Stronger longer: Build and maintain healthy bones
Lifestyle choices, weight workouts and your hormones can all impact the risk of osteoporosis. Here’s how to build, and keep, healthy bones.
Itwas French pathologist and surgeon Jean Lobstein who coined the term osteoporosis in 1835, but it wasn’t until 1941 that endocrinologist Fuller Albright connected the dots between menopausal women and bone density. And so we began to understand our body as it ages, and how that impacts our bones and life. Today we have oodles of data, bone-building medication and can even take a real-time snapshot of how many grams of calcium and minerals are packed into our bones, and yet we still have far to go; make no bones about it (sorry, first and last pun).
You’ve likely read the stats, but they bear repeating: Half of all women and one-third of men over 60 are affected by osteoporosis, as well as some younger people. Adding to the complexity, this is a disease without symptoms (until a fall from standing height causes a fracture), meaning that it’s believed many suffering with osteoporosis will go undiagnosed and untreated.
We have a mindset problem too: osteoporosis is more common than breast and cervical cancer combined, and yet studies reveal many don’t actually believe they’re at risk. The good news? “It’s never too late to get your bone health back on track,” says Dr Ginni Mansberg. Here’s what we know about how to protect and improve bone health today.
Start training for bones
For healthy bones, you’ve got to “use it or lose it,” says Belinda Beck, a professor in the School of Allied Health Sciences at Griffith University and founder of The Bone Clinic in Queensland. “What typically happens is that when people get an osteoporosis diagnosis, the therapeutic approach from your GP will likely be to recommend medication to increase bone mass, but not everyone wants to take it,” says Professor Beck, whose research is focused on forms of exercise targeted specifically at bone. “I call bone the princess tissue because if you’re looking after your heart or lungs or brain or metabolism, doing anything at all will be of benefit. But that’s not the case with bone. You can’t go for a nice long walk or a ride on your bike: it doesn’t do anything for bone.”
What Professor Beck’s research has revealed is that to improve bone density with exercise, it has to be a specific type of exercise that overloads the bone. Historically, she says, research trials investigating the link between exercise and bone density shied away from participants doing anything that created too much strain, “and no one was willing to risk finding out whether high-intensity lifting was able to help,” says
Professor Beck, who decided to find out with a careful, monitored studies. The clinical trials that followed were able to show that a specific set of high intensity resistance and impact training was effective at improving bones, as well and strength and function, and that it was safe.
“This represents a change in what we believed was possible,” she says. “We’ve shown that the bones and muscles adapt to this change – it never ceases to amaze me what people in our clinic can lift.”
“The good news is that it’s never too late to learn about your bone density and get your health back on track.” – Dr Ginni Mansberg
In a nutshell, she describes the program as involving barbell lifting and balance training, but won’t divulge much more “because it’s crucial that people are monitored to avoid injury”, she says. That’s why she opened The Bone Clinic, where anyone can train and be part of ongoing research. She also made the “Onero” program available to physiotherapists and accredited exercise physiologists.
“One of the most interesting things we’ve found is that the more frail people are, the more they respond,” says Professor Beck, who adds that watching it change people’s lives is so fulfilling. “As participants build strength, they’re able to garden for the first time in years, start looking after their grandchildren again, and even walk without a walker.”
Understand the hormonal connection
Fact: Our bone density unravels very quickly after menopause.
“That’s why I always suggest a bone density scan as a routine investigation at the time of menopause, if a patient is amendable to it,” says Dr Mansberg, noting that the cost (around $180) can be prohibitive. However, getting a clear picture of your bone health at this stage is important, says Dr Mansberg.
“If you have weaker bones than would be expected, we need to look at strategies to increase your bone density, which could include HRT, resistance training and also medication.”
Mostly, doctors want to avoid you suffering from a hip fracture because the statistics of recovering are terrible. In fact, often a hip fracture in someone over the age of 65 can lead to a significant decline in independence. “We have the notion that bones mend,” says Dr Mansberg. “While that’s true, statistics tell us this injury sets in motion a set of circumstances that mean that life is never the same again.”
“We worry about the bone density of anyone who fractures a bone after a fall from a standing height,” says Professor Jackie Center, an endocrinologist and Research Fellow at the Garvan Institute of Medical Research. “It significantly increases your risk of another fracture and decreases your quality of life.”