10 Ways to Prevent and Manage Osteoporosis

Osteoporosis is a musculoskeletal condition that affects the strength and density of the bone tissue, leaving them weak and at a greater risk of fractures. Osteoporosis can affect anyone, but is more common among women and becomes more likely with age, with around 20% of Australians over the age of 75 diagnosed with osteoporosis or osteopenia. Living with osteoporosis can affect how you live your life, and put you at greater risk of injury from minor falls or accidents. Luckily, there are plenty of ways you can protect your bone health and prevent osteoporosis, or manage your condition. Here are 6 ways to prevent, or manage, osteoporosis by keeping your bones as healthy and strong as possible. 

What Is Osteoporosis and Osteopenia?

The word osteoporosis loosely translates to ‘holey bones’, coming from the root words ‘osteo’ which means bone, and porosis which means porous or containing holes. Osteoporosis is a condition where bones become less dense and strong as a result of losing calcium and other minerals faster than the body can replace them. Over time, this can lead to excessively porous, fragile bones that can fracture or break as a result of even minor falls and accidents. Osteopenia describes a state in which the bones have lost some density, but to a less severe degree than in full osteoporosis. 

The cells that make up our bones are constantly being broken down and rebuilt, just like all the other cells in our body. However, if bone cells are broken down at a faster rate than they are rebuilt, your bones can quickly start to deteriorate. Some people can live with osteoporosis with few or no symptoms, however for others it can lead to painful side effects such as postural problems or broken bones. 

Who Is Affected by Osteoporosis?

Osteoporosis can affect anyone, however, some people are at a higher risk than others. Loss of bone density, osteopenia and osteoporosis becomes more common as we age, and is more common among women than men. One reason for this has to do with hormones, particularly oestrogen, which plays a large role in maintaining bone density for women.

Women

When women enter menopause, oestrogen levels start to fall, with some women losing 10% of their total bone mass within the first five years after menopause. Women who enter menopause before the age of 45 can be at a greater risk of osteoporosis as a result, as they typically live with reduced oestrogen for a longer time period which allows more time for bone mass to be lost. 

People Who Live With Some Other Health Conditions

They can also be at an increased risk of osteoporosis, including people who use corticosteroids for rheumatoid arthritis or asthma, and people with thyroid conditions or chronic liver or kidney disease. People who have conditions such as coeliac disease, inflammatory bowel conditions and Crohn’s disease are also at a higher risk, as these illnesses can impair your ability to absorb essential nutrients, like calcium, which are critical for bone health. The population in Australia and elsewhere in the world is ageing, meaning that people are living for longer and as a result there are a greater number of older people alive today than in previous generations. This increases the amount of people living with chronic health conditions, like osteoporosis, which is predicted to affect 6.2 million Australians by 2022, a 31% increase from 2012.

What Are the Risk Factors for Osteoporosis?

Some osteoporosis risk factors, like family history of low bone density or being assigned female sex at birth, cannot be changed. However, for most of us, there are plenty of lifestyle changes we can make to reduce our risk of osteoporosis. People who smoke cigarettes, are physically inactive, drink more than two standard drinks per day, and have low levels of calcium intake and vitamin D absorption are at a greater risk of bone mineral loss and bone diseases like osteoporosis. Early menopause, some medications, and premature loss of menstrual cycle for women also increase the risk of osteoporosis. Some women lose their menstrual cycle early in life, well before they enter menopause, as a result of excessive dieting or exercise. Since the menstrual cycle plays a key role in maintaining oestrogen levels, young women who cease menstruating can be at risk of early and accelerated bone loss, leading to osteopenia or osteoporosis. 

Signs and Symptoms That You May Have Osteoporosis

Some people can live with osteoporosis and not even realise it. Osteoporosis doesn’t always have specific, unique symptoms, so it can be easy to miss it if you don’t know what to look for. If you have experienced fractures from minor falls or accidents, have a family history of osteoporosis or osteoporotic fractures, or have other risk factors for osteoporosis, it may be worth checking your bone density. This is done using a painless, short dual-energy absorptiometry scan, or DXA scan for short. This is the most reliable way to measure any bone loss, before an injury or fracture occurs. Some people in Australia are eligible for Medicare rebates for DXA scans, so make sure to speak to your General Practitioner if you are concerned. 

