What is Osteoporosis?
Osteoporosis is a condition that affects the bones. The literal translation of the word, “bones with holes”, is an accurate description of what happens. As the bones lose minerals such as calcium more quickly than the body can replace them, they become less dense. As a result, bones lose the internal structure that provides them with their strength, making them weaker and more susceptible to breaking.
During the early years of life where growth occurs, more bone is constantly being made than broken down. Once peak bone mass is achieved, around 30 years of age, bone growth has been completed. For most men and women, the next greatest change in bone mass occurs around menopause. This is because sex hormones such as oestrogen and testosterone play important roles in maintaining bone strength. During menopause, oestrogen levels fall, leading to accelerated bone loss. This is more pronounced in women than men with the average women losing up to 10% of her total body bone mass during the first 5 years after menopause.
Who can get Osteoporosis?
Osteoporosis affects both men and women, most commonly over the age of 50. In Australia, over 1 million people have osteoporosis. Below lists a few factors that increase your risk of osteoporosis. If you are concerned about any of the following, speak to your doctor or pharmacist.
How do I know if I have Osteoporosis?
There are no specific symptoms with osteoporosis. Unfortunately many people do not know they have osteoporosis until they have a fracture, giving osteoporosis its reputation as a “silent disease”. For this reason it is important that anyone with the above risk factors, especially those over 50 who have experienced a broken bone, be tested for osteoporosis.
Why is it important to be tested for osteoporosis?
If you have had a fracture, your risk of sustaining another fracture increases after each new fracture. In other words, fracture risk increases in a ‘cascade effect’. As such, it is important that osteoporosis is diagnosed and treated to minimise the risk of fractures.
How can it be prevented?
Adequate calcium intake, vitamin D and certain exercises can help maintain health bones.
Why is Calcium important?
Calcium is important as it is the main mineral used for forming the bone structure, giving bones its strength. Most of the body’s calcium is found in bones (approximately 99%). The rest of the calcium is important for the normal functioning of the heart, muscles, blood and nerves. However, when insufficient calcium is provided through our diet, the body takes the calcium from the bones to ensure the heart, muscles, blood and nerves continue functioning normally. This results in decreased bone density and bone strength, increasing your risk of osteoporosis.
Calcium can be found in a wide variety of foods but the levels in each type of food varies. Below are a few tips on how you can increase your calcium intake through your diet.
Whilst ideally we should obtain our calcium from our diet, if levels remain low, supplements may be required. Below are just a few examples.
Why do I need vitamin D?
Vitamin D helps with calcium absorption and thus plays an important role in healthy bones. The main source of vitamin D is from sun exposure. When our skin is exposed to ultraviolet B (UVB) from sunlight, vitamin D is produced. However, only a small amount of sun exposure is required to produce recommended levels of vitamin D. The amount of sun exposure also varies with the season, location in Australia, skin type and area of skin exposed. Below are some recommendations provided by Osteoporosis Australia.
|Skin type||Season||Skin exposed||Time of day||Duration|
|Moderately fair||Winter||Arms or equiv.||Midday||7-30 mins|
|Darker skin||Winter||Arms or equiv.||Midday||20mins-3hrs|
|Moderately fair||Summer||Arms or equiv.||Mid-morning or mid afternoon||5-10 mins|
|Darker skin||Summer||Arms or equiv.||Mid-morning or mid afternoon||15-60 mins|
Despite Australia being known for its beautiful blue skies and sunshine, over 30% of adults are vitamin D deficient. Below are some groups who are at risk of vitamin D deficiency. If you are concerned about your vitamin D levels, speak to your doctor about being tested.
If you have been found to be deficient in vitamin D, you may require a supplement. Below are just a few examples and dosage methods that can be found. It is recommended that you speak to your doctor who will provide advice on a dose that suits your needs.
What combination products are available?
For convenience, calcium and vitamin D can also be found in combination products. Below are just a few examples.
What types of exercise will help?
Exercise is important as it provides some impact and strain on bones which is crucial for maintaining bone strength and density. However, benefits through exercise depends on the type of exercise, amount of exercise, and maintaining exercise long-term. The purpose of exercise with respect to bone health also varies depending on our stage in life. As children and adolescence, exercise helps with maximising bone strength. In adulthood, exercise helps maintain muscle and bone strength, whist in the elderly, exercise aims to maintain or increase muscle mass and strength, improve balance and walking ability, and overall minimise the risk of falls. Below are a few examples of some exercises and their impact on bone health in relation to osteoporosis. In general, weight bearing exercises and progressive resistance training are important types of exercise for improving bone strength.
If you have had a fall or have osteoporosis, a physiotherapist can help with developing an exercise program to suit you and minimise your risk of having another fall.
What else can be done to minimise falls?
Some small things can be done around the home to minimise the risk of falls. Below are just a few examples.