The statistics are quite shocking as 1 in 2 women over the age of 50 will break a bone from osteoporosis! Whilst osteoporosis cannot be reversed, there are plenty of things you can do to stop it getting worse and to support your bone health.
- Osteoporosis is a silent disease of the bones and you may not even know you have it until you have a fracture or break a bone most commonly in the hip, spine or wrist. Bones are living tissue and constantly change throughout our lives. The body is very clever and in a healthy person, old bone is broken down and replaced with new bone in a continuous cycle. Osteoporosis develops when more bone is broken down than is replaced.
- The inside of a bone looks like honeycomb with a hard outer shell – think of a Crunchie bar with fine honeycomb on the inside and a hard chocolate shell. With osteoporosis, the holes in the honeycomb get larger and the outer shell becomes thinner and more brittle so that in severe cases of osteoporosis, it only takes a small bump or even cough or a sneeze to break a bone. When you have osteoporosis, it may take longer to heal from a fracture. The recovery from fractures can sadly affect mobility, quality of life and well-being.
- Osteoporosis affects 1 in 5 women over 50 and just 1 in 20 men. More than 3 million people in the UK are estimated to have osteoporosis. It is estimated that over 500,000 broken bones are caused by osteoporosis in the UK each year – that’s 1 every minute!!
What causes osteoporosis?
At peri-menopause and menopause, declining hormone levels in particular oestrogen levels impact the activity of the cells that replace new bone. This means we lose more bone than we can replace. There are some risk factors which may also impact bone loss:
- A family history of osteoporosis - Your genes control the strength of your skeleton
- A History of taking steroids
- Smoking
- History of drinking alcohol
- Previous surgery affecting reproductive organs such as a hysterectomy / ovaries
- Early menopause
- Low body weight or low BMI/ underweight
- Being over 50
How do you know you have osteoporosis?
In the UK many, many women are undiagnosed with osteoporosis until they break a bone with a low level impact injury such as breaking a wrist from tripping from a curb. At this stage you may be referred for a Dexa scan which is a low dose x-ray that is able to detect how dense and strong your bones are. It detects the mineral content of the bone and gives you something called a T score - a T score between zero and -1 is normal. A T score between -1 and -2.5 is known as osteopenia and a T score of below -2.5 is a diagnosis of osteoporosis.
If you have any of the risk factors mentioned above, it’s definitely worth talking to your GP about your concerns and seeing whether they would consider referring you for a Dexa scan. Because of the cost to the health service not every person can get a dexa scan but it’s worth considering the short and long term health and social impacts of a fractured hip.
What can I do to help myself?
Prevention is better than cure! Once you reach the stage of osteoporosis, this is not reversible but there are ways to prevent further bone loss and even cause a small boost to your bone density. There are so many positive things you can do for your bones!
- Exercise! One of the biggest benefits to the body is thought to come from weight bearing exercise. Bones are really clever and respond to load through the long bones as well as muscles which pull on the bone to make them stronger so jogging, walking, tennis, dancing, lifting weights, climbing stairs are all excellent ways to stimulate your bones.
- It’s recommended to exercise 2.5 hours of moderate intensity impact per week or 30 minutes x 5 per week e.g. briskly walking the dog for 15 minutes morning and evening
- Strength training 2 – 3 days per week. Examples are press ups on your knees or against a wall or table, lifting weights – a short arms work out with a 1kg weight in each arm can make a big difference.
- It’s important to note that whilst swimming and cycling are excellent forms of exercise they aren’t specifically good for bone health.
- At the One Life clinic we love to support women to exercise and overcome mental and physical hurdles, especially around lifting weights. It’s so inspiring to see someone try a side plank in my Pilates class for the first time and gain confidence to overcome their beliefs or lift a heavier weight than they thought they could!
- Healthy eating and nutrition. Guidelines suggest 700 mg of calcium per day. Foods rich in calcium such as dairy products or for non-dairy eaters many plant based milks are fortified with calcium, leafy greens such as broccoli, cabbage and Kale, nuts – especially almonds, dried fruits or soya products.
- An example of 700mg of calcium might be 30 – 50 mg cheese, a glass of milk and a 125 pot of yoghurt or with a vegan diet 120 g tofu, 2 veggie sausages and 200ml calcium boosted plant based milk.
- Supplements – As we have relatively low levels of sunlight in the UK during the winter, it is recommended to take a regular dose of Vitamin D – 10 mcg or 400 iu which is readily available in many supermarkets and pharmacists
- Giving up smoking or moderating alcohol intake. This will give you many other health benefits – your bone health is just one factor influenced by smoking and alcohol.
- HRT – Hormone replacement therapy has been shown to keep bones strong by maintaining levels of oestrogen and preventing bone loss. Discuss this with your GP.
As you can see, there are lots of positive steps you can take to improve your bone health.
Where else can I find information about osteoporosis?
The Royal Osteoporosis Society is a great charity which supports people with the condition and aims to champion bone health. They have a strong focus on research and a strategy which starts with building healthy bones for life and minimising fracture risk as well as supporting those who already have the disease. The under-treatment of osteoporosis remains a key care gap. Due to covid there are significant back logs and waiting lists for scans it’s thought that 2/3 of people are not getting the treatment they need!
There are some great resources on the Royal Osteoporosis Society website. There is a risk checker which you can take to determine your risk of osteoporosis via simple web based questionnaire which helps you to understand your own individual risk, preventative measures and also when to have a conversation with a health care professional. The website also has information if you are newly diagnosed, exercises to help with your bones and also information about drug treatments for osteoporosis
