World Osteoporosis Day is observed annually on 20 October, and launches a year-long campaign dedicated to raising global awareness of the prevention, diagnosis and treatment of osteoporosis and metabolic bone disease. Organized by the International Osteoporosis Foundation (IOF), World Osteoporosis Day involves campaigns by national osteoporosis patient societies from around the world with activities in over 90 countries.
What is osteoporosis?
Osteoporosis is a condition that affects bone strength (the word osteoporosis literally means “porous bones”). Bone is a living tissue and contains cells that make, mould and resorb (take back up) bone. Initially, as you grow, bone formation exceeds bone resorption. But, as you get older, this reverses and, after about the age of 45, you start to lose a certain amount of bone material. Your bones become less dense and less strong. The amount of bone loss can vary. If you have a lot of bone loss, then you have osteoporosis. If you have osteoporosis, your bones can break more easily than normal, especially if you have an injury such as a fall. If you have a milder degree of bone loss, this is known as osteopenia.
Measures to prevent osteoporosis:
1) Exercise Regular weight-bearing exercise throughout life is best, but it is never too late to start. This means exercise where your feet and legs bear your body’s weight, such as brisk walking, aerobics, dancing, running, etc. For older people, a regular walk is a good start. However, the more vigorous the exercise, the better. For the most benefit, you should exercise regularly – aiming for at least 30 minutes of moderate exercise or physical activity at least five times per week. Excessive exercise such as marathon running may not be so good. (Note: because swimming is not weight-bearing exercise, this is not so helpful in preventing osteoporosis.)
Muscle strengthening exercises are also important. They help to give strength to the supporting muscles around bones. This helps to increase tone, improve balance, etc, which may help to prevent you from falling. Examples of muscle strengthening exercises include press-ups and weight lifting but you do not necessarily have to lift weights in a gym. There are some simple exercises that you can do at home.
2) Diet Calcium and vitamin D are important for bone health. Your body needs adequate supplies of vitamin D in order to absorb (take up) the calcium that you eat or drink in your diet. The recommended daily intake for calcium in adults over the age of 50 is at least 1,000 mg per day. Everyone aged over 50 years should also aim for adequate amounts of vitamin D daily (800 IU). Protein is also important in your diet and one gram a day of protein per kilogram of your body weight is recommended. Briefly:
Calcium – you can get 1,000 mg of calcium most easily by:
- drinking a pint of milk a day (this can include semi-skimmed or skimmed milk); plus
- eating 50 g (2 oz) hard cheese such as Cheddar or Edam, or one pot of yoghurt (125 g), or 50 g of sardines.
- Bread, calcium-fortified soya milk, some vegetables (curly kale, okra, spinach, and watercress) and some fruits (dried apricots, dried figs, and mixed peel) are also good sources of calcium. Butter, cream, and soft cheeses do not contain much calcium.
Vitamin D – there are only a few foods that are a good source of vitamin D. Approximately 115 g (4 oz) of cooked salmon or cooked mackerel provide 400 IU of vitamin D. The same amount of vitamin D can also be obtained from 170 g (6 oz) of tuna fish or 80 g (3 oz) of sardines (both canned in oil). Vitamin D is also made by your body after exposure to the sun. The ultraviolet rays in sunshine trigger your skin to make vitamin D.
Some people over the age of 50 may need to take supplements if they are unable to get adequate amounts of calcium or vitamin D from their diet or sunlight. In fact, for most people aged over 65, an adequate amount of vitamin D can only be achieved by taking vitamin D supplements. For this reason, a dietary supplement of vitamin D is commonly recommended for people over the age of 65 and for others who may lack vitamin D. For example, people who have a poor diet, or people whose exposure to sunlight is limited, such as those who are largely housebound or women whose whole body is always covered by clothing.
3) Smoking and drinking Chemicals from tobacco can get into your bloodstream and can affect your bones, making bone loss worse. If you smoke, you should try to make every effort to stop. Also, you should try to cut down on your alcohol intake if you drink more than three units of alcohol daily.
4) Hormone replacement therapy HRT contains oestrogen. A few years ago, HRT was widely used to prevent osteoporosis. However, the recent findings on the potential long-term health risks of HRT have meant that it is now not commonly used for this purpose (except in women who have had an early menopause). This is because of the small increased risk of breast cancer and cardiovascular disease (heart disease and stroke) if HRT is used in the long term.