Keeping our bones strong and healthy.

During our growth from babyhood to adulthood, our bone mass increases, becoming the strongest between 25 and 35 years of age. It then starts to decline. The rate of bone loss becomes greater in women during and after menopause, due to a decrease in the hormone oestrogen. This makes older women more susceptible to developing osteoporosis, a disorder affecting the bones in which there is a decrease in bone mass, resulting in a greater risk of fracturing and breaking our bones. 80% of those affected by osteoporosis are women, and 1 in 3 women over the age of 50 will have fractures caused by osteoporosis in their lifetime.

Who is at risk?

Women who have experienced menopause have a higher risk of developing osteoporosis, as are women who reach menopause at a young age and women with a family history of osteoporosis. Women with thin, small bones are more at risk than those with a heavier bone structure.

Many of the risk factors for osteoporosis are within our control. Exercise and calcium intake during childhood and adolescence have the greatest impact on our peak bone mass, while physical activity as adults helps to maintain bone mass. Smoking damages our bones and alcohol interferes with calcium absorption. Diets high in fats, proteins and refined sugars cause the body to lose calcium.

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What are the symptoms?

Osteoporosis can be a silent disease for decades with no symptoms until a painful fracture occurs. The most common fractures are of the wrist, spine and hips. Spinal fractures can result in a curving of the spine and loss of height. Some patients have a more generalised, aching pain resulting from the changing biomechanics of the spine.

How can I treat osteoporosis?

Certain medications have been shown to increase bone density and therefore decrease the risk of fractures. However, not all patients with osteoporosis need medication. In most instances a change in lifestyle, diet and exercise are all that are necessary.

Stop smoking and limit your intake of alcohol, caffeine and 'fizzy' drinks. Eat a diet low in protein and fat and avoid refined and processed foods, opting for whole grain products instead.

Calcium helps build strong healthy bones so increase your dietary intake and take a calcium supplement. Your daily intake should be between 1000 and 1500mg per day. Good sources of calcium are dairy products like milk, cheese and yoghurt. However, dairy is not the only source of calcium and a balanced intake is important. Remember to include other sources in your diet such as dark green leafy vegetables (spinach, broccoli and cabbage), legumes (beans, chickpeas, maize and tofu), fish (sardines and salmon) and nuts and seeds (almonds, sunflower and sesame seeds).

Calcium is only one of the substances necessary for strong bones. Vitamin D and magnesium support the absorption of calcium and help to regulate calcium metabolism. Magnesium can be found in vegetables and whole grain foods, while Vitamin D can be obtained through direct exposure of our skin to sunlight.

Exercise is essential to a healthy skeleton as it helps to build bone density. Weight-bearing exercises are the most important because bones respond to the stresses placed on them by increasing their density and becoming stronger. Activities like walking, stair climbing and weight training should be done for approximately 30 minutes three times a week. Exercises that help to improve balance are also important to minimise falls resulting in fractures. Those already diagnosed with osteoporosis should check with their doctor before beginning an exercise programme.

Dr Shoshanna Dunn is a chiropractor working in Windhoek.

By Dr Shoshanna Dunn