Dr Sarah Jarvis
My Weekly’s favourite GP from TV and radio writes for you
With World Osteoporosis Day around the corner on October 20, it’s a good time to think about bones. 1 in 3 women over 50, and 1 in 5 men, will break a bone due to osteoporosis. Fortunately, lifestyle changes and, if necessary, medication can help.
It’s never too early to take steps to avoid osteoporosis – and literally taking steps (plenty of them) is the best form of defence. Osteoporosis is sometimes called “the silent epidemic” – many people don’t know they have weak bones until they break one. Since osteoporosis gets more common with age and we’re living longer, more of us are at risk each year.
Life expectancy has gone up 13 years for men and almost 10 years for women since 1970. An “average” woman of 65 today can expect to live for another 21 years, and an average man for more than 18 years. New bone is constantly being laid down and old bone tissue broken down. Until your 40s, bone is formed faster than it’s taken away, so your bones get thicker. From then on the process is reversed – and in women, bone loss speeds up after menopause. Men also have stronger bones to start with. Obviously if your bones are less strong you’re more likely to break one, but some bones are more at risk. A “fragility fracture” is a break when you’ve fallen from standing height or lower, and your hip (technically the “neck” of your femur, or thigh bone) and your wrist are top of the list. Up to half of people who break a hip can’t live independently afterwards.
IF YOU BREAK A BONE AFTER A MINOR FALL, YOUR DOCTOR SHOULD ALWAYS ARRANGE A BONE SCAN TO SEE IF YOU HAVE OSTEOPOROSIS
The bones of your spine are also prone to breaking. This can lead to persistent pain, stooping and sometimes breathing problems if your ribcage is squashed.
The first step is to know if you’re at risk. You’re more likely to break a bone if a parent or sibling had osteoporosis; if you’re very underweight; if you went through menopause before 45; if you’ve taken steroid tablets for any length of time; or if you have certain medical problems. See your GP if you think you might be at risk; they may suggest a bone scan.
Lifestyle is key. For instance smoking makes you more prone to broken bones as well as lung cancer – see your doctor for help to quit!
Drinking more than about 4 units of alcohol a day (2 “normal” glasses of wine or 2 pints of beer) can make bones more brittle. Even more than 2 units a day increases your risk to an extent.
Exercise goes a long way to protecting your bones, but non-weight bearing kinds like swimming (and to an extent cycling) don’t produce the impact your bones need to rebuild. However they are great for your heart and general fitness, so don’t stop! Instead add brisk walking, running, dancing or exercise classes. You can even exercise with osteoporosis – just avoid bungee jumping!
Ideally, combine this with strength and resistance training. Arm curls with a can of beans; pushing yourself up from an armchair using your arms; and repeatedly going onto tiptoe and down to flat feet (make sure you’re well balanced!) will work different muscle groups. This improves balance as well as strength, making you less prone to the falls that lead to breaks.
Calcium in your diet helps keep bones strong. Dairy products, tinned fish with bones, fortified cereals and bread, or veg like spinach are sources. Next week: Say goodbye to thrush forever…
TAKE A 10MICROGRAM SUPPLEMENT OF VITAMIN D FROM OCTOBER-APRIL, AND ALL YEAR ROUND IF YOU’RE OVER 65 OR DON’T GET OUTSIDE MUCH
ENOUGH CALCIUM IN YOU UR DIET HELPS KEE EP YOUR BONES STRONG’’