What You Can Do to Prevent Osteoporosis?

Maybe you think your bones are solid, but in fact your bones are constantly changing. The earlier you start taking action to support your bone health to prevent osteoporosis, the better. Calcium has become the most popular dietary supplement and the most purchased  among HongKongers. 

In Hong Kong, 50% of postmenopausal women have osteoporosis. Women have increased bone loss over a period of 5 to 7 years after menopause, and then the rate slows down again. Osteoporosis affects 45% of women who are 50 years of age or older. 

Osteoporosis is a metabolic disease of the bone which leads to a reduction in the bone density. The density of the affected bones become lower and the bones become more fragile, and are therefore more likely to break, resulting in fractures that most commonly occur in the hip, wrist or spine. Women typically start out with lower bone density than men, and loss of estrogen over time can increase the risk for osteoporosis.

Bones are made of protein fibres filled in with calcium and other minerals to create a hard structure. Bones are always changing in response to our lifestyle. During childhood and early adulthood they develop their strength but from our mid-30s onwards our bones start to lose calcium slowly, causing bone thinning.

What affects bone health?

Actually, protecting your bone health is easier than you think. On a fundamental level, understanding how diet, nutrients, physical activity and other lifestyle factors can affect your bone mass can greatly enhance bone health.

  • Low calcium diet. A diet low in calcium contributes to diminished bone density, early bone loss and an increased risk of fractures.
  • Physical activity. People who are physically inactive have a higher risk of osteoporosis than do their more-active counterparts. 
  • Smoking and alcohol use. Research suggests that tobacco use contributes to weak bones. Similarly, regularly having more than one alcoholic drink a day for women or two alcoholic drinks a day for men may increase the risk of osteoporosis.
  • Gender. You're at greater risk of osteoporosis if you're a woman, because women have less bone tissue than men.
  • Size of body frame. You're at risk if you are extremely thin (with a body mass index of 19 or less) or have a small body frame because you might have less bone mass to draw from as you age.
  • Age. Your bones become thinner and weaker as you age.
  • Race and family history. You're at greatest risk of osteoporosis if you're white or of Asian descent. In addition, having a parent or sibling who has osteoporosis puts you at greater risk — especially if you also have a family history of fractures.
  • Hormone levels. A study found that too much thyroid hormone can cause bone loss. In women, bone loss increases dramatically at menopause due to dropping estrogen levels. Prolonged absence of menstruation (amenorrhea) before menopause also increases the risk of osteoporosis. In men, low testosterone levels can cause a loss of bone mass.
  • Eating disorders and other conditions. Severely restricting food intake and being underweight weakens bone in both men and women. In addition, weight-loss surgery and conditions such as celiac disease can affect your body's ability to absorb calcium.
  • Certain medications. Long-term use of corticosteroid medications, such as prednisone, cortisone, prednisolone and dexamethasone, is damaging to bones. Other drugs that might increase the risk of osteoporosis include aromatase inhibitors to treat breast cancer, selective serotonin reuptake inhibitors, methotrexate, some anti-seizure medications, such as phenytoin (Dilantin) and phenobarbital, and proton pump inhibitors.

    What can you do to keep your bones healthy?

