Why You Need to Know About Osteoporosis

As oestrogen decreases, your bones become less dense and strong. Dr Louise Newson advises how exercise and diet can build them back up again.

What is osteoporosis?

Osteoporosis is a condition in which your bones lose their strength and are therefore more likely to break (or fracture), usually following a minor bump or fall.

Your bone tissue is made up of protein hardened by calcium salts and other minerals to make it strong. Bone tissue is alive and it constantly changes throughout your life in order for it to be as healthy as possible. You have cells in your body which are constantly laying down new bone (osteoblasts) and other cells which are removing old bone (osteoclasts).

How does menopause affect bone density?

Until you are around 30 years of age, you normally build more bone than you lose. However, during the menopause, your bone breakdown occurs at a faster rate than your bone buildup, resulting in a loss of bone mass. Once this loss of bone reaches a certain point, a person has osteoporosis.

The drop in oestrogen levels during the menopause results in increased bone loss which leads to your bones becoming less dense and less strong. Around 10% of a woman’s bone mass is lost in the first five years of the menopause and this increases your risk of osteoporosis developing.

What are the risks of osteoporosis?

People with osteoporosis have an increased risk of fractures occurring even with little or no trauma. These are called ‘fragility fractures’. This means that normal stresses on your bones from sitting, standing, coughing or even hugging can result in painful fractures occurring. These fractures can happen in any of your bones, including your spine, hips and wrists. This can lead to considerable pain and also sometimes disability. People who fracture their hip find it much harder to get back to their previous level of function and may lose their independence without the right physiotherapy or overall level of health needed to regain good mobility.

How common is osteoporosis?

Osteoporosis is more common in women who do not take HRT after the menopause. One in two women and one in five men over the age of 50 experience fractures, mostly as a result of low bone strength.

What are the best vitamins to avoid osteoporosis?

It is very important to have adequate vitamin D levels because it is a very important vitamin for keeping your bones healthy as it enables calcium, which is essential for healthy bones and teeth, to be absorbed.

Vitamin D is made in the skin following sun exposure and is found in very small amounts in some foods. A deficiency of vitamin D can lead to rickets developing in children and osteomalacia, which causes the bones to become soft and even deformed in some people.

To have adequate levels of vitamin D you need to be exposed to the midday sun for at least 20 minutes on at least three times a week, every week. You can not obtain adequate vitamin D levels by having the occasional holiday in the sun. This amount of regular sunshine exposure is clearly not possible for most people.

If there’s no sun, can vitamin D be taken as a supplement?

The Scientific Advisory Committee on Nutrition (SACN) has published its recommendations on vitamin D. They are recommending a Reference Nutrient Intake (RNI) for vitamin D of 10 μg (400 IU) to be taken every day, throughout the year, for everyone in the general UK population aged 1 year and above. Babies under one year need a slightly lower dose.

How else can you help your bones?

Regular exercise can be very beneficial and it is important to find a type of exercise that you enjoy as exercising should be fun not a chore. Sport such as running, walking, yoga, tennis, and dance can all help to keep you fit and healthy. These sports can also help keep your bones strong. Bone is a living tissue that grows stronger in reaction to increases in loads and forces. Weight-bearing exercises that use your body weight (such as jogging) and weight resisted exercise both help to improve bone strength.

Can diet help osteoporosis?

It is really important also to eat a healthy balanced diet; you need nutrients as well as to do weight-bearing exercise. Not eating enough can be as damaging to your health as eating too much. Eating disorders are actually quite common in menopausal women.

A healthy balanced diet, including foods rich in vitamin D such as fatty fish, like tuna, mackerel and salmon, mushrooms, cheese, egg yolks, beef liver and foods fortified with vitamin D (some cereals and dairy products and orange juice) will also help boost the correct levels of vitamin D.

Is HRT the best way to avoid osteoporosis?

HRT is the best treatment for the prevention and also the treatment of osteoporosis. Taking HRT has been shown in many studies to improve bone density and also reduce the risk of fractures occurring.  The earlier HRT is taken the better it is for our bone health.

Find out more about Dr Louise Newson and the Newson Health Menopause and Wellbeing Centre at www.menopausedoctor.co.uk

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