Here’s a funny thing: not one of us gals wants to be the proud owner of a set of brittle bones. No one wants to fall and fracture a hip. No one wants to sneeze and break a rib. No gal here covets a dowager’s hump. As if, right? So, since absolutely no one is putting up their hand saying ‘pick me, pick me!’ when it comes to osteoporosis, why aren’t we doing more to protect and strengthen our precious bones? Maybe because this stuff is trickier to get right than it first appears. So let’s get cracking (although not literally we hope), and sort this out.
What is osteoporosis?
- It happens when bones lose calcium and other essential minerals faster than the body can replace them, which can cause bones to become fragile and more prone to fractures. Imagine a once solid mass that now looks more like honeycomb – that’s what brittle bones look like.
- As bone mass declines, it can also lead to height ‘shrinkage’ and curvature of the spine, aka a widow’s or dowager’s hump.
- About 1.2 million Australians have it, with millions more unaware they are already at risk. It affects mainly women, although it certainly affects men too, and women over 50 are at increased risk. The rapid decline of oestrogen during menopause leaches the good stuff from bones at breakneck speed.
- Once you sustain an osteoporotic fracture, you are pretty much a shoo-in for another more serious break down the line. Something as dumb as stubbing your toe or coughing too hard can cause a fracture. Crazy!
- Osteoporosis is not only painful, but debilitating and emotionally devastating as quality of life declines.
- Although genetics plays a major role in your risk for osteoporosis, there is much you can do to ensure your bones are as strong as they can possibly be.
What is osteopenia?
- It means low bone density and is a precursor to full-blown osteoporosis. It’s when your bone density slips from the OK range into the ‘we gotta do something about this’ range. If you get this diagnosis, you will need to work with your doctor and act on it without delay.
Why so tricky?
While many of us know a calcium-rich diet is important, it’s not the whole story – we also need enough of its little helper, vitamin D. Regular weight-bearing exercise is also critical for building and maintaining strong bones. And therein lies the 1-2-3 conundrum:
1 Many of us avoid dairy, the richest source of calcium, because of its fat content. Good news! Low-fat dairy contains just as much, if not more, calcium than full-fat dairy. Studies show including dairy in your diet is more likely to help than hinder weight loss. Even those with lactose intolerance can safely eat yoghurt and most cheeses with no ill effects. If you are not a dairy fan, there are plenty of other calcium-rich options.
2 About 30 per cent of Australians have vitamin D deficiency. Food isn’t a great source of D, but our bodies can produce all we need with a little unprotected sun exposure each day. About 5 to 10 minutes of sunlight on your bare arms will do the trick, and about 20 minutes during winter. A simple blood test can reveal your vitamin D levels and if you are running super low, a D supplement may be recommended.
3 We are often too tired/busy/insert other ‘reason’ to not exercise. This is chop logic, ladies! The benefits of exercise outweigh any excuses. Weight-bearing exercise means exercise you do on your feet so that you ‘carry’ your own weight. Walking, jogging, skipping, playing tennis, dancing and aerobics are all good examples. Resistance or strength training is another great way to improve bone health. This might mean lifting free weights or using specific equipment at home or the gym. You can pick up an inexpensive resistance band and use it while watching telly! You need at least 30 minutes of exercise on most days of the week.
Other issues impact bone health, too. Illnesses like coeliac disease, rheumatoid arthritis, asthma, inflammatory bowel disease, certain thyroid conditions and the medications used to treat them can inhibit calcium absorption – as can smoking and excessive amounts of alcohol.
Get creative! Snack on fresh vegies dipped in tangy Greek yoghurt, blend up a super smoothie with kale and unsweetened vanilla almond or soy milk, and munch on celery spread with a yummy nut butter.
Have a bone density scan
If you have certain risk factors (see Are You at Risk?, below) for osteoporosis or are over 50, talk to your GP about a getting a bone density test. This short, painless scan, usually at the hip and spine, reveals the strength of your bones. The result, called a T-score, will be normal (higher than -1); osteopenia (between -1 and -2.5) or osteoporosis (-2.5 or lower). Once you know your score, you can work on a plan of action. If you receive a positive diagnosis, there are many drug treatments available to help slow bone loss and prevent fractures. Your doctor will work with you to find the most effective medicines for you and your progress will be closely monitored.
Can’t I just pop a supplement?
Ideally, no. Osteoporosis Australia recommends we get our calcium from the food we eat; it’s the most efficient, safest delivery system. When this isn’t possible, a supplement of no more than 500-600mg per day may be necessary, but only in consultation with your doctor who will be able to advise if, what kind, when and how to take it. Although a rare occurrence, calcium supplements may lead to blood disorders or kidney problems. New concerns about the link between calcium supplements and heart health are also being keenly investigated.
So how much do I need?
The recommended dietary intake of calcium for women and men between 19 and 50 years old is 1000mg a day. Women and men over 50 should aim for 1300mg, achieved with three to five servings of calcium-rich foods per day. A serving size is equal to a 250ml glass of whole, skim or reduced fat milk; a calcium-fortified drink such as soy or almond milk; a 200g tub of yoghurt; or a slice of hard cheese, such as cheddar or parmesan.
Get your calcium on by including a wide variety of the following foods in your daily diet.
- Cow’s milk (regular, skim, reduced fat, calcium-fortified, or evaporated)
- Soy milk, almond milk (regular, reduced fat)
- Tofu (firm)
- Yoghurt (regular, low fat)
- Cheddar cheese (regular, reduced fat)
- Parmesan, edam, pecorino, camembert
- Sardines with bones,in water or oil
- Pink salmon, red salmon
- Almonds, brazil nuts
- Dried figs, dried apricots
- Bok choy, silverbeet, celery, broccoli, mustard cabbage
- Chickpeas, edamame, fortified brekkie cereals
Are you at risk?
Tick the boxes to assess your risk:
- Over 50
- Family history of osteoporosis, especially parents or siblings
- Sedentary lifestyle (little to no exercise)
- Heavy alcohol or caffeine user
- Delayed puberty
- Early menopause
- Frequent use of prescription corticosteroid drugs for conditions such as asthma, arthritis
- Liver or kidney disease
- Low body weight or excessive body weight