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Osteoporosis, osteopenia and osteoarthritis?

 We have peak bone mass roughly around the age of 25, and from that time on, we slowly lose some bone density, which is a natural and normal process.

 Osteoporosis occurs when a person has low enough bone mineral density that is below what is considered normal for your age.  Osteopenia is a decrease in bone mineral density below normal, but not yet low enough to be classified as osteoporosis. Osteoporosis and osteopenia are diagnosed via a DEXA scan (Dual Energy X-Ray Absorptiometry). The score from the scan will determine which one you have (or neither).

Osteoarthritis on the other hand involves the degeneration of cartilage over time which can then include bone and joint surfaces.  It is possible to have both osteoporosis and osteoarthritis or osteopenia at the same time.

Fractures and osteoporosis

Fractures are the biggest concern when it comes to osteoporosis. In women, fractures of the hip and spine are the most common. Prevention of osteoporosis is important as it can lead to fractures. It is important to avoid fractures as especially in the older population, they are associated with loss of quality of life, independence, mortality and morbidity.

Who is at risk?

Postmenopausal women are most at risk for getting osteoporosis. It doesn’t just affect women though, men can also get osteoporosis.

Risk factors are varied. We see lots of people that have taken cortisone for long periods of time, including for asthma that get lower bone density. Not having your ovaries is also a leading cause. Other factors can be  smoking, low calcium and vitamin D, not enough physical inactivity, low BMI and certain medical conditions such as coeliac and Inflammatory Bowel Disease.

What can I do about it?

Prevention of osteoporosis starts young. Weight bearing physical activity and exercise are a great way to help prevent and treat osteoporosis.  Once you are comfortable with weight bearing, adding in some resistance training with weights is a great way to step up your exercise. Finally, especially as we age, it’s important to do balance training. This is helpful in the prevention of falls which can lead to fractures.

Vitamin D levels are probably important.  Getting enough Calcium is also important, although there are varying studies and opinions regarding taking Calcium as it also may get deposited in other tissues like kidneys, arteries etc and Calcium is present in kidney stones and arterial plaques/disease.

Foods that are high in calcium include;

  • Dairy products such as milk, cheese and yoghurt
  • Seafood such as trout, salmon or canned sardines
  • Vegetables such as broccoli, kale and book choy
  • Nuts such as almonds, hazelnuts and walnuts

Vitamin D is important because it helps your body absorb the calcium you’re consuming. Your main source of Vitamin D is through the sun, but ensure your exposure is balanced with skin protection and supplement may be required, especially during the winter months.

Top Take Away Tips

  1. Weight bearing exercise such as yoga, tai chi and walking, alongside resistance and balance training are great at preventing osteoporosis and fractures
  2. Keep up those Calcium and Vitamin D levels for strong bones
  3. Lifestyle changes, such as reducing smoking and alcohol intake, can help lower your likelihood of developing osteoporosis.