Bone Health Matters

Bones are Living Tissue

It is easy to think of bones as a hard, lifeless part of our body. But bone is a living, growing tissue that changes over the course of a lifetime, with old bone being removed and replaced with new bone. This process where the bone is constantly being renewed is called bone remodeling. For most people, bone formation continues at a faster pace than removal until bone mass peaks usually in your 30s. From your 40s onwards the bone renewal tends not to keep pace with bone loss.

For many people, this bone loss can be prevented or reduced by continuing to get calcium, vitamin D, and exercise and by avoiding tobacco and excessive alcohol use. A bone-healthy diet is an essential ingredient in helping to slow the rate of bone thinning and preserve muscle function. This in turns helps reduce the risk of falls and fractures.

Osteoporosis

After the age of about 35 years, the difference between the amount of bone that is removed and the amount of bone that is formed starts to get slightly out of balance as part of the ageing process. As a result, bones can become weaker and are more likely to break. This condition is called Osteoporosis. 

Osteoporosis develops slowly over several years and is often only diagnosed when a fall or sudden impact causes a bone to break (fracture). One in two women and one in five men over the age of 50 experience fractures, mostly as a result of low bone strength. 

The most common fractures in people with osteoporosis are:

• broken wrist
• broken hip
  
• broken spinal bones (vertebrae)

However, breaks can also happen in other bones, such as in the arm or pelvis.

Causes of osteoporosis

Losing bone is a normal part of ageing, but some people lose bone much faster than normal. Women also lose bone rapidly in the first few years after the menopause. Women are more at risk of osteoporosis than men, particularly if the menopause begins early (before the age of 45) or they've had their ovaries removed. 

However, osteoporosis can also affect men, younger women and children.

Many other factors can also increase the risk of developing osteoporosis, including:

• a family history of osteoporosis - particularly a hip fracture in a parent
• long-term use of certain medicines that can affect bone strength or hormone levels, such as anti-estrogen tablets that many women take after breast cancer
• taking high-dose steroid tablets for more than 3 months
• other medical conditions - such as inflammatory conditions, hormone-related conditions, or malabsorption problems
• having or having had an eating disorder or malnutrition
• having a low body mass index (BMI)
• not exercising regularly
• heavy drinking and smoking

Preventing osteoporosis

If you're at risk of developing osteoporosis, you should take steps to help keep your bones healthy. This may include:

• Exercise regularly to keep your bones as strong as possible
• Eat Healthy - including foods rich in calcium and vitamin D
• Lifestyle changes - such as giving up smoking and alcohol consumption 

How can I get the Calcium that I need?

There are three ways you can get vitamin D:

1. from sensible sunlight exposure - 10 minutes of sunshine on face and arm up to twice daily
2. from food and drink that contain vitamin D, either naturally or fortified;
3. Vitamin D supplements 
   

Calcium rich foods are important in building and maintaining strong, healthy teeth and bones and helping to protect you from osteoporosis. Each full portion gives you about 200 to 300mg of calcium 

Some examples of food that contain vitamin D are

• Oily fish (the richest source) Liver and liver products
• Eggs, Margarine and low-fat spreads*
• Breakfast cereals*
• Yoghurts*
• Milk powder*
• Evaporated milk*
• Supplements - Calcium tablets may be necessary for some people.

* from vitamin D supplements added to some brands 

Some recommended amounts

• Cow’s milk - all types 200mls (⅓ pint)
• Calcium enriched soya milk 200mls (⅓ pint)
• Cheese (hard) 30g (1oz)
• Yoghurt 150g (6oz)
• Milk dishes e.g. custard, rice pudding 200g (8oz)
• Sardines or salmon with bones 60g (2oz)

Speak to your doctor about taking a food supplement and whether you need to consider any nutritional aspects, such as food allergies, sugars and potential interactions with mediations you might be taking.

Speak to a or nutritionist about what other foods promote good bone health.

Osteoarthritis

Osteoarthritis (OA) is another disease that impacts the bones. It is a degenerative joint disease where the cartilage within a joint begins to break down and the underlying bone begins to change.

These changes usually develop slowly and get worse over time. OA can cause pain, stiffness, and swelling that may lead to reduced function and disability.

Also known as “wear and tear” arthritis, osteoarthritis is the most common form of arthritis. It occurs most frequently in the hands, hips, and knees.

What are the signs and symptoms of OA?

• Pain or aching
• Stiffness
• Decreased range of motion (or flexibility)
• Swelling

What are the risk factors for OA?

• Joint injury or overuse - Injury or overuse, such as knee bending and repetitive stress on a joint, can damage a joint and increase the risk of OA in that joint.
• Age - The risk of developing OA increases with age.
• Gender - Women are more likely to develop OA than men, especially after age 50.
• Obesity - Extra weight puts more stress on joints, particularly weight-bearing joints like the hips and knees. This stress increases the risk of OA in that joint. Obesity may also have metabolic effects that increase the risk of OA.
• Genetics - People who have family members with OA are more likely to develop OA. People who have hand OA are more likely to develop knee OA.
• Race -  Some Asian populations have lower risk for OA.
  

What are the treatment options for OA?

There is no cure for OA, so doctors usually treat OA symptoms with a combination of therapies, which may include the following:

There is currently no cure for OA and doctors usually prescribe treatment for OA symptoms, such as:

• Increasing physical activity
• Physical therapy with muscle strengthening exercises
• Weight loss
• Medications, including over-the-counter pain relievers and prescription drugs
• Supportive devices such as crutches or canes
• Surgery (if other treatment options have not been effective)

However, people with OA can adopt certain self-management strategies designed to help reduce pain and disability.