What is osteoporosis?
Osteoporosis is a disease in which the bones become fragile and brittle. They fracture more easily than normal bone. Even a minor bump or fall can cause a serious fracture. Half of all women and one-third of men over 60 in Australia will have a fracture due to osteoporosis.
Osteoporosis and fractures are major causes of injury, long-term disability and even death in older Australians. One fifth of people who suffer a hip fracture will die within six months. Of those who don’t die, 50 per cent will be unable to walk without help or stay in their own homes. Some may even need full-time nursing care.
Osteoporosis is often called a silent disease, as there are usually no signs or symptoms until someone has a fracture. Any bone can be affected but the most common are bones in the hip, spine, wrist, ribs, pelvis and upper arm.
What causes osteoporosis?
The health of your bones depends on:
- Your genes (60-80%)
- The level of hormones in your body. In women this hormone is oestrogen in men it’s the hormone testosterone.
- How physically active you are
- What you eat
These things affect how well bones form in early adulthood when your bones are at their strongest. After the 30s, it’s important to maintain bone strength and prevent bone loss.
Menopause and osteoporosis
Menopause means the time around a woman’s last period. Most Australian women reach menopause between the ages of 45-55, but it can happen earlier.
From about the age of 45 years, women may begin to lose bone at the rate of about 1-2% per year. This is because women’s bodies usually make less oestrogen at this age. After menopause, oestrogen levels keep decreasing, and this speeds up bone loss to about 2-4% per year, especially in the first 5-10 years after menopause. This stage of bone loss caused by menopause may last up to 15-20 years. All women lose bone at menopause. The amount varies, but some can lose as much as 30% of their bone during those years. If you have an early menopause for some reason, you will begin to lose bone at an earlier age. You should ask your doctor about preventing osteoporosis.
Men and osteoporosis
The male hormone, testosterone, does not decrease suddenly like oestrogen does in women during menopause. Instead, testosterone gradually decreases from about 50 years of age in men. However, men’s bone density tends to stay the same until they are much older. But after 75 years of age, both men and women lose more bone, especially in the hip. This is part of the ageing process.
Risk factors for osteoporosis
Risk factors for osteoporosis and fractures caused by osteoporosis are similar in women and men. They include some things that you can change, and some that you can’t.
Risk factors you can change
You have a higher risk of having a fracture due to osteoporosis if you:
- Do little or no physical activity
- Are a smoker
- Have a high alcohol intake
- Have low body weight
- Have low calcium intake
- Frequently fall
Risk factors you can’t change
You have a higher risk of having a fracture due to osteoporosis if you:
- Have a parent or grandparent who has osteoporosis or who has had a fracture caused by osteoporosis.
- Are female
- Are Caucasian or Asian
- Have a small body build
- Had delayed puberty or early onset of menopause
- Had anorexia which caused loss of periods
- Have already had a fracture caused by osteoporosis
- Are over 60 years of age
- Have rheumatoid arthritis, chronic liver disease or kidney failure
- Have a history of over-active thyroid or parathyroid glands, or have been treated with thyroid hormones in the past
- Are a male with low levels of testosterone
- Have had long-term drug treatment with corticosteroids (such as prednisone)
Preventing osteoporosis – reduce your risk
Preventing osteoporosis is important. Although there are treatments for osteoporosis, there is no cure. You can reduce your risk of developing osteoporosis and having a fracture by:
- Having a balanced diet rich in calcium and vitamin D.
- Vitamin D to help the body absorb calcium (see fact sheet on Vitamin D for more information). Vitamin D is in small amounts in foods such as dairy products fortified with vitamin D, egg yolks, saltwater fish and margarine. The best source of vitamin D is from safe sunlight exposure.
- Weight-bearing, high impact and strengthening exercises (such as walking, tennis, dancing and weight training)
- Having a bone density test, if appropriate
- Asking your doctor if you need medication
- Asking your doctor if any medicines you take may be causing bone loss
- Not smoking
- Drinking less alcohol
Info from; http://www.arthritisnsw.org.au/what-is-osteoporosis/
Common areas of Osteoporotic bone fractures
Exercise keeps bones strong in adults
Exercise in adults can help keep bones strong. Bone loss begins gradually in the late thirties. During the middle adult years, exercise is important to keep bones strong, as well as improving muscle strength and heart and lung fitness.
Exercise keeps bones strong in elderly people and helps prevent falls
The main aim of exercise for older people depends on how healthy their bones are. If you haven’t been diagnosed with osteoporosis it’s important to exercise to keep bones and muscles strong. Exercise will also help improve your balance, posture and co-ordination.
Exercise helps posture and balance
People with osteoporosis are more likely to have a bone fracture than people with normal bone strength. It’s often a fall that causes the fracture. Elderly people have a higher risk of a fracture because they tend to fall more often. Every year, about 40% of people over 65 fall at least once. Avoiding falls means fewer fractures, especially hip fractures. Most hip fractures are caused by falls.