    • When your body doesn’t have enough calcium, it will start to break down your bones to get what it needs. That means you lose bone mass. So it’s important to make sure you have plenty of calcium every day in your diet or from supplements. For adults ages 19 to 50 and men ages 51 to 70, the Recommended Dietary Allowance (RDA) is 1,000 milligrams (mg) of calcium a day. The recommendation increases to 1,200 mg a day for women age 51 and older and for men age 71 and older.
    • Pay attention to vitamin D. Your body needs vitamin D to absorb calcium. For adults ages 19 to 70, the RDA of vitamin D is 600 international units (IU) a day. The recommendation increases to 800 IU a day for adults age 71 and older. However, BMJ study showed consistent, daily supplementation of Vitamin D3 is more effective and the recommendation dosage for individuals at risk of vitamin D deficiency should be 1500-2000 IU.
    • Magnesium deficiency may promote osteoporosis, since about 60% of total Magnesium is stored in the bone. Magnesium deficiency contributes to osteoporosis in various direct and indirect ways. From impacting crystal formation in bone cells, to impacting section and activity of parathyroid hormone to promoting low grade inflammation. The recommended amount of magnesium is 300mg to 500mg daily.  A good rule of thumb is a 2:1 calcium-to-magnesium ratio. For example, if you take 1000mg of calcium, you should also take 500mg of magnesium, at the very least. 
    • Protein is also important for bone health. Protein is in every cell in your body, including your bones. Studies have shown that eating protein increases bone mineral density. The recommended daily protein intake is 0.4 grams per pound of body weight. So, if you’re a 140-lb. woman, you need about 60 grams of protein per day. However there are more and more studies showing benefits of a higher intake of 0.8g to 1g per pound of body weight.  
    • Eat more anti-inflammatory foods. Omega-3s have great anti-inflammatory properties which can be beneficial to bone health. The body becomes inflamed as part of a protective mechanism. It can be short-term, caused by strenuous exercise, acute infections, injury or allergies. It can, however, also be long-term due to chronic disease or being overweight. Although this is a supportive mechanism, it can reduce the body's ability to continue with normal bone production. 
    • Include physical activity in your daily routine. The body needs 'encouragement' to rebuild bone. Weight-bearing exercises, such as walking, jogging, and climbing stairs, can help you build strong bones and slow bone loss.
    • Don't smoke. Smoking can have an incredibly negative effect on bone health. This is because smoking not only reduces the body's ability to absorb calcium but also its ability to make bone with the calcium it does manage to absorb. Smoking is also a cause of chronic inflammation in the body. The good news is that as soon as smoking is stopped, the body can quickly get back to full efficiency, so it is possible to recoup bone density.                                           
    • Reduce acid forming foods. It is thought that the high levels of saturated fat, processed meat and sugar in this diet cause acidity in the body which then triggers the body to rebalance by releasing elements from bone into the blood.The high levels of salt in our typical diet are also bad news for bone. One study suggested that unhealthy eating could lead to almost half our skeletal mass of calcium to be lost in urine over time, mainly because of the amount of salt in the processed foods that are frequently eaten. So, although convenient, try to limit the amount of processed foods you consume and always check the labels of products for salt, sugar and saturated fat. At home,get into the habit of tasting food before you add salt to meals to try to reduce salt intake.

    Osteoporosis is a condition that can have serious effects. It can lead to fractures, which can be painful, take a long time for treatment, and may lead to other complications. The good news is, there’s a lot you can do to prevent osteoporosis in order to improve your bone health and reduce the risk of complications from eating right, exercising, changing lifestyle to taking appropriate supplements.

    Read More: What Women Need

    Reference: 

    1. https://www.hkcfp.org.hk/Upload/HK_Practitioner/2006/hkp2006vol28oct/update_article.html#:~:text=In%20Hong%20Kong%2C%2050%25%20of%20postmenopausal%20women%20have%20osteoporosis.&text=Women%20have%20increased%20bone%20loss,years%20of%20age%20or%20older.
    2. Wong, P. K., Christie, J. J., & Wark, J. D. (2007). The effects of smoking on bone health. Clinical Science, 113(5), 233-241.
    3. Rizzoli, R., Bonjour, J. P., & Ferrari, S. L. (2001). Osteoporosis, genetics and hormones. Journal of molecular endocrinology, 26(2), 79-94.
    4. https://www.mayoclinic.org/diseases-conditions/osteoporosis/symptoms-causes/syc-20351968
    5. Martineau AR, Jolliffe DA, Hooper RL, Greenberg L, Aloia JF, Bergman P, Dubnov-Raz G, Esposito S, Ganmaa D, Ginde AA, Goodall EC, Grant CC, Griffiths CJ, Janssens W, Laaksi I, Manaseki-Holland S, Mauger D, Murdoch DR, Neale R, Rees JR, Simpson S Jr, Stelmach I, Kumar GT, Urashima M, Camargo CA Jr. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ. 2017 Feb 15;356:i6583. doi: 10.1136/bmj.i6583. PMID: 28202713; PMCID: PMC5310969.


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