Osteoporosis: Protect your bones from the “silent thief”

What is osteoporosis?

Osteoporosis is a disease that causes bones to become thin and brittle, increasing the risk of fractures. It is often referred to as the “silent thief” because it can slowly weaken bones over many years without pain or other symptoms. (Note that osteoporosis is different than osteoarthritis, which affects joints and their surrounding tissue.)

When bones are very weak, they can break after a minor bump or fall – or even when a person coughs, reaches, twists or bends over. These breaks, or fragility fractures, are most common in the wrist, spine, shoulder and hip.

The disease can strike at any age, but it is most common in people over age 50. According to Osteoporosis Canada, two million Canadians are affected by the disease. At least one in three women and one in five men will have a broken bone due to osteoporosis, and the disease is responsible for 80% of fractures in people age 50 and older. Unfortunately, many people who suffer an osteoporotic fracture break another bone within a few years, including more than half of those who break a hip.

No single cause of osteoporosis has been identified, but risk factors include older age, being female, family history (a parent or sibling with the disease, and especially if one of your parents has broken a hip), long-term use of corticosteroids, vertebral compression fractures, fragility fracture after age 40, small body frame size and other factors.

Certain other medications and diseases can also contribute to bone loss. Reduced levels of sex hormones are also a risk factor – estrogen decreases for women of menopausal age, and men have less testosterone as they grow older, and these changes can weaken bones. Dietary risk factors include low calcium intake and health conditions that affect nutrient absorption. Talk to your physician about your risk factors.

Diagnosing osteoporosis

Early detection and treatment of osteoporosis can help prevent broken bones. The best method for diagnosing osteoporosis is assessing an individual’s risk for the disease and testing for bone loss. A bone mineral density (BMD) test can determine whether you have osteoporosis or how likely you are to develop it.

A BMD test is painless and non-invasive. The most common type uses an X-ray detector to scan the hip or spine while a patient lies on a table. The test takes only a few minutes. Based on the results, the patient’s bone density is given a score indicating how far it deviates from the bone density of an average young adult.

Osteoporosis Canada recommends that adults age 65 or older get a BMD test. It also recommends BMD testing for adults age 50 and younger who have a condition associated with low bone mass or bone loss, including fragility fractures, use of high-risk medications (such as corticosteroids), chronic inflammatory conditions, malabsorption syndrome, hyperthyroidism and other conditions.

If you are diagnosed with osteoporosis or osteopenia (low bone mass), your physician may prescribe drug therapy to prevent or slow bone loss. They may also recommend dietary changes to increase calcium intake.

Preventing osteoporosis

Calcium is a mineral that has many roles in the human body. We often associate calcium with bones and teeth, but it also supports the functioning of our cells, muscles and blood vessels. If calcium is in short supply, our bodies take it from our bones. That’s why it’s important to get enough calcium in our diets at every life stage, not just our growing years.

Adults aged 19 to 50, and pregnant or breastfeeding women, need 1,000 mg (milligrams) of calcium per day. Adults over 50 need 1,200 mg per day. Include calcium-rich foods at each meal, such as dairy products, calcium-fortified products (check food labels), almonds, salmon or sardines with bones, beans, collard greens, and tofu with calcium sulphate. If it is difficult to get enough calcium from your diet, ask your physician about supplements.

Vitamin D helps us absorb calcium from food. Our bodies produce vitamin D when exposed to sunlight. In Canada, it is difficult to make enough vitamin D, especially in winter. Osteoporosis Canada recommends vitamin D supplements for Canadian adults year-round: 400 to 1,000 IU daily for adults aged 19 to 50, and 800 to 2,000 IU daily for adults over 50 and for younger adults at high risk (due to osteoporosis, multiple fractures or conditions that affect vitamin D absorption).

Physical activity helps build and maintain bones. It also improves muscle strength, balance and coordination, which helps to prevent falls. Consult your physician before starting or changing your fitness routine.

Living well with osteoporosis

If you are diagnosed with osteopenia or osteoporosis, you may feel afraid, helpless, nervous or depressed. It is helpful to learn about your condition and be pro-active about managing it. Medication and lifestyle changes can go a long way to preventing fractures. You may also wish to join an osteoporosis support group.

Daily living:

• Avoid movements that put pressure and strain on your back, such as bending forward.
• When lifting objects, bend with your knees, not your back.
• Instead of picking up a small child, let them come over to sit in your lap.
• Be careful when getting in and out of bed.
• Read while sitting on a chair or couch, not lying in bed.
• Prevent falls by keeping your home clutter-free, removing tripping hazards, improving lighting, and installing railings, grab bars and other safety equipment around stairs and in bathrooms.
• Always be aware of your surroundings, and avoid crowded places.

Exercise:

• Weight-bearing exercises promote stronger bones. Exercises to try (with your physician’s approval): brisk walking, gardening, low-impact aerobics, elliptical machine, stair-climbing, dancing or tai chi.
• Lifting light weights, using weight machines or doing exercises with resistance bands can help build strength in your arms, shoulders and upper back.

Resources

Osteoporosis Canada
www.osteoporosis.ca

Osteoporosis Canada Toll-Free Information Line
English: 1-800-463-6842, French: 1-800-977-1778

Lower Your Risk of Osteoporosis (Dietitians of Canada)
www.unlockfood.ca/en/Articles/Bone-Health/Lower-your-risk-of-osteoporosis.aspx

7 Tips to Help Keep Your Bones Strong (Dietitians of Canada)
www.unlockfood.ca/en/Articles/Bone-Health/7-Tips-to-Help-Keep-Your-Bones-Strong

Food Sources of Calcium (Dietitians of Canada)
www.unlockfood.ca/en/Articles/Bone-Health/Food-Sources-of-Calcium.aspx