Osteoporosis - What is it and Why should I care?
STRONG BONES!
Good bone health makes living an active independent life possible – Live the life you want to live and be able to play and enjoy your activities. Poor bone health can lead to fractures, poor posture, reduced function and long term care. So Get strong, Stay Strong and Live long and Stay on Your Feet!
WHAT IS OSTEOPOROSIS?
Osteoporosis is a condition where the bones are compromised as they become more porous, less dense, thinner and weaker. Our bones continually remodel as we age. Bone resorption (breakdown and removal) and bone formation (generation of new bone) is normally a balanced process. We build bone in our childhood, youth and up until we are 30 years of age.
We can usually maintain good bone health between the ages of 30-50 years if we lead a healthy lifestyle. Otherwise we can start to lose 1% bone strength per year after 30 and 2-5% strength per year for women after menopause. After menopause, women have to make more of an effort to maintain bone strength because more old bone may get removed than new bone gets created. Over time this leads our bones to slowly lose their strength and density. Everyone is different and may lose bone mass at a different rate. Which is why encouraging people to gain strength and build bone in their youth is so important.
WHY SHOULD I CARE?
Osteoporosis is the single greatest cause of fractures among Ontarians over 50 years of age and can occur without symptoms. Breaking a hip or wrist after a minor fall or vertebrae fractures from little movement or from sneezing (fragility fractures) can greatly affect our lifestyle and independence. Breaking a hip can be life altering. 40% of hip fracture survivors never return to their previous health and life expectancy is decreased by 6 years. Broken vertebrae can lead to persistent pain, and changes in posture, decreased lung function, decreased weight, decreased sleep, decreased function and ability to walk well. 24% of survivors of a hip fracture were institutionalized. Maintaining strong dense bones and avoiding falls is the best way to reduce the risk of fractures.
AM I AT RISK?
The following are risk factors for osteoporosis
Post menopausal women
Early menopause (before age 45)
Medication induced – prolonged antacids (for heartburn), sedation, syncope, steroids, hormonal therapy for breast or prostate cancers
Rheumatoid arthritis
Female athlete triad - disordered eating, amenorrhea, low bone mineral density
Anorexia Nervosa
Systemic disease – bowel, endocrine, rheumatoid arthritis, uncontrolled diabetes
Hip or wrist fracture from a fall from standing height (fragility fracture)
Dementia
Historical Height loss - >60 years with >6cm HHL, or <60 years with > 4 cm HHL
Vertebrae fractures are early consequence of decrease in bone health
Family history of osteoporosis
Smoking
Alcohol (>3 drinks a day)
Men are at risk too. More men die post hip fracture than do from prostate cancer. 1 in 5 men will have osteoporosis.
WHAT CAN I DO?
Find out if you are at risk. Speak with your primary health care practitioner. Get a bone density test.
Ensure you get adequate vitamin D. Vitamin D is best taken with some fat.
· Vitamin D – 800-2000 IU > 50 yr, 400-1000 IU < 50 Yr
Ensure you get adequate calcium - 1200 mg from food first and supplementation if necessary (dairy, sardines and salmon, fortified food, dark green leafy vegetables such as broccoli, bok choy and kale)
Vitamin D supplements when taken in combination with calcium can reduce falls by 22%.
If you need medication – speak to your health care practitioner and pharmacist
Do what you can to prevent falls – check your medications, exercise, strengthen, improve balance, improve posture, and avoid risky behaviours!
Move well and get stronger You need to exercise and stimulate your bones to make them grow a little bit more in a carefully controlled way. Weight bearing exercises are best! Stay tuned for exercise examples!
1. Practice balance exercises every day
2. Strength/resistance train 2-3 times a week (think push, pull, lift and weight bearing exercises)
3. Do aerobic fitness 5 times a week (mostly weight bearing exercises).
4. Impact exercises (You don’t have to start with jumping exercises! Build up your ability to include impact into your program).
If you have osteoporosis –Avoid REPEATED, SUSTAINED, WEIGHTED, END-RANGE, RAPID/FORCEFUL OR COMBINED (flexion, rotation, side bending). Ask me for more details.
Not every fall breaks a bone, but if you don’t fall, you have much less risk of fractures! Practice fall prevention.
REMEMBER - It is never too late to do something about our bones and our health. Even in our 90’s we can minimize the risk of breaking bones.
Resources
https://www.osteoporosis.ca
https://www.iofbonehealth.org/what-sarcopenia
https://www.frontiersin.org/articles/10.3389/fnut.2019.00075/full
https://www.osteoporosis.ca/wp-content/uploads/Osteoporosis-Assessment-Tool_REV5.pdf
https://www.healthandbone.ca
https://www.osteoporosis.ca/bone-health-osteoporosis/calcium-calculator/#page-2