Preventing Osteoporosis

Luckily, there are plenty of ways we can all keep our bones strong and healthy, and prevent debilitating conditions like osteoporosis. It is never too soon to start thinking about protecting our bone health, so that we can stay fit, active and healthy well into our older age. The following healthy lifestyle tips can be used by men and women of any age to prevent osteoporosis later in life.

1. Enjoy a Healthy, Varied Diet

Our diet plays a key role in maintaining healthy tissue throughout our body, including bone tissue. Having a varied diet that contains plenty of fruit, vegetables, grains and protein sources is essential for preventing diseases like osteoporosis. Fresh fruits and vegetables are great sources of vitamins and minerals that support strong bones.

Magnesium, which can be found in avocados, dark chocolate, nuts, whole grains and greens, is associated with preventing bone loss and osteoporotic fractures. Vitamin C-rich foods like citrus foods, capsicum and broccoli also play a crucial role in maintaining bone mineral density. Zinc, which is found in whole grains, oysters, red meat and chickpeas, plays an important role in bone regeneration, and vitamin K, found in green vegetables, has been associated with better bone mineral density and lower fracture rates.

Whilst it is definitely possible to meet all of these nutritional needs through food alone, for some people a supplement can be helpful in providing peace of mind on days where you may consume fewer fruits and vegetables. Talk to your doctor about your current diet, and what type of supplement may work best for you.

2. Include Plenty of Calcium-Rich Foods Into Your Diet on a Daily Basis

Ensuring that you have enough calcium in your diet is essential for maintaining good bone health. If you consume too little calcium, there will not be enough calcium in your blood, causing it to be drawn from your bones to replace the levels in the bloodstream. Over time, this can greatly damage your bone mineral density.

Foods that are rich in calcium include dairy products like milk, cheese and yoghurt, as well as calcium-fortified alternatives like soy milk for people who don’t consume dairy. Plant-based sources of calcium include green leafy vegetables, almonds and brazil nuts, and some foods like fortified cereal and bread that have calcium added to them. Canned fish that are eaten with the bones, like salmon and sardines, are also great sources of calcium. Most adults should aim for around 1,000mg of calcium per day, but for post-menopausal women and children, the amount should be a bit higher at around 1,300mg per day.

If you think you may be at risk of low calcium levels, it is also a good idea to watch your intake of salty foods like potato chips and other processed snacks. Excessive sodium levels can inhibit the absorption of calcium into the body, causing a deficiency even when we are eating plenty of calcium-rich foods. Certain plant-based foods like wheat bran and beans and legumes can also affect calcium absorption because of a compound they contain called phytates. To avoid these foods interfering with your calcium levels, try soaking your beans and legumes before eating them, and try to avoid eating phytate-rich foods in combination with foods high in calcium, or when taking your calcium supplements. 

3. Make Sure You Are Getting Enough Vitamin D

Contrary to its name, vitamin D is actually not a vitamin, but a hormone. This hormone plays an important role in regulating calcium levels in the blood, which is why adequate vitamin D is so important for bone health. Some small amounts of vitamin D can be found in certain foods, including fish, eggs, and fortified milk. However, the main source of vitamin D is exposure to the sun’s ultraviolet (UV) rays, which trigger internal production of this important hormone.

Whilst some sun exposure is important for adequate vitamin D levels, it’s important to remember that overexposure to the sun can increase your risk of skin cancer. For most people, a small amount of sun exposure obtained incidentally by walking your dog or spending 10-15 minutes outside is enough, especially in the summer months when UV ratings are high. However, in winter, when the days are shorter and there is less sunlight, you may need to spend up to an hour outside to get enough vitamin D absorption. It is important to find a balance between getting enough sunlight for your vitamin D requirements, without putting yourself at risk of sunburn or skin cancer. It is a good idea to check the UV rating online before heading outside to get your daily dose of sunshine, and always be SunSmart when outside to ensure you protect your skin. 

4. Avoid Smoking Cigarettes

Smoking places you at a higher risk of many serious diseases, including osteoporosis. The relationship between cigarettes and bone density is complicated, however smokers consistently report poorer bone health and greater risk of osteoporosis and fractures than non-smokers. Seeking help to reduce or quit smoking is a great way to protect your health and prevent conditions like osteoporosis.

