How to strengthen your bones

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It’s easy to dismiss osteoporosis as an inevitable part of growing old - but understanding the causes, and how to manage the condition, can make a big difference.

It’s believed that more than three million people in the UK are currently living with osteoporosis, associated with weakened, fragile bones.

The vast majority of those affected are over 50, and mostly women - one in two women, and one in five men over the age of 50 will break a bone as a result of osteoporosis, according to the National Osteoporosis Society (nos.org.uk), with the wrists, hips and spine most commonly affected.

While bone density can decrease with age, and for some people osteoporosis may be linked with other health problems or medications, generally speaking, there’s a lot we can do to try and prevent it, and ensure those who do develop problems can minimise pain and complications.

IS OSTEOPOROSIS SERIOUS?

Severe osteoporosis can be very problematic due to the increased risk of fractures - which can have a knock-on effect, including pain and mobility difficulties. “Severe osteoporosis weakens bones, meaning they can’t cope with minor traumas like falls. This can then lead to fractures that need surgery,” explains Dr Tim Woodman, Medical Director at Bupa UK (www.bupa.co.uk). “A common and serious example are weak hip bones; these can lead to a major procedure resulting in permanently reduced mobility. In more progressive cases, the vertebrae can’t support their own weight and collapse, causing severe pain and often leading to greatly reduced mobility.”

WHY IS IT MORE COMMON IN WOMEN?

The key reason for this is menopause, when a woman’s ovaries stop producing eggs, and eventually periods stop. “Menopause is the biggest risk factor for osteoporosis, and the risks are greater if a woman goes through early menopause (before 45), or has a prolonged time with no periods, due to over-exercising, too much dieting or eating disorders,” explains Dr Catherine Hood, women’s health specialist and ambassador for Kira for women health supplements (www.kiraforwomen.co.uk).

“Not only do the ovaries stop producing eggs, they also stop releasing oestrogen into the blood stream. Oestrogen has many effects on the body, including modulating the turnover of bone. Falling levels can have several consequences, including alterations to bone health.”

Dr Hood notes osteoporosis risk can also be higher in women with other hormone related conditions, “such as an overactive thyroid gland or pituitary gland disorders”, while certain medications, including some cancer treatments, “can affect hormone levels and bone density”.

DO GENES PLAY A PART?

Yes - though it isn’t always clear how. “Research has shown that a person’s genetics can have a large influence on their likelihood of developing osteoporosis. Genes play an important part in regulating bone mineral density. There are likely to be many genes involved but the precise ones responsible for osteoporosis risk have yet to be defined,” says Dr Hood.

WHAT ABOUT DIET?

Nutrition also plays a major role in bone health, and this applies from childhood through to older age. “The building of healthy bones starts in childhood and it’s important to adopt healthy habits to prevent osteoporosis and broken bones later in life,” says Dr Hood. “Calcium is an important constituent of bone, so children should eat plenty of leafy green vegetables and dairy products. Vitamin D is also essential and can be found in oily fish and eggs,” says Dr Hood. “But nutrition’s important in adults too and all adults should have 10mcg of vitamin D a day and 700mg of calcium, and eat a diet rich in these things, especially woman after menopause. It can be difficult to get enough of these minerals via diet alone, so adults should consider taking a daily supplement to help maintain strong bones.”

AND STRESS?

We’re increasingly paying attention to the links between mental and physical health, and it’s known that stress can wreak havoc with hormones - which can impact our bodies in countless ways. “Stress exerts its adverse effects on bone density, mainly via the action of cortisol, one of the major ‘stress hormones’,” says Max Tuck, author of Love Your Bones: The Essential Guide To Ending Osteoporosis And Building A Healthy Skeleton (Hammersmithbooks.co.uk). “Cortisol inhibits the formation of osteoblasts, our bone-building cells. Cortisol also breaks down structural proteins, including collagen, which is the matrix upon which our bones are built. Not only this, but elevated cortisol levels - as a result of daily stress - inhibits the absorption of vitamin D. Finally, chronic stress depletes the body of magnesium, a mineral that’s even more important than calcium for creating strong bones.”

WHAT ROLE DOES EXERCISE PLAY?

Alongside “a good diet and attention to calcium and vitamin D intake”, Bupa’s Dr Woodman stresses that “regular exercise will help prevent the development of severe osteoporosis”.

Dr Hood points out that this, again, is important from childhood through to old age. “Regular weight bearing and resistance exercise is good for improving bone density, such as walking, running or just climbing the stairs at work rather than taking the lift,” she says.

Understandably, it’s not uncommon for people with any type of pain or conditions that affect bones and joints to avoid physical activity, out of concern for doing for damage or triggering more pain. However, this can often be counterproductive and keeping active can play an important part in managing long-term conditions. Your healthcare team should be able to advise on how best to go about this if you’re unsure, and always seek advice from your doctor before embarking on any new exercise regimes. “Prolonged rest worsens osteoporosis, so maintaining mobility with therapy and pain control is essential,” says Dr Woodman, who adds that medications can also be used “if bones are already fractured, to help reduce the risk of further damage, as well as reducing pain”.