Osteoporosis is a condition in which there is excessive reduction of calcium, the mineral that gives bones its stiffness, accompanied by loss of size. The rigidity and density of bones is important to allow our skeleton to withstand the pull of gravity and be the anchor for muscles to contract and perform our daily functions.  This is particularly important in many of the activities that Silver Grey Sports Club members participate in.

During childhood and in particular, during adolescence, there is rapid increase in bone size and density and we reach our peak bone density and mass around the age of 17-20. From then on, there is normally a natural slow and steady decline, and a sharper decline occurs after the cessation of production of sex hormones e.g. the menopause in women. 

The steady decline in testosterone also leads to male osteoporosis in old age.  In osteoporosis, bones are weakened and so are prone to fracture, particularly in weight-bearing areas like the spine and top of the thigh bone within the hip joint.  Trivial falls/tripping over an obstacle can lead to a fracture. In addition, there are usually microfractures within the bone in more advanced cases, typically in the spine, which are often the cause of severe bone pain. Bone density scan (DEXA) is a simple radiological method to assess whether the bone mineral content of your bones are within the normal  limits of your age group.  This procedure uses XRays to scan a few low back bones and the hip joint, and is widely available.

There are several reasons for osteoporosis to develop.  Our genetic makeup is one important component and family history is often revealing as to whether one is more likely to develop this condition.  Current research has shown that there are variants of genes that can contribute to osteoporosis with varying degrees.  There is ongoing research to find the genes responsible.

However, even with bad family histories and declining production of sex hormones, exercise can minimise and may halt the tendency to osteoporosis. This is because the working muscles provide the necessary stimulus to the bone cells to take up calcium and maintain its size and density. So resistance exercises as well as weight-bearing exercises are particularly important to prevent osteoporosis.  It may be that more exercise is needed to maintain the status quo!

An essential co-factor in the prevention of osteoporosis  is nutrition, in particular adequate intake of protein, calcium and vitamin D. Bone cells are constantly reabsorbing bone and laying down new bone, and so we need calcium and protein to build healthy bones.  Good food sources of calcium are dairy products, bones in tinned fish, green vegetables like broccoli, nuts and some fruits like apricots and figs. For calcium to enter our bodies, Vitamin D is essential. Some sources of  vitamin D are oily fish, eggs, fortified cereals and milk. In addition, vitamin D is made by our skin cells on exposure to sunlight. However, in countries with poor sunshine record and especially if one is dark in complexion, vitamin D deficiency is common and supplements are often necessary. A related condition caused by vitamin D deficiency is osteomalacia, a softening of the bones in which fractures often occur without trauma. Because of the  inability to absorb calcium into the body from food, calcium leaks out of the skeleton to maintain the minimum levels needed by cells to function, including contraction of muscle cells. The symptoms resulting from these changes are  tiredness as well as bone and joint pains.

Osteoporosis can be treated  medically with calcium and vitamin D supplements, but in more severe or chronic cases there are drugs that reduce the rate of bone resorption or increase new bone formation. It is best to visit your local rheumatologist for advice. Fortunately, alongside the adequate intake of Vitamin D and calcium, regular weight-bearing and resistance exercises will keep our bones healthy, as long as we are prepared to make the effort!

Also see Weblink: www.iofbonehealth.com