How strong are your bones?

More than three million people in the UK are thought to have osteoporosis – the disease caused when bone density decreases, making bones more brittle and susceptible to fractures. And it's not just us. Worldwide, someone, somewhere suffers a broken bone caused by osteoporosis every three seconds.

You could argue that few people are unduly concerned about bone health. Until there's a problem, that is. Unfortunately osteoporosis can creep up on you, and you may not know anything's wrong until you start breaking bones.

And it's much more common than you might think too. For instance, while most of us realise it's important to look after our hearts, we may not give our bones a second thought. Yet according to statistics the combined lifetime risk for a broken hip, arm or vertebra is equivalent to that for cardiovascular disease (40 percent).

Similarly, the lifetime risk of a broken hip in caucasian women, for instance, is one in six – that's higher than the risk of developing breast cancer (which is one in nine). In fact, osteoporosis among women aged 45 and over accounts for more days spent in hospital than many other health problems including heart attack, breast cancer and diabetes.

Men aren't immune, either, with men over the age of 50 having a 30 percent lifetime risk of having an osteoporosis-related broken bone (about 25 percent of hip fractures happen in men, statistics suggest).

And if you think a broken bone isn't that serious, experts reckon that 1,150 people die in the UK every month as a result of hip fractures. Not just that, but broken hips are estimated to cost the NHS a whopping £6 million a day (that's hospital and social care costs combined).

Stronger for longer

If you're diagnosed with osteoporosis, you may need treatment in the form of prescription drugs in tablet or injection form. There are, however, ways of reducing your risk of developing osteoporosis, including the following:

• Exercise, especially weight-bearing activities such as walking, skipping, running, aerobics and resistance training, can help build strong bones. Activities such as gardening, playing golf, swimming and practising t'ai chi are ideal if you already have osteoporosis too, as they may all help keep you fit and therefore reduce your risk of falling and breaking a bone.

Aim to be active on a regular basis. But don’t overdo it, as exercising too much can increase your risk of developing osteoporosis.

• Eat a calcium-rich diet. According to the National Osteoporosis Society, adults need 700mg of calcium each day. That's around the amount you'd find in a pint of semi-skimmed milk. The best sources include dairy products, as the calcium in milk products is most easily absorbed by the body. Other calcium-rich foods include fish such as salmon, tuna, pilchards and sardines, plus sesame seeds, almonds, fortified soya milk, figs, oysters and prawns.

Vegans should make especially sure that they’re getting enough calcium, as should anyone on a weight-loss diet, because of their reduced intake of calcium-rich dairy products.

If, for any reason, you're not getting enough calcium in your diet, ask your pharmacist if taking a calcium supplement may help.

• Other nutrients such as magnesium, potassium, zinc and vitamin D are thought to help boost bone health too. At this time of year, however, it may be important to get more vitamin D through your diet or in supplement form, thanks to the fact that there's not enough sunshine to help your skin create its own supply (vitamin D is made in the body when sunlight reacts with your skin).

Unfortunately vitamin D isn't naturally found in that many foods (the best sources are fish – especially cod liver oil – eggs, margarine and fortified breakfast cereals). So if you think you could be missing out on vitamin D or any of the other bone-healthy nutrients, ask your pharmacist if a vitamin/mineral supplement may be the best option.

• Avoid processed foods. The best way to get bone-building nutrients in your diet is to eat fresh, wholesome foods, rather than junk food or too many ready meals.Eating too much protein – or too little – can also lead a loss in bone density. However, moderate amounts of protein are essential to maintain a normal bone mass.
• Nicotine over-stresses the adrenal glands, which produce bone-building hormones. Some experts also believe that smoking hinders the body's absorption of calcium, which could also weaken your bones. So if you’re a smoker, quit now, for your bones’ sake. Ask your pharmacist for help with giving up smoking if you need support (you don't have to do it alone).
• Stick to recommended alcohol guidelines, since drinking too much booze may affect your bones too. Heavy drinkers, for instance, are thought to be more susceptible to bone loss and fractures. So stay within the official limits, which are two to three units a day for women and three to four for men. To give you an idea of what a unit looks like, half a pint of weak beer or lager (4 percent alcohol) is one unit, a pint of strong lager (5 percent alcohol) or cider has three units, while two small (125ml) glasses of wine (12 percent alcohol) are three units too. Watch out for wine measures, as most pubs and restaurants serve wine in much larger glasses than they used to.
• Other stimulants may also be bad for your bones, including caffeine and fizzy drinks. Fizzy drinks, for instance, contain phosphoric acid, which may affect bone strength. This, however, has not been proven – but if you drink lots of fizzy drinks, you may want to reduce your intake to be on the safe side. Caffeine, meanwhile, is thought to increase the amount of calcium you lose through your urine. Tea, on the other hand, is not thought to create the same problem.

Too much salt in the diet is also linked with decreased bone density, since it also increases the amount of calcium the body loses in urine. Keep to the recommended salt intake, which is 6g per day (just over a teaspoon). 

• Crash dieting can lead to bone problems, as people who are trying to drastically lose weight often cut out bone-building foods – such as dairy – from their diet. Being underweight can also hinder your bones, as it reduces the production of bone-building hormones.

For more information about osteoporosis, including how to change your lifestyle in order to prevent it, contact the National Osteoporosis Society on 01761 471 771 or visit www.nos.org.uk

Advice for the elderly

The older you get, the more careful you should be to prevent suffering a broken bone. So if you're elderly – or you have an elderly friend or relative – it's important to make your or their home as safe as possible.

That means making sure you have sufficient lighting, and that there are as few hazards as possible that could make you trip or fall. For instance, make sure there are no electric appliance cords that could get in your way, and that your carpets are secure and other floor surfaces not slippery.

If necessary, you may need special rails or grab bars to stop you falling on the staircase or in the bathroom, for instance.

And if you take any medication or a combination of medicines that makes you feel dizzy, light-headed or drowsy – any of which may result in a fall – ask your GP or pharmacist for advice.