. Osteopaenia is a condition of lowered bone density, a step on the way to osteoporosis if preventative measures are not adopted. A dose taken twice a day can optimise absorption. Make sure your supplement contains a range of calcium-enhancing minerals including magnesium boron, zinc, manganese, silicon, strontium and copper as well as vitamins K and D.
- Vitamin D is crucial for calcium absorption. It has been shown to decrease your risk of fracture. If your blood levels of Vitamin D are low (as found in a blood test), take a supplement until they are above mid-range.
Dairy products are often recommended for their high calcium levels. And indeed, they do contain admirable amounts of calcium. However, milk products are not the only source of calcium in food. Nuts and seeds, leafy green vegetables and legumes all contain calcium. Osteoporosis is less common in Asian countries where diets are traditionally dairy-free. Magnesium is important for calcium absorption and utilisation. They need to be in a certain ratio for this to be optimised: that is, 2 parts calcium to 1 part magnesium. In the case of milk, the ratio is 10 parts calcium to 1 part magnesium. Enjoy good quality milk products such as unsweetened yoghurt and whole milk cheese as part of a good diet, but don’t be bullied by the media into thinking you ‘have’ to eat milk products in order to prevent osteoporosis. If you are not fond of dairy products, or have a dairy sensitivity, then ensure you are eating an array of other calcium-rich foods.
- Enjoy regular weight-bearing and resistance exercise. With exercise, muscle pulls on the bone, causing them to become stronger. Try weightlifting, balancing (as in strong yoga poses), tai chi, jogging, dancing, cross-country skiing and gym work. The aim is to strengthen bone as well as improve muscle tone and balance to help prevent falls.
- Enjoy some sunshine (out of the midday sun) to help maintain your vitamin-D levels.
- Don’t smoke.
- If you believe you may have been exposed to heavy-metal toxicity in your life, for instance from pollution, mining or agricultural practices, a hair mineral analysis can be done to diagnose which minerals are involved. A process known as chelation can then be undertaken, which draws the toxic minerals from your bone. Certain environmental doctors and some naturopaths specialise in this area.
At a glance
- Increase calcium-rich foods
- Reduce coffee, tea, sugar and salt as they all increase calcium excretion.
- Decrease animal protein in your diet and increase plant protein. Down with meat, up with legumes, seeds and nuts.
- Take a calcium supplement if you are at risk of osteoporosis or a scan has shown that your bone density is less than ideal.
- If your vitamin-D levels are low, take a supplement until your blood tests show levels above the mid-range.
- Exercise is vital to prevent osteoporosis. Weight-bearing and balance exercises are best.
- Don’t leave it too late. Get a DEXA scan if you think you might be at risk of osteoporosis. Prevention is far better than cure.
- Enjoy some sunshine.