According to the International Osteoporosis Foundation One in Three women and One in Five men over the age of 50 will be affected by osteoporosis. What is Osteoporosis? According to the Osteoporosis society, it can be defined as condition where your bones lose strength, making you more likely to break a bone than the average adult. But it does not mean that you are going to break a bone just you are at a higher risk.
So, what are the risk factors for getting osteoporosis and can you reduce these?
Osteoporosis can affect men and women. It's more common in older people, but it can also affect younger people. I have seen women in their 20’s with osteoporosis but it is more common as I mentioned in older people.
Women are more at risk of developing osteoporosis than men because the hormone changes that occur in the menopause directly affect bone density.
The female hormone oestrogen is essential for healthy bones. After the menopause, oestrogen levels fall. This can lead to a rapid decrease in bone density. When I see people going through the menopause, I always ask about bone density and if they know their bone density score. I will explain more about this later.
Women are at even greater risk of developing osteoporosis if they have:
· an early menopause (before the age of 45)
· a hysterectomy (removal of the womb) before the age of 45, particularly when the ovaries are also removed
· absent periods for more than 6 months as a result of over exercising or too much dieting
In most cases, the cause of osteoporosis in men is unknown. However, there's a link to the male hormone testosterone, which helps keep the bones healthy.
In around half of men, the exact cause of low testosterone levels is unknown, but known causes include:
· the use of certain medications, such as oral corticosteroids
· hypogonadism (a condition that causes abnormally low testosterone levels)
To find out about your bone health, you can have a DEXA scan either through your GP or privately. Generally, the GP will only do one if osteoporosis runs in the family, you are going through the menopause or have experienced a number of bone fractures. A DEXA scan is a non-invasive test that measures bone mineral density to assess if a person is at risk of osteoporosis or fracture. DEXA stands for dual energy x-ray absorptiometry, in which two X-ray beams are aimed at the bones. You will the be given a ‘T’ score. The World Health Organization (WHO) classifies T scores as follows:
· above -1 SD is normal
· between -1 and -2.5 SD is defined as mildly reduced bone mineral density (BMD) compared with peak bone mass (PBM) – Osteopenia
· at or below -2.5 SD is defined as osteoporosis
The International Osteoporosis Foundation has a One Minute Osteoporosis Risk Test Online (see below). This quickly checks for risk factors known to conventional medicine including: - Poor nutrition, Vitamin D deficiency, Long term glucocorticoid therapy and Alcohol intake.
It will not determine if you have osteoporosis, but it is a useful tool to see if you are at risk depending on your family background, diet, exercise and medical history. Interestingly, this test does take into account nutrition, a poor diet could increase your chance of having weaker bones. A high alcohol intake will affect the stomach as it will not absorb calcium adequately "Alcohol interferes with the pancreas and its absorption of calcium and vitamin D. Alcohol also affects the liver, which is important for activating vitamin D -- which is also important for calcium absorption." https://www.webmd.com/osteoporosis/features/alcohol#1
How to look after your bones
It’s never too soon to look after your bones and keep them strong and if you have reduced BMD, it is really, important to change some key areas in your diet.
1. Eat a plant-based whole food diet – This will provide you with the nutrients you need to keep healthy in all respects – calcium and magnesium are found in green leafy vegetables and are essential for bone health.
2. Vitamin D is also essential, since it helps calcium absorption from the intestines into the blood. Vitamin D is made in our skin with exposure to the sun’s ultraviolet rays. In most people casual exposure to the sun for as little as 10-to-15 minutes a day is usually sufficient. However, in elderly people, people who do not go outdoors, and during the winter months in northern latitudes, food or supplemental sources of vitamin D is of importance (International Osteoporosis Foundation).
3. Another nutrient that has come to light recently is vitamin K2. A little bit of biology is needed here to help you understand how this vitamin works. Bone is composed of a hard outer shell and a spongy matrix of inner tissues and is a living substance. The entire skeleton is replaced every 7 to 10 years. During the skeleton’s remodeling, the body releases calcium from the bone into the bloodstream to meet an individual’s metabolic needs. This remodeling is regulated by osteoblasts—cells that build up the skeleton—and osteoclasts—cells that break down the skeleton. Osteoblasts produce osteocalcin, which helps take calcium from the blood circulation and bind it to the bone matrix. The newly made osteocalcin, however, is inactive, and it needs vitamin K2 to become fully activated and bind calcium (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4566462/). Foods that are rich in vitamin K2 include: natto, fermented soy and egg yolks.
4. Eat an alkalising diet – Acid-forming diets are one of the biggest problems when it comes to osteoporosis. People who eat a conventional ‘western’ diet (such as large amounts of animal protein, processed foods, low-quality or damaged fats and refined sugars) will experience numerous health problems- including bone loss. The tolerance for acid/alkaline level fluctuations in our bodies is very sensitive and if we move outside the optimal 7.365pH. your body will do what it can to re-establish the balance. So, if your diet is too acid forming your body will leach alkaline minerals from your bones (including calcium) in order to ‘buffer’ the acid and neutralise it. By including more fruits, vegetables, nuts, beans and seeds in your diet, you can significantly sway your metabolism to the more optimal alkaline pH.
5. Exercise – I recently starting working at https://www.bridgehamclinic.com/ who have a number of classes including Buff Bones & Back Care Pilates which is really good for people osteoporosis or if you just want to improve your fitness. They also have other classes to keep yourself and your bones healthy. Our bones respond to the demands we place on them and the old ‘use it or lose it’ saying is true. While most types of exercise are good for you, not all types are good for healthy bones. For example, weight-bearing exercises can build healthy bone. These exercises involve challenging your muscle strength against gravity and putting pressure on your bones. As a result, your bones will signal your body to produce added tissue to build stronger bones.
6. Supplementation – depending on the health of your bone’s supplementation can be really useful. If you have done a DEXA scan and your score is low, there are certain supplements that can be really beneficial in supporting your bone health. In particular, a formulation that includes calcium, magnesium, vitamin D3 and Vitamin K2. I would also recommend finding out what your vitamin D levels are so you know if you have to increase your supplementation of this particular nutrient. These can all be organised through B Nutrition.
7. Monitoring – If you have had a DEXA scan and want to see if your dietary changes and supplementation is helping improve your bone health we use a test called ‘Bone Turnover’. This simple urine test, which measures how much your bone is turning over i.e. the rate at which you are losing bone. This is a good monitoring tool in between DEXA scans.
There is so much more you can do to help keep your bones healthy, for more information and to get a personalised nutrition plan please contact B Nutrition to arrange a consultation.