All you need to know about osteoporosis

What is osteoporosis?

Osteoporosis is a medical condition where the bones become brittle, fragile and thin. The thinning of bones typically occurs because of hormonal changes, or if you develop a deficiency in calcium or vitamin D.

Who is affected by osteoporosis?

Osteoporosis can affect men and women, though it is most common in women. Osteoporosis can affect people of all ethnicities, but it is more common in white and Asian communities.

Women are more prone to osteoporosis than men for two reasons. The first is partly because their bones are less dense in the first place. The second, is because of the menopause. This is because oestrogen has a protective effect on bone health and after the menopause, our oestrogen levels plummet.

What causes osteoporosis?

As already mentioned, oestrogen has a protective effect on bones, so anything that reduces oestrogen in women can increase the risk of developing osteoporosis, such as:

• Stopping your periods for more than six months (apart from during pregnancy)
• Starting your periods late in life
• The menopause
• Early menopause (before the age of 45)
• Surgical removal of the ovaries

Bones need calcium to become strong, so it is important to eat a healthy diet with lots of calcium-rich foods, such as dairy products and dark green, leafy vegetables.

Taking long-term or high-dose steroids also increases the risk, as does the following medical conditions:

• Overactive thyroid
• Rheumatoid arthritis
• Bowel conditions such as IBS

These reduce the amount of calcium we absorb from the food that we eat. Consuming too many fizzy drinks can also leach calcium from bones.

People who are in-active or don't do enough exercise (150 minutes per week is recommended) are more prone to osteoporosis as exercise helps to keep joints supple.

Being too thin also increases your risk of osteoporosis, which is why we often see osteoporosis in later life in those who have suffered previously with anorexia.

Smoking and drinking too much alcohol can affect your bone health too.

How to protect your bones from osteoporosis:

There are some risk factors you can't do anything about, such as: race, family history, or any medical conditions that you may have.

But there is a lot you can do to influence the health of your bones even if your genetics and medical history are going against you. The following lifestyle factors can help you protect your bones from osteoporosis:

• Try to be as active as you can - weight bearing exercise is best. Walking or jogging are perfect for keeping bones strong. Swimming is great exercise, though less effective at protecting bone health.
• Make sure you eat a healthy, well-balanced diet that is rich in calcium. Keep fizzy drinks to a minimum and alcohol to within recommended limits.
• Try to maintain a healthy body mass index (BMI) between 18.5 and 25. You can calculate your BMI by dividing your weight in kilos by the square of your height in metres.
• Quit smoking by visiting smokefree.gov or nhs.uk/livewell/smoking for more information.
• Take calcium supplements which will guarantee you get enough calcium to have a beneficial effect on bone health.

How can women protect their bones during the menopause?

It is very important for women to do all the things mentioned above after the menopause to protect their bone health. But, as the menopause causes a natural drop in oestrogen, there are some extra steps you can take to protect your bones.

Post-menopausal women need more calcium in their diet than normal. The recommended daily requirements are 1 - 1.2grams for premenopausal women and 1.5grams for postmenopausal women. Foods rich in calcium include dairy products, leafy green vegetables such as spinach, and fortified grains.

Vitamin D is also essential to help your body absorb calcium from your diet into your bones. It is found naturally in oily fish such as salmon, tuna and mackerel, and in lesser amounts in liver, cheese and egg yolks.

Vitamin D also needs sunlight to activate it so you need to get out in the sun for 15 minutes each day. Consider taking a supplement from October to April when the sun is usually too low in the sky to activate vitamin D production.