Maintaining a solid internal structure
“OSTEOPOROSIS is often painless and symptomless in the early stage,” says Dr Mohd Rusdi Abdullah, consultant orthopaedic surgeon at Subang Jaya Medical Centre. Because of that, osteoporosis is often only discovered when a patient experiences a fracture, commonly to the hip, spine or wrist.
In such cases, the osteoporosis will typically have already progressed significantly. However, he shares that depending on severity, osteoporosis can be reversed or at least halted through the right combination of routine weight-bearing exercises and a specially constructed nutritional programme sustained over several years.
Osteoporosis is a skeletal disorder characterised by the loss of bone density, increased bone porosity, fragility and susceptibility to fractures. Symptoms related to osteoporosis can impair the ability to perform daily activities due to bone pain and the high risk of fracturing after a trivial fall.
Dr Rusdi explains that osteoporosis is classified as either primary or secondary depending on the underlying causes. Primary osteoporosis can be further subdivided into Type 1 and Type 2. Type 1, also known as postmenopausal osteoporosis, commonly occurs 15 to 20 years after menopause in females, following a decline in oestrogen levels, while Type 2 – ageassociated or senile osteoporosis – occurs approximately beyond the age of 70. In contrast, secondary osteoporosis is the result of specific conditions such as disease, surgery and drugs.
Exercise helps strengthen bones
Today, most children and adults lead sedentary lifestyles and are at risk of having low peak bone mass and, eventually, osteoporosis. “Children should exercise for at least one hour each day and adults should get 30 minutes each day of moderate intensity physical activity,” says Dr Rusdi.
He advises people to maintain healthy weights, as being overweight increases the risk of joint wear and tear disease and falling while being underweight increases the risk of bone loss and fractures. “A combination of weight-bearing and strengthtraining exercises is the best way to build and maintain bone density,” he says.
Weight-bearing exercises include walking, running and hiking. Strength-training exercises use free weights, resistance bands or your own body weight to add resistance to natural movement. Examples of strengthening exercises are toe and heel rises, wall slides, leg lifts, bicep curls, tricep extensions and body weight squats.
He suggests that as a general guideline for bone health, everyone must work to build up to 30 minutes of weight-bearing activities three or four days a week and strength-train major muscle groups at least twice a week, with at least one rest day between the two days. These exercises are important for building strong bones, especially in younger people. As one ages, focus should then be shifted to maintaining bone strength. These exercises increase bone mineral density, reduce inflammation, protect against bone loss, promote good posture and improve balance.
Keep in mind that all exercises should be tailored to your individual ability and tolerance to prevent injury.
The right diet
Aside from exercise, Dr Rusdi advises that to maintain good bone health, having a balanced diet with plenty of dairy, fish, fruits and vegetables is key. “The health of our bones depends on a steady stream of nutrients, especially calcium and vitamin D.”
Dr Rusdi explains that you must get enough calcium in your diet as bones break down and grow each day. He says, “The recommended daily intake of calcium for those aged nine to 18 would be 500mg while 1,200mg is recommended for women above the age of 50 and men aged 70.”
Good sources of calcium include dairy products, almonds, broccoli, kale, sardines and soy products such as tofu.
Vitamin D is important as it helps the body absorb calcium. People with vitamin D deficiencies have a higher risk of losing bone mass. One can absorb vitamin D through moderate sun exposure, consume fatty fish and seafood, mushrooms and egg yolk.
Like calcium, magnesium and zinc are minerals that provide important support for bone health and density. Magnesium helps activate vitamin D so it can promote calcium absorption. Zinc exists in the bones, promoting bone growth and helping prevent bones from breaking down. Foods rich in magnesium and zinc include nuts, legumes, seeds and whole grains.
Dr Rusdi says, “Eating vegetables that are high in vitamin C promote bone growth in children and maintain bone density and strength in adults.” This is because the high content of polyphenols and potassium in vegetables can reduce bone turnover and calcium loss.
Vitamin K-2 plays an essential role in bone health by reducing calcium loss and helping minerals bind to bones. Foods that contain vitamin K-2 include sauerkraut, cheese and natto. Additionally, protein and omega-3 fatty acids play a role in maintaining bone density. Omega-3 fatty acids are present in a variety of foods, such as salmon, mackerel, nuts and seeds. You can consume these fatty acids through your diet or supplements.