THREE EASY WAYS TO PREVENT OSTEOPOROSIS

Published August 2022 | 6 min read
Expert contributors Dr Sonia Davison, Australasian Menopause Society; Greg Lyubomirsky, CEO, Healthy Bones Australia
Words by Caitlin Reid and Stephanie Osfield

Osteoporosis is common in women and men over 50, but prevention is possible. Here are simple tips to reduce your risk factors and keep your bones strong for life.

Osteoporosis is known in the healthcare world as the ‘silent thief’ because bone loss occurs without any obvious symptoms until a bone is broken. It’s likely to affect more than one million Aussies but most don’t know they have it or how to prevent it. The disease reduces the density and quality of your bones, increasing the risk of fractures – and a fracture is often when people learn they have the condition.

Any bone in the body can be affected by the disease but the hip, spine, humerus (in the upper arm), pelvis, ribs and wrist are the most common places for osteoporosis-related fractures.

Not only are these fractures painful, living with osteoporosis can result in disability and a loss of independence, both of which can impact your quality of life.

The good news is you can reduce your osteoporosis risk factors by making some simple lifestyle changes.

Who’s at risk of osteoporosis?

Osteoporosis can affect anyone, but women are at greater risk of osteoporosis diagnosis than men as their bones begin to weaken sooner. It’s estimated that, for Aussies aged 50 and over, one in four men and two in five women will experience a minimal trauma fracture in the future. A major feature of osteoporosis is fractures that occur following little or no trauma.

As well as gender, other risk factors out of your control include menopause, age, certain medical conditions and genetics. Here are risk factors you can influence:

• lack of weight-bearing exercise like walking, hiking and jogging
• not getting enough calcium 
• vitamin D deficiency
• low body weight – a BMI of less than 18.5
• excessive body weight – ask your GP for advice on lowering your weight for better bone health
• smoking
• excessive alcohol consumption – more than four standard drinks daily or 10 a week
• long-term use of corticosteroids (medication commonly used for inflammatory conditions like asthma and rheumatoid arthritis).

Why women are more likely to get osteoporosis

Menopause and its associated hormone changes are the key reason women are more prone to osteoporosis. Most women go through menopause between the ages of 45 to 55.

“At this point, their menstrual periods stop and they experience a drop in the main female hormone, oestrogen,” says Dr Sonia Davison, board member of the Australasian Menopause Society.

“Oestrogen plays an important role in maintaining a woman’s bone strength and bone density. So as oestrogen levels lower at midlife, this may increase bone loss in some women.”

For this reason, when women reach menopause they should chat to their doctor about their bone health and any related risks.

“If you have a family history of osteoporosis, have been taking corticosteroid medication for a long time, or you have a slight body frame or low weight, your risk of osteoporosis may be higher and may go up after menopause,” says Dr Davison.

A bone density scan, also called a DEXA scan, compares your bone density to the averages expected for your age group. Your GP may recommend you have one. It’s a simple process – you lie flat (fully clothed) on a padded bench for around 15 minutes. Your doctor may also recommend menopause treatments to protect your bone health.

So, how can you reduce your risk of osteoporosis?

1. Boost your calcium intake

Almost 99% of your body’s calcium is found in your bones. The rest can be found circulating in your body, where it plays a role in the healthy functioning of everything from your heart and muscles, to your nerves and blood.

If you don’t get or absorb enough calcium, your body will maintain your blood calcium levels by taking it from your bones. Eating plenty of calcium-rich foods is vital to keep your bones healthy. For adults the daily recommended intake is 1,000mg a day. Men aged 70+ and women over 50 are recommended to have 1,300mg a day.

Dairy products are high in calcium, but there are also non-dairy sources of calcium. These have a slightly lower calcium content, so you’ll need to increase your intake to hit your daily target.

Dairy-based sources of calcium (include three or more of each of these standard serves every day):

• 1 cup (250ml) fresh or long-life milk
• ½ cup (120ml) evaporated milk
• 2 slices (40g) of hard cheese, like cheddar
• ½ cup (120g) ricotta cheese
• ¾ cup (200g) yoghurt
• 1 cup (250ml) soy, rice or other plant milk with at least 100mg of added calcium per 100ml.

Non-dairy sources of calcium (you’ll need to track calcium levels to make sure you’re hitting your target. This chart shows the calcium content of many common foods; this printout will also help, and a rough guide is below):

• calcium-fortified soy milk (1 cup = 309mg calcium)
• canned salmon and sardines with bones (½ cup canned salmon with bones = 230mg calcium; 50g canned sardines with bones = 190mg calcium)
• vegetables like broccoli, bok choy, spinach and silverbeet (1 cup/340g cooked spinach = 170mg calcium; 1 cup/100g cooked broccoli = 30mg calcium)
• almonds (15 almonds = 50mg calcium)
• dried figs and apricots (60g dried figs = 96mg calcium).

If you’re not getting enough calcium from your diet, you can also discuss calcium supplements with your GP.

2. Get enough vitamin D

Vitamin D plays a vital role in bone health, as it improves calcium absorption from the intestine. It also helps control calcium levels in your blood and maintains muscle strength.

The sun is the best source of vitamin D and most of us can keep our levels up through regular incidental sun exposure, like walking or gardening outside. But surprisingly, many Aussies are lacking in this vital nutrient – almost one in four of us doesn’t get enough of the ‘sunshine supplement’.

Not getting enough vitamin D can lead to bone and joint pain, muscle weakness and increased risk of falls and bone fractures in older adults.

While sun exposure can help you get enough vitamin D, it’s important to remember you should be sun safe when the UV Index is three or above.

Small amounts of vitamin D can be found in some foods including oily fish (herring and mackerel), liver and eggs. But if you have a vitamin D deficiency you may be advised to take supplements if you’re unable to meet your needs through sun exposure or diet. Ask your doctor about a blood test to check your vitamin D levels.

3. Exercise for healthy bones

Working out regularly can reduce the risk of developing osteoporosis, so get active for your bones by doing a brisk daily walk, joining a sports team or heading to the gym.

“Weight-bearing and resistance exercise as well as balance exercises are good for bones,” says Greg Lyubomirsky, CEO of Healthy Bones Australia.

Weight-bearing workouts include jogging, walking, tennis, team sports like netball and activities like dancing.

Resistance training involves training with weights like dumbbells, weight machines or resistance bands.

“The resistance makes you work harder and as you do, you strengthen your bones as well as your muscles,” Greg explains.

Balance exercises can also help keep bones strong and assist mobility, helping prevent falls in older Aussies, Greg says. Yoga, Pilates and tai chi are all good options and as they can also help reduce stress levels, they have added benefits for your bones.

Other lifestyle changes you can make include kicking unhelpful habits like smoking, drinking too much alcohol and having no more than three cups of coffee a day.

“Tea is a better option as studies show it may even benefit bone health,” Dr Davison points out.

Do you have risk factors like smoking or being inactive?

At every age or life stage, it's important to maintain a healthy weight. That’s why we’ve partnered with Prima Health Solutions, to give eligible members free access to our Healthy Weight for Life programs to help improve quality of life. These programs are available to members who are overweight and have osteoarthritis^* or are at risk of developing a chronic condition^*.