Osteoporosis

Author BSc (Hons)

Bone Basics
Osteoporosis literally means ‘porous bones’. Bone consists of an outer layer or shell called the cortex and an inner layer called spongy trabeculae. This inner layer consists of a network of bone in an arrangement that resembles a sponge. Osteoporosis is characterised by the gaps in this inner layer getting bigger, resulting in a reduction in bone density. This reduced bone density diminishes the bone’s resistance to loads and impact, making the bone fragile and more likely to break. Osteoporosis affects the whole skeleton but fractures occur most often to the hip, spine, and wrist. Bone is alive and just as skin dies and is replaced by new layers of skin, old, worn out bone is broken down and replaced by new bone. Osteoporosis occurs when the rate of production of new bone does not keep up with the rate at which old bone is broken down and dies. Bones grow in volume and density until peak height is reached, after which, bone length remains the same while bone density continues to increase. Bone density increases until it reaches a maximum around age 20-30 years. This is referred to as Peak Bone Density. Once this Peak Bone Density has been reached bone density may remain stable or decline, depending on a variety of lifestyle factors. Some decline can be expected as part of the natural aging process.

Breaking News

1 in 2 women and 1 in 4 men over the age of 50 will have an osteoporosis-related fracture in their remaining lifetime.
80 % of those affected by osteoporosis are women.
Women may lose up to 20 % of their bone mass in the 5-7 years following menopause.

Bone Busters
There are a number of risk factors (National Osteoporosis Foundation) that indicate that a person is more likely to develop osteoporosis, these include :

Personal history of fracture after age 50;
Current low bone mass;
History of fracture in a 1° relative;
Being Female;
Being thin and / or having a small frame;
Advanced age;
A family history of osteoporosis;
Estrogen deficiency as a result of menopause, especially early or surgically induced.;
Abnormal absence of menstrual periods (amenorrhea);
Anorexia nervosa;
Low lifetime calcium intake.;
Vitamin D deficiency;
Use of certain medications (corticosteriods, chemotherapy, anticonvulsants and others);
Low testosterone levels in men ;
An inactive lifestyle;
Current cigarette smoking;
Excessive use of alcohol;
Being Caucasian or Asian, although African Americans and Hispanic Americans are at significant risk as well.)

Don’t Wait for the Break!
Osteoporosis is often referred to as a ‘silent disease’ because the reduction in bone density can occur without symptoms. Often people do not realise that they have osteoporosis until their bones have become so weak that a sudden bump or fall causes a breakage. A reduction in bone density may also cause vertebrae to collapse resulting in severe back pain, reduction in height, or spinal deformities.
The old saying ‘prevention is better than cure’ is paramount when considering osteoporosis. Whilst there are treatments available to increase bone mass the most effective way to avoid osteoporosis is to maximise peak bone mass and to reduce the rate of its decline. The two key factors for optimising and maintaining bone density are nutrition and physical activity. Bone responds to physical activity in a similar way to how muscles respond, in that if you exercise your bones they will get stronger. Any physical activity that puts pressure on the bones will help to build and maintain bone density. Adequate nutrition is vital to ensure that the necessary‘ ingredients’ are available to build new bone.

Bone Building Physical Activity
The two forms of physical activity that are most effective at building bone density are weight bearing exercise and resistance exercise. Weight bearing exercise includes running, walking, jogging, dancing, skipping, stair running, racket sports, and many team sports, essentially any physical activity in which your feet and legs are bearing your body weight. Resistance exercises include weight lifting using free weights and weights machines typically found in health and leisure clubs and activities such as heavy lifting or carrying. Cycling and swimming have numerous health benefits but are less effective forms of physical activity for preventing osteoporosis. Professor Liam Donaldson, top medical advisor to the British government, recommends that adults take 30 minutes of moderate intensity physical activity on five or more days each week and that children and young people do at least 60 minutes everyday.

Bone Feeding
Nutrition: Our bodies need adequate amounts and combinations of nutrients in order to build new bone effectively. Calcium is the bone related nutrient that immediately springs to mind and is indeed vital for bone production. There are also other nutrients that are required to optimise the bone production process. Calcium and Osteocalcin (a protein involved in bone formation) are essential for bone production and vitamin K is needed to make osteocalcin. Vitamin D, magnesium, and essential fatty acids are required to facilitate calcium absorption. Phyto-estrogens may also have a beneficial effect on bone mass, especially after the menopause. The following table outlines recommended daily intakes of calcium (National Osteoporosis Society) for different groups of people.

Adults	Men	700mg
	Women	700mg
Teenagers	Boys 11-18	1000mg
	Girls 11-18	800mg
Children	1-3 years	350mg
	4-6 years	450mg
	7-10 years	550mg
Infants		525mg
Pregnant Women		700mg
Breastfeeding women		700 - 1250mg

Balanced diets containing sufficient amounts of dairy products and dark green leafy vegetables may provide some people with the required amounts of Calcium. However, due to the importance of other nutrients involved in calcium absorption and bone formation, and the increasing numbers of people who are restricting dairy intake (for weight control or due to a food intolerance), it is wise to make an individual assessment of ‘bone nutrition’ for each individual. People who lack any of the above nutrients in their normal diet or with any of the risk factors for osteoporosis (listed above) should consider taking a supplement. But make sure the supplement contains a readily absorbable form of calcium.
For information regarding the suitability of other supplements please seek advice from your Health Advisor, Nutritionalist or Naturopath It is important to note that any Calcium containing supplement should not be taken at the same time of day as an iron supplement as Calcium is known to interfere with iron absorption. Ensure you take a bio-available form of Calcium

Don’t wait for the BREAK – Build a Bit of Bone today.