Why should you be worried about your bones?
When should you start thinking about your bone health? You may think that this is something that doesn’t concern you if you are young or haven’t had any fractures. However, it is never too early to start looking after your bones.
Osteoporosis is very common
Osteoporosis is a common condition that causes bones to weaken and become more susceptible to fracture, even from minimal impact. One in two women and one in five men are expected to break a bone over the age of 50. Yet many of us probably haven’t thought about our bone health.
Until about the age of 30, we produce bone faster than we lose it. Your bone mass (or bone density) then tends to plateau until about 40. After this time, the reverse is true and bone mass declines. And for women this bone loss is particularly accelerated during the menopause. This is the key reason why more women than men suffer with osteoporosis.
Who is at risk of osteoporosis?
There are a number of risk factors which make you more susceptible to osteoporosis:
· Being a women of white or Asian origin
· Being of small build and slim
· Having an early menopause
· Having an eating disorder (e.g. anorexia, bulimia)
· A family history of osteoporosis
· Not exercising regularly
· Taking certain medications (e.g. steroids, anti-oestrogen medications)
· Having certain medical conditions, such as inflammatory conditions, hormone-related conditions
· Having digestive problems that cause poor nutrient absorption
· Taking a lot of antacid medications
· Heavy drinking
How do I know if I have osteoporosis?
How do you know whether you have osteoporosis? The answer is you don’t. Osteoporosis is a silent condition until you have fracture. The only way to know how strong your bones are is to have a scan known as a DEXA scan.
A DEXA scan measures your bone mass density at your hip, spine and sometimes also your wrist. Your bone density is then compared with a healthy adult at their peak bone density. A statistical measure of the difference, called a standard deviation, provides a score known as a T score.
· A T score of -1 or above is normal
· A T score below -1 and above -2.5 indicates a low bone density (this is known as osteopaenia)
· A T score below -2.5 is diagnosed as osteoporosis
Osteoporosis is a silent condition
While osteoporosis mostly manifests itself as a fracture in women in their 70s and beyond, it is a silent disease which starts much earlier. Targeting your bone health before the age of about 30 years will help reach your maximum bone density so your bones are as strong as possible before you start to lose bone density. That way you are building a reserve of bone to avoid them becoming too fragile and susceptible to easy fracture in later life.
It’s never too late to look after your bones
If you are over 30, or indeed at any age, you can still do a lot to help your bones. Don’t wait until you have a fracture. The younger you can start to implement changes to your diet and increase exercise, the stronger your bones will be.
If you have two or more of the risk factors described earlier, I would advise having a DEXA scan. In fact, ideally I believe all women should have a DEXA scan in their 40s to find out where they stand in terms of bone health. After all it is a condition affecting one in two women – that’s pretty high odds.
A DEXA scan can either give you piece of mind that your bones are OK. If your bones are borderline (osteopaenia) or show osteoporosis you can implement a nutrition and exercise plan and continue to monitor your bone health through further scans (usually recommended at 2-5 year intervals) and other measures.
What next if you have a diagnosis of osteoporosis or osteopaenia?
If you have been given a diagnosis of either osteoporosis or osteopaenia (low bone density), what can you do? There is a lot you can do to monitor and take control of your own bone health. While your doctor may offer you medication, many of these come with a number of unpleasant side effects and you may prefer to manage your condition more naturally. Even if you do take medication, it is also important to pair your treatment with other measures:
Check your bone turnover
This is measure of either the rate of bone building or the rate of bone breakdown. This can be tested as a urine test. It is a useful tool alongside a DEXA scan to monitor your bone health and any measures you are taking to help your bones, whether they are medical or natural.
Check your blood calcium and vitamin D levels
Keep an eye on your calcium and vitamin D levels. Your calcium levels should usually fall within the normal limits but if they are not, there is a test which will help identify other possible rare underlying conditions.
In the UK many of us are deficient in vitamin D as the main source is sunlight. Vitamin D can be easily supplemented but it is also important to measure and monitor your levels to check you are taking the correct dose.
Certain foods can increase acidity within the body. As the blood must always be maintained at a certain pH (level of acidity), your bones act as a buffer to neutralise any excess acidity. Therefore, if your diet is too acidic your bones will leach calcium to neutralise that acidity. Calcium is a key mineral within the bone and loss of calcium will weaken the bones.
Eating foods rich in calcium and taking vitamin D supplements are important for bone health. However, they are not the only important nutrient needed to keep bones healthy. Other nutrients, including magnesium, zinc, boron and vitamin K2 are also important.
Inflammatory conditions can inhibit bone production and increase bone breakdown, thus weakening the bones. Therefore it is vital to reduce inflammation and maximise anti-inflammatory foods such as omega 3, found in oily fish.
Maintaining a healthy weight is important for bone health. Having a low body mass index increases the risk of osteoporosis. This is partly because body weight puts more stress through the bone stimulating it to form more bone. However, being excessively overweight is not protective for your bones.
Good digestion is as important as your diet. It’s important that your digestive system is working optimally to help ensure you can absorb the nutrients from your food.
Your nutritionist can guide you with a nutrition programme designed to help, and arrange all necessary tests.
Since alcohol and smoking are risk factors for the development of osteoporosis, smoking and excessive alcohol consumption should be avoided.
Regular exercise, particularly weight-bearing and resistance training are key for building bone density, and helping to prevent osteoporosis and resultant fractures. It is vital that exercise is combined with a nutrition programme and healthy lifestyle to optimise your bone health.
If you don’t have osteoporosis and you have a normal DEXA scan it is still advisable to take precautions to reduce your future risk. Your bone density naturally declines with age and the key to preventing development of osteoporosis and fractures is to prevent your bone density from falling too low, particularly if you have risk factors that predispose you to this condition.
Dr Sharon Pitt is a registered nutritionist at Nutrition First, with 18 years’ experience. Nutrition First is a small and personal nutrition consultancy providing expert nutrition advice, based on sound scientific evidence.
At Nutrition First we see patients with a whole range of conditions at all stages of life, as well as helping those who simply wish to maintain and optimise their health.
We can provide you with a tailored plan to help you optimise your bone health and manage osteoporosis. Contact us at Nutrition First to see how we can help you.