Ones of osteoporosis

PROTECT YOUR BONES

an of c cts (steroid) tablets, anti-epileptic drugs, breast cancer treatments such as aromatase inhibitors, and some prostate cancer drugs. The Depo- Provera contraceptive jab is also known to affect bone density.

Some medical conditions: Rheumatoid arthritis, low levels of testosterone in men, low levels of oestrogen in women (eg early menopause, anorexia nervosa, hysterectomy before age 45), Crohn’s, coeliac disease and certain thyroid diseases are linked to osteoporosis.

Smoking: Women who smoke tend to have an earlier menopause, upping their risk, and the habit seems to affect bone-building cells.

Drinking too much alcohol: Alcohol seems to affect cells that build and break down bone and, of course, under the influence, you become unsteady – increasing your risk of falls.

Over-exercising: Over-training, together with not eating enough for endurance workouts, can negatively impact bone health. This is something known as the “female athlete triad” or “relative energy deficiency in sport” (as it can affect men, too).

Diet: People who are vegan or lactose intolerant should ensure they get calcium from other sources, such as tofu, dried fruit, pulses, almonds and broccoli. And be wary about extreme diets that eliminate dairy, warns Sarah. Vitamin D – from exposure to sunlight, oily fish and eggs – is vital for calcium absorption. Osteoporosis doesn’t necessarily have any symptoms. In fact, most sufferers are unaware of their condition until they suffer a fracture. LIFESTYLE factors can mean the difference between a healthy, strong skeleton and weak, fracture-prone bones: ■ Aim for a minimum of 700mg of calcium a day, advises Sarah. “That’s the equivalent of a pint of milk.” Although dairy is the best food source, calcium is also found in bony fish such as tinned salmon and sardines, leafy green veg including kale, broccoli and spinach, dried fruits, and cereals fortified with calcium. ■ Vitamin D is made in the body by sunlight on the skin and helps us to absorb calcium. Studies suggest most Brits are deficient in the winter so consider taking a supplement, suggests Sarah. Try Healthspan Super Strength Vitamin D3 (£4.99 for 60, healthspan.co.uk). ■ Ideally, do some form of weight-bearing exercise, advises Sarah. “It needs to be something more than just walking so activities that involve impact, such as running, jumping and skipping are effective. It’s the impact of your foot hitting the floor, causing a jolt through the skeleton that helps maintain bones.

“Swimming and cycling doesn’t count as the body’s weight is supported. You should also do resistance exercise, such as lifting weights, in which your muscles are pulling on your skeleton as this boosts bone strength.” “Broken wrists in middle-age women, following a minor fall or bump, are classic warning signs,” said Sarah. “However, some might notice they suffer back pain or a loss of height.”

If you have had an eating disorder, suffered a fracture after a minor fall, reached the menopause early, have a history of missed periods, or are on a long-term course of corticosteroid drugs, ask your GP for a referral to a specialist for a fracture risk ■ Rethink high-protein plans: Diets like these often limit fruit and vegetables (especially Atkins and Dukan) and can cause bones to thin, said Dr Marilyn Glenville, author of Osteoporosis: How to Prevent, Treat and Reverse it (Kyle Cathie, £10.99).

“Our blood exists best at a neutral pH of around 7.5 where acid and alkaline levels are even. But high-protein diets cause an acidic effect on the body so it tries to rebalance its pH levels by leaching alkalising calcium from the bones and teeth. Over time, this can weaken bones.

“If you’re trying to lose weight, having protein such as lean meat, fish, poultry, pulses or nuts at every meal satisfies appetite – but try to pair it with alkalising fruits and vegetables so your blood pH remains neutral.” ■ Salty convenience foods and fizzy drinks containing phosphoric acid can leach calcium from bones. Too much caffeine and salt are also linked with lower levels of calcium in the body, which, in the long term, can weaken bones. ■ Yoga, Pilates, barre work – anything that builds up your balance could help reduce falls later in life. One study published in the Journal of the American Geriatrics Society found that tai chi practised weekly could reduce the risk of multiple falls in later life by almost 50 per cent. ■ Prunes contain potassium and boron which are thought to boost bone metabolism and prevent loss of bone mass over time. assessment. This may include a bone density (DEXA) scan to help measure your bone strength.

Assess your risk of osteoporosis by taking the Stop at One quiz: stopatone.nos.org.uk Ask about Fracture Liaison Services in your area, which are designed to ensure everyone over 50 who breaks a bone is assessed for osteoporosis. Unfortunately, only 55 per cent of the population have access to these services.

Fractures are more common in women as bone loss is more rapid for several years after menopause

Drugs to reduce fracture risk act in different ways – reducing resorption or increasing bone formation. Most are antiresorptive drugs that slow down the activity of cells that break down old bone, while anabolic drugs stimulate cells that build new bone.