Wednesday 26 October 2016

15 simple steps to mind your bones

Published 05/05/2015 | 02:30

Pilates is a safe and beneficial form of exercise
Pilates is a safe and beneficial form of exercise
Calcium foods
Prevention of osteoporosis should ideally start in utero - Professor Moira O'Brien

Osteoporosis is a silent disease that affects both men and women later in life. In fact, it's the cause of 90pc of hip fractures in Ireland. But there are plenty of preventative measures we can take decades before it strikes

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It's easy to forget about your bones - after all you don't see them, hidden away under layers of skin, muscles and tissue. We only ever really think about our bones when something goes wrong - a break, a fracture or aches and pains.

However, maintaining and improving your bone health is something that gets even more important the older we get, and keeping your skeleton well means you've a better chance of retaining your independence well into old age.

"Many people are not aware that if you do not have a healthy skeleton, you will not be able to sit up in a chair, for example, or walk across a room unaided," says Michele O'Brien, physical therapist and CEO of the Irish Osteoporosis Society. "Ninety per cent of hip fractures are from osteoporosis, and there were over 3,000 hip fractures in Ireland in 2013." With those unnerving statistics in mind, here are 15 ways to mind dem bones, dem bones...

1 Start protecting your children's bones early

You can give your children a massive boost for their future bone health by making sure you're getting lots of calcium when you're pregnant. Pregnant women absorb calcium more effectively, and the oestrogen produced during this time is also good for bone health.

"Prevention of osteoporosis should ideally start in utero," says Professor Moira O'Brien, an osteoporosis consultant with Euromedic Dundrum. "It's also essential that parents and grandparents encourage children to be physically active. Bones by Brent Pope is a children's book for 7- to 12-year-olds which explains why physical activity and eating healthy is so important. This book is available from the Irish Osteoporosis Society Charity."


2 If you're under 30, act now - or tell your kids to

We normally achieve peak bone mass in our 20s up until the age of 30, and then start to lose it over time. According to Mayo Clinic, after that, bone remodeling continues, but you lose slightly more bone mass than you gain. How likely you are to develop osteoporosis depends on how much bone mass you amass by the time you reach age 30, and how rapidly you lose it after that. That means you need to be aware of your bone health from an early age - and making sure that those younger than you are aware of this is essential. Preventative measures with diet and exercise can be taken to avoid osteoporosis in later life, so talk to your children (even if they're grown up) about the importance of bone health.

3 Remember the importance of calcium

Many of us aren't getting the required calcium from our diets. "Unfortunately, one third of women in Ireland consume inadequate calcium. The National Children's Food Survey also found that 28pc boys and 37pc girls aged 5-12 have inadequate calcium intakes," says Professor Brennan. The richest sources of calcium in the diet are yogurt, milk and cheese. Three servings a day will help meet calcium needs of an adult or child, five servings are recommended during adolescence and pregnancy.

Smaller amounts of calcium come from other food sources, such as green vegetables, bread and sardines. For some, milks fortified with extra calcium can be useful. However, if you still feel you're not getting enough from your diet, a supplement is a good idea. Especially because you need calcium to absorb another important vitamin for bone health - Vitamin D.


4 Make sure you're getting enough vitamins

The Irish sun doesn't give us enough Vitamin D unfortunately, even in summer. "Those that are obese or dark skinned have a reduced ability to absorb vitamin D from the sun," explains Michele.

You should ideally aim to get Vitamin D and calcium from your diet, eating things like sardines, leafy greans, low fat dairy products and fortified foods like orange juice and milk. Foods like egg yolks and cheese are good too, but can be high in fat and cholesterol, so be careful with your intake. Again, a supplement isn't a bad idea if you're concerned about weak bones or have a family history of osteoporosis. You can get specific ones to promote better bone health, or a general multivitamin.

5 Do the right kind of exercise

Exercise in your 20s, 30s, and 40s can help to prevent osteoporosis in later life. Stretching and strengthening exercises that don't put too much pressure on the joints or have too high an impact on bones are best, like weight-training, yoga or pilates. Anna Frankland of Reform Pilates says, "Pilates is a very safe and beneficial form of exercise for anyone with low bone density. Not only does it improve balance, which is critical when trying to prevent falls, but it is also a form of resistance training, strengthening the muscles to pull on the bones creating tension to fortify the bones." The Irish Osteoporosis Society keenly stress though that those who know they have osteoporosis already shouldn't engage in a new routine without professional advice first.


6 But make sure it's safe for you

"No one over 50 (especially women) should start any form of exercise programme, unless you have been assessed for your risk of having undiagnosed osteoporosis," explains Aidan Woods, a chartered physiotherapist at Pearse Street Physiotherapy. "Anyone who has been diagnosed with osteopenia and/or osteoporosis should avoid exercise that puts stress on your spine, like regular sit-ups, high impact exercise and touching your toes with straight legs."