5. Reduce or Limit Your Intake of Alcohol

Keeping your alcohol intake to a minimum can help reduce your risk of osteoporosis, as alcohol can impair your body’s ability to absorb vitamin D and calcium, both of which are important for bone density. Research has consistently shown an increased risk of osteoporosis among regular drinkers compared with people who don’t drink, with the more drinks consumed, the greater the risk of bone diseases and reduced bone density. 

6. Participate in Regular Exercise, Particularly Strengthening and Weight-Bearing Exercise

Exercise is great for our health in an abundance of ways, including supporting strong and healthy bones. In particular, exercise that involves weight-bearing, like running, skipping, walking, or lifting weights, can prevent the loss of bone mass, and even contribute to improving bone strength and density.

Exercise that helps improve your strength, balance and coordination can also help to prevent falls and consequent fractures, which can cause serious health problems particularly for older, frailer people with osteoporosis. Always check with your doctor before beginning a new exercise regime, especially one that is high impact or high intensity, or if you are new to exercise or have been sedentary for a long time. Where possible, seek the support of a fitness professional such as an exercise physiologist, to ensure proper form and an appropriate exercise intensity and duration in order to avoid any injuries. 

7. Be Conscious of Phytates

Certain plant-based foods like wheat bran and beans and legumes can negatively affect calcium absorption because of a compound they contain called phytates. To avoid these foods interfering with your calcium levels, try soaking your beans and legumes before eating them, and try to avoid eating phytate-rich foods in combination with foods high in calcium, or when taking your calcium supplements. 

8. Avoid Excessive Amounts of Sodium

If you think you may be at risk of low calcium levels, it is also a good idea to watch your intake of salty foods like potato chips and other processed snacks. Excessive sodium levels can inhibit the absorption of calcium into the body, causing a deficiency even when we are eating plenty of calcium-rich foods. Excess sodium intake can also lead to elevated blood pressure, which in turn can cause calcium to be lost from the bone tissue at a faster rate.

9. Consume Caffeine in Moderation

A daily cup of coffee is one of life’s great pleasures, and for the most part it is a harmless, enjoyable daily habit. However, excessive consumption of caffeine may pose a risk to your bone mineral density. Research has shown that consuming over 800mg, or around four cups of coffee, within a working day was linked to losing more calcium through the urine. Small amounts of caffeine per day seem to be perfectly safe, so enjoy your one or two coffees and then consider switching to caffeine-free alternatives if you still crave a warming, comforting beverage. 

10. Manage your stress levels

Most of us lead busy, stressful lives full of responsibilities and competing priorities, which can lead to high levels of the stress hormone cortisol. Emerging research has found that people experiencing psychological distress may be at increased risk of having poor bone mineral density and acquiring osteoporosis. Take care of your mental health by engaging in relaxing activities, leading a balanced, healthy lifestyle, and be sure to reach out for support if you need it.

I Already Have Osteoporosis, How Can I Best Manage My Condition?

All of the above prevention strategies are also great lifestyle tips to help manage your condition. However, if you have already been diagnosed with osteoporosis, there are some additional things to consider. Exercise is still recommended for most people living with osteoporosis, however you may need to reduce the intensity and impact of the exercise you choose in order to protect your bones. The risk of fractures as a result of high impact exercise can outweigh the potential benefits, in which case you should seek medical advice and have a tailored exercise program made for you that takes your needs and abilities into consideration. 

Preventing falls is an important part of managing osteoporosis, as these can easily lead to fractures and serious injuries and health events. Some general tips for preventing falls include wearing appropriate, stable footwear, building your balance and coordination through gentle exercise, getting regular eye tests and wearing your prescription glasses or contact lenses if you have them, and removing trip hazards or obstacles from your living environment. Fractures occurring in the hip can be particularly dangerous for people with osteoporosis, so adaptive equipment like hip protectors can also be a useful preventative tool.

Medication Options for Osteoporosis Treatment

Some people will be able to manage their osteoporosis with lifestyle changes alone, however, your doctor may also prescribe medications depending on your unique circumstances. There are a wide range of medical options that can play a role in maintaining adequate bone density, so if you are concerned about osteoporosis, make sure to reach out and discuss suitable treatment options with your doctor or trusted medical professional. 

Osteoporosis is a serious condition, but one that is usually preventable and manageable. By incorporating some of these simple lifestyle tips, you can reduce your risk of acquiring osteoporosis or successfully manage your condition, allowing you to lead a healthy, active life well into your older age.