Osteoporosis. It’s not necessarily what you think.
Most people think of Osteoporosis as a condition that affects older females and something that they don’t need to worry about. Well, whilst the population group most at risk are post-menopausal women over the age of 60, you may be surprised to hear that there are many other risk factors for developing Osteoporosis for both women and men.
Every year, World Osteoporosis Day is celebrated on the 20th October and in 2020 Osteoporosis Australia want to highlight the fact that men are also at risk of Osteoporosis by using the theme “Real men build their strength from within”.
For those with a short attention span, here is osteoporosis in a nutshell:
- Osteoporosis is a condition where the bones are weakened and brittle.
- Osteoporosis can affect both men and women.
- Prevention priorities: Calcium, Vitamin D, Weight Bearing Exercise.
- Treatment: Calcium, Vitamin D, Exercise, Medication, Lifestyle Modification.
For those who are interested to know more, read on…
First of all, what is osteoporosis?
Osteoporosis is a condition that affects over 1 million Australians and cases bones to become brittle, leading to a higher risk of fractures and breaks.
Osteopenia is essentially the precursor to osteoporosis. It is characterised by bones that are weaker than normal, but not yet at the brittle stage of osteoporosis.
Your body is constantly breaking itself down (Osteoclast activity) and rebuilding (osteoblast activity) to keep yourself strong and healthy. Osteoporosis occurs when your bones break down faster than you are able to rebuild, resulting in a gradual decline in bone strength until they become too weak to handle minor bumps or falls.
Here’s a few stats from the Australian Institute of Health and Welfare:
|Prevalence of self-reported osteoporosis by age and sex, 2017–18|
|Age group||Per cent||Per cent|
As you can see, while women are at considerably greater risk of developing osteoporosis, men do have a level of risk which is worth paying attention to.
So, what are the risk factors?
- Family history,
- Low Calcium and Vitamin D levels,
- Medical History including:
- Corticosteroid use,
- Low estrogen or testosterone,
- Thyroid conditions,
- Absorption issues such as coeliac, IBS, etc.,
- Some chronic conditions such as rheumatoid arthritis, chronic liver & kidney disease,
- Long term use of some medications.
- Lifestyle factors such as:
- Low levels of physical activity,
- Excessive alcohol intake,
- Weight – underweight or obesity (it has been suggested that hormones related to obesity may impact bone density).
Screening for Osteoporosis
Osteoporosis is normally asymptomatic (there are no symptoms) and as such many individuals can have osteoporosis or osteopenia without realising it. Whilst there is no need to get tested unnecessarily, if you are over 50 or have any of the above risk factors it is worth speaking to your GP about a screening. A simple bone scan, which is non-invasive is normally enough to determine your bone density.
That’s great, but how do I keep my bones as strong as possible or reverse the decline in bone density?
Almost 99% of the calcium in your body is found in your bones – consider these your fuel tank for calcium. Calcium is essential for healthy functioning of the heart, muscles, blood and nerves and therefore if you do not get enough calcium through your diet then your body will be forced to use the calcium stored in your bones. Eventually, the calcium in your bones becomes depleted, leading to an increased risk of osteoporosis.
Food sources with high calcium:
- Milk, cheese & dairy,
- Green leafy vegetables,
- Soy and tofu,
- Nuts and seeds,
- Fish where you also consume the bones such as sardines and pilchards,
- Calcium fortified food.
- To improve absorption:
- Ensure you get enough Vitamin D,
- Reduce caffeine and alcohol intake,
- Manage existing medical conditions as well as possible.
2. Vitamin D
Vitamin D supports calcium absorption and therefore has a significant effect on growth of the skeletal system and regulating calcium levels in the blood.
Things to note when it comes to Vitamin D:
- The main source of Vitamin D in Australia comes from the sun. VitD is produced when the skin is exposed to Ultraviolet B (UVB) rays.
- Relatively low exposure to the sun is required to obtain adequate VitD.
- Sun exposure for VitD is seasonal. You may need to pay more attention to your exposure in the winter months as more time is spent inside and less skin is exposed to UVB when outdoors.
- You should always be wary of your sun exposure, particularly when the UV index is above 3. Make sure you use adequate sun protection if outdoors for more than a few minutes.
- Your GP can prescribe VitD supplements if required.
Our body remodels and strengthens based on the stress we place on it. That’s why when we work out our muscles grow – the same thing happens with our bones. When exercising for bone strength, you should:
- Perform weight-bearing exercises,
- Include progressing resistance/weight training,
- Exercise at least 3 times per week,
- Increase your exercise over time (increase frequency, duration, intensity),
- Vary your training to ensure your body and bones is stressed in a varied way,
- Include balance and stability exercises in order to assist in avoiding falls (which have a high risk of causing fracture in those with osteoporosis),
- Review with an Accredited Exercise Physiologist for advice on your exercise program.
The ability of an exercise to assist in building bone strength is called the osteogenic capacity and this should be considered when choosing an exercise:
If you have been diagnosed with Osteoporosis or Osteopenia it is important that you review with your GP and an Accredited Exercise Physiologist when commencing an exercise program. If you have severe Osteoporosis it is likely that you will need to avoid all impact activities such as running and jumping, whereas if you have osteopenia or mild osteoporosis you may be able to tolerate a slightly higher level of impact. Regular reviews with experts will mean that your exercise regime remains appropriate and that you will get the most out of your training.
Sam Rooney, Accredited Exercise Physiologist