"People with bone loss are high risk to fracture and it is essential that you have an individual assessment by someone who is up to date on osteoporosis," explains Michele.

7 Keep your weight in the healthy zone

Those who have a low BMI (under the healthy range of 19) are more likely to be frail and at risk of having weak or brittle bones. Similarly, those who are overweight are putting more pressure on their frame in general, and those with bad diets absorb less of the vitamins and minerals required for good bone health. It can be tough to put weight on, as it can be to lose it, but the answer is to eat regularly throughout the day, and aim for fresh, unprocessed food with every meal.

People who have had eating disorders like anorexia or bulimia have a higher chance of developing osteoporosis.

"Anyone with a past or present eating disorder is at extremely high risk to develop osteoporosis at a very young age," says Michele. "These people should discuss having a scan with their doctor as soon as possible." Following preventative advice could stop the condition worsening.


8 Quit smoking

There are so many reasons to give up cigarettes, but this is yet another one. Tobacco doesn't just have a negative influence on your heart and lungs, but it also contributes to weak bones. The exact reason isn't clear, but several research studies in the US have revealed smoking as a risk factor for osteoporosis.

According to the National Institute of Health in the United States, the longer you smoke and the more cigarettes you consume, the greater your risk of fracture in old age. Smokers who fracture may take longer to heal than non-smokers and may experience more complications during the healing process. Also, quitting smoking appears to reduce the risk of low bone mass and fractures.

9 Watch your alcohol intake

Alcohol has an impact on bone health for many reasons. Firstly, excessive alcohol consumption interferes with the balance of calcium in the body, and increases certain hormone levels that reduce the body's reserves. It can also stop your body absorbing calcium correctly. Drinking a lot can mess with your hormone levels, which can affect your bones. You're also simply more susceptible to falling over when under the influence, and if you have undiagnosed osteoporosis, this could lead to a devastating break or fracture.

10 Check your family history

According to the Irish Osteoporosis Society, research shows that 60pc of a person's bone is influenced by genetics, especially in laying down the amount of bone during childhood. That means if somebody in your family has or had osteoporosis, the chances of you developing it are significantly higher. Ask your relatives if you're concerned, and talk to your GP about how to proceed. They will more than likely recommend a bone scan and preventative measures.


11 Talk to your GP about your hormone levels

If you started your periods later in life (older than 15) or went through menopause early (around 45), your oestrogen levels could have affected your bones. Similarly, if you're going through menopause, your oestrogen levels drop which can have a negative impact on bone mass. Talk to your GP about your options - if you've had a recent break, or if you display some of the risk factors, a bone scan is a good idea.

Men who have low levels of testosterone are also at higher risk of osteoporosis; it's often thought that this is a condition that solely affects women, but that's not the case - according to Michele, more men die from osteoporosis-related incidents than from prostate cancer in Ireland.

12 Check your medications

According to the US National Osteoporosis Foundation, some medicines can be harmful to your bones, even if you need to take them for another condition. Bone loss is usually greater if you take the medication in high doses or for a long time. Steroids, for example, can increase bone loss, as can Warfarin, chemotherapy and long-term lithium therapy. It's worth discussing with your doctor if you have a family history of bone loss, or you're concerned about your bone health.


13 Do what you can to prevent falls

There's a reason elderly people fear falling - according to the Irish Osteoporosis Charity, 50pc of people over 60 who fracture their hip will not be able to wash or dress themselves or walk unaided.

So prevention is key here, at any age. Strength and balancing exercises, checking eyesight, making sure there are no hazards in the home that might trip someone up and reviewing medication to avoid dizzy spells all help.

"If you have broken a bone from a trip and fall, even if on ice or cement, you should have a DXA scan done," urges Dr O'Brien. "If your bones were healthy, they should not break from a fall."

14 Be mindful of how you're feeling

Studies have shown that people suffering with depression are at greater risk of osteoporosis. This can be due to lower levels of mobility, decreased hormonal activity and some medications used to treat depression. High stress is also a risk factor, both physical and emotional. Cortisol, the stress hormone, can increase bone loss.

15 If you're concerned, get a bone scan

According to Osteoporosis Ireland, the only way to find out if you have poor bone health is to have a DXA scan of your spine and hips.

If you have lost height, have undiagnosed back pain, your head is protruding forward from your body (rounded shoulders) or you have developed a hump on your back, you may have undiagnosed broken bones in your back.

"Osteoporosis is a silent disease as there are no signs and symptoms prior to a person breaking a bone," explains Michele. "You can look perfectly healthy on the outside but your bones can be crumbling on the inside."

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