Saturday 20th October was world osteoporosis day, where we learned about this important condition from public health campaigns around the world. Do you know the risks and what we can do to protect our bones?
Osteoporosis is characterised by loss of the calcium or strengthening element of bone structure rendering it prone to fracture. In the early stages there are NO SYMPTOMS so most people don’t realise they have the condition until they suffer a fracture. By then they have already suffered a possibly life-changing fracture of their hip, upper arm, spine or wrist, which are the bones most commonly affected.
The statistics are surprising and stark
Osteoporosis accounts for more days spent in hospital than other diseases, for example, breast cancer and diabetes, however both of these get far more coverage in the media than osteoporosis.
Up to 20% of patients die in the first year following hip fractures, mostly due to pre-existing medical conditions made worse by the immobility enforced by hospitalisation.
Less than 50% of those who survive the hip fracture regain their previous level of function. This can mean being housebound or even needing residential care.
Vertebral fractures can lead to back pain, loss of height, deformity, immobility, increased number of bed days, and even reduced lung function. Their impact on quality of life can be profound as a result of loss of self-esteem, distorted body image and depression.
We can prevent this by being BONE AWARE. If you identify with any of the factors below it may be worth discussing your risk with your doctor who will clarify your individual risk and organise a Bone Mass Density Scan.
- Genetics: does bone fracture run in the family?
- High alcohol intake: more than 4units per day doubles the risk
- Sedentary lifestyle
- Previous personal wrist, arm or hip fracture especially if low impact fall
- Low BMI increases bone loss. (in particular past anorexia nervosa)
- Early menopause without HRT treatment
- Drugs: steroids, some indigestion medicines (eg omeprazole, lansoprazole), some antidepressants
- Medical conditions such as thyroid disease and coeliac disease.
What can we do about it?
Here are some ways in which you can look after you bone health in order to keep your bones in tip-top condition:
Basic lifestyle measures
- Stop smoking
- Reduce alcohol intake
- Increase “weight bearing” exercise
- Consider our diet
Ideally the earlier we start the better for us as the bones develop at different stages of life but it is never too late to start taking care of our bones!
Here is some more detail about the different ways to protect them:
Epidemiological studies have shown that hip fractures are reduced in groups who exercise regularly. This may be due to the increased bone density this stimulates but also because the fitter you are from exercising, the less likely you are to fall in the first place.
Weight-bearing exercise has the best benefit, but you don’t have to go to the gym….this can include brisk walking, dancing and, of course, household chores! All have been shown to improve bone mass density but, unfortunately, not swimming or cycling although of course, they do have other benefits.
Exercise in childhood and adolescence
Bone mass increases significantly during these years so a sedentary childhood is particularly detrimental to the normal bone accrual, as is anorexia nervosa at this crucial time.
One study showed that individuals who practice Tai Chi have a 47% reduction in falls, presumably due to improved core stability, and a 25% reduced risk of hip fracture.
Calcium and Vitamin D
These are the most important dietary influences on bone health, and supplementation has been shown to increase bone mass density in the frail elderly population. Good nutrition is especially important in children as adequate levels of calcium and vitamin D maximise the benefit of exercise in this age group.
Our main source of Vitamin D is from sunlight so it’s no surprise that in the UK we are all at risk in the winter. People who rarely go outside (care homes, people housebound with chronic illness) or who rarely expose their skin will be particularly prone to low levels of Vitamin D. Even people who live in sunny climates may not have enough Vitamin D. For example, as many as 40% of older people in Florida don’t have enough Vitamin D in their systems!
Similarly, people with dark pigmentation are less able to absorb sunlight and synthesise vitamin D in their skin. New advice from Public Health England states that all at risk adults and children over 10 years should consider taking a Vitamin D supplement during the autumn and winter months.
It’s never too late!
Start now and take action to protect your bones. If you would like to speak to one of our GPs about your bone health, please call 01625 704777 to book an appointment at Pinches Medical + Wellbeing.