World Osteoporosis Day - 20 October

The difference between osteoporosis and osteopenia

Osteopenia is a warning diagnosis. It indicates that you have low bone mass, and your bone health is not as good as it used to be. If you have received an osteoporosis diagnosis, it is time to take action.

Osteoporosis is a medical diagnosis of degenerated (broken down) bone.

What causes osteoporosis

Your bones are in a constant state of renewal — new bone is made, and old bone is broken down. When you are young, your body makes new bone faster than it breaks down old bone, and your bone mass increases. After the early 20s, this process slows, and most people reach their peak bone mass by age 30. As people age, bone mass is lost faster than it is created.

How likely you are to develop osteoporosis depends partly on how much bone mass you attained in your youth. Peak bone mass is somewhat inherited and varies also by ethnic group. The higher your peak bone mass, the more bone you have "in the bank" and the less likely you are to develop osteoporosis as you age.

Risk factors that you can control

Current and previous lifestyle habits can lead to osteoporosis. Some bad habits can increase your risk of osteoporosis.

Examples include:

Sedentary lifestyle. People who spend a lot of time sitting have a higher risk of osteoporosis than do those who are more active.

Excessive alcohol consumption. Regular consumption of more than two alcoholic drinks a day increases your risk of osteoporosis.

Dietary factors also play are role. Osteoporosis is more likely to occur in people who have:

Low calcium intake. A lifelong lack of calcium plays a role in the development of osteoporosis. Low calcium intake contributes to diminished bone density, early bone loss, and an increased risk of fractures.

Eating disorders. Severely restricting food intake and being underweight weakens bone in both men and women.

The consequents of osteoporosis

Osteoporosis causes bones to become weak and brittle — so brittle that a fall or even mild stresses such as bending over, or coughing can cause a fracture. Osteoporosis-related fractures
most commonly occur in the hip, wrist, or spine. Spine and hip fractures, in particular, may lead to chronic (long-term) pain and disability, and even death. The main goal of treating osteoporosis is to prevent such fractures in the first place.

Detecting osteoporosis

Because Osteoporosis is silent, the bone density test, or DEXA, has become of major importance. You can learn if you have osteoporosis by having a simple test that measures bone
mineral density. It tests the amount of bone you have in a given area — is measured at different parts of your body. Often the measurements are at your spine and your hip, including a part of the hip, called the femoral neck, at the top of the thighbone (femur). The test is quick and painless. It is similar to an X-ray but uses much less radiation.

Preventing osteoporosis

  • Lifestyle changes may be the best way of preventing osteoporosis. Here are some tips:
  • Make sure you get enough calcium in your diet or through supplements (roughly 1,000–1,200 mg/day but will depend on your age).
  • Get enough vitamin D (400–1,000 IU/day, depending on your age and your blood level of vitamin D measured by your doctor).
  • Stop smoking.
  • Avoid excess alcohol intake: no more than two or three drinks a day.
  • Be physically active and do weight-bearing exercises, like walking, most days each week.  Aim for at least 2½ hours a week (30 minutes a day five times a week or 50 minutes a day three times a week), or as much as you can. Exercises that can improve balance, such as yoga, may help prevent falls.
  • Change lifestyle choices that raise your risk of osteoporosis.
  • Implement strategies to help decrease your risk of falling.

Bone-protecting foods

Good sources of calcium include:

  • milk, cheese, and other dairy foods
  • green leafy vegetables, such as broccoli, cabbage, and okra, but not spinach
  • soya beans
  • soya drinks with added calcium
  • nuts
  • fortified orange juice
  • sesame seeds
  • bread, cereal, and anything made with fortified flour
  • fish where you eat the bones, such as sardines and pilchards

Exercises for bone strength and mobility

Exercising can also help us maintain muscle strength, coordination, and balance, which in turn helps to prevent falls and  related fractures.

Any weight-bearing exercise and activities that promote balance and good posture are beneficial for your bones, but walking, running, jumping, dancing, and weightlifting seem particularly helpful.