Exercise and Falls Prevention
Falls can sometimes be prevented. People with better posture, better balance and stronger muscles are less likely to fall and are therefore less likely to be injured. On the other hand, people who are not very active are more likely to have a hip fracture than those who are more active. There are many causes of a fall, but some major factors, which could put you at higher risk include:
- Having had a fall already
- Taking many different medications
- Having chronic diseases
- Having arthritis, especially in the legs
- Problems with vision
- Having poor balance and poor muscle strength
What are the best exercises for strong bones?
Exercises which mean your body has to carry its own weight (e.g. walking, but not swimming), and which involve running, jumping or skipping, help new bone to grow and prevent bone loss. Walking, jogging, dancing, tennis, volleyball, lifting weights, and netball, are all good.
Tips for a good bone-health exercise program
- To have an effect on bone, exercise needs to be REGULAR and FAIRLY VIGOROUS. Doing a VARIETY of different exercises is best because it exercises bone in different ways. SHORT, INTENSE BURSTS of exercise (e.g. 15 minutes lifting weights or very brisk walking) is probably better for bones than a leisurely one hour walk.
- 2 short exercise sessions (20 minutes) separated by 8 hours is better for bone, than one long session
- Start slowly and progress gradually
- Activities that promote muscle strength, balance and co-ordination, help to prevent falls. Pilates, gentle yoga and Tai Chi are all good activities to help prevent falls.
Info from;http: //www.arthritisnsw.org.au/osteoporosis/lifestyle/exercise-and-fitness/
Coping with Arthritis & Osteoporosis
What is vitamin D and why is it important?
Vitamin D forms in the skin when it is exposed to UVB radiation from sunlight. Some foods, such as oily fish and eggs also contain small amounts of vitamin D, while margarine and some types of milk have added vitamin D. However, food only makes a small contribution to the body’s overall vitamin D levels and it is difficult to get enough from diet alone.
We need vitamin D to maintain good health, in particular to keep bones and muscles strong and healthy.
How much sun do we need for vitamin D?
When the skin is exposed to UV radiation from the sun, vitamin D is formed through a series of processes that start in the skin.
The amount of sunlight you need to make vitamin D depends on a range of factors such as the UV level, your skin type, and your lifestyle. UV levels vary across Australia and throughout the year. Therefore, the amount of time you need to be in the sun to make vitamin D will vary according to your location, the season and the time of day.
Prolonged sun exposure does not cause your vitamin D levels to increase further, but does increase your risk of skin cancer. Short incidental exposure to the sun, such as walking from the office to get lunch, is the best way to produce vitamin D. The amount of vitamin D you make is also related to the amount of skin exposed to the sun – if you expose more of your skin, in most cases you’ll make more vitamin D.
During summer in the southern parts of Australia (for example Sydney, Melbourne, Canberra, Adelaide, Hobart and Perth), and all year round in the north (Brisbane and Darwin), most of us need a few minutes a day of sun exposure to an area of skin equivalent to your face, arms and hands to help with our vitamin D levels.
In winter in the southern parts of Australia, where UV radiation levels are below 3 all day, most of us need about two to three hours, spread over each week, to the face, arms, hands or equivalent area. People with naturally very dark skin need 3-6 times this amount.
Daily exercise will also assist your body with the production of vitamin D
How much sun is enough? Chart
When do I need sun protection?
Most Australians need sun protection when the UV Index is 3 or above. The UV Index is an international standard measurement of the strength of UV radiation from the sun at a particular place on a particular day. UV levels are low in the early morning as the sun comes up, gradually increasing to a peak around the middle of the day when the sun is at its highest, and then decreasing slowly as the sun gets lower in the sky.
In the northern parts of Australia (for example Brisbane and Darwin), UV levels are above 3 all year round and reach extreme levels of 14+ in summer, so sun protection is needed daily.
In the southern parts of the country, there are times of the year when sun protection is not necessary. For example, in Adelaide, Melbourne and Hobart, the average daily UV levels remain below 3 from May to August, so sun protection is not required unless you are at high altitudes, outside for extended periods or near highly reflective surfaces like snow.
The table above is a guide to average peak UV levels by month for Australian capital cities.
The shaded area identifies the months of the year when sun protection may not be required.
You can refer to the SunSmart UV Alert to find out the sun protection times for your location.
Info from: http://www.arthritisnsw.org.au/wp-content/uploads/2012/09/how-much-sun-is-enough-2012.pdf & Cancer Council
Bone Density TestHow strong are your bones?
Australia national toll free number for bone density test 1800 242 141
The effects of calcium supplementation taken from the onset of menopause: