Healthy bones are important at any time of life but, in later years, they’re absolutely key to maintaining our health and mobility. Despite this, many of us never give the health of our bones a second thought. “Most of us take our bones for granted and assume they will always be strong enough to carry us through life,” says Carrie Ruxton freelance dietician and expert for the Bone Health Information Panel. “But that’s not the case for the three million people in the UK — most of them women aged over 45 — who suffer from osteoporosis.”
Osteoporosis is a condition in which the bones become weak and fragile and this in turn increases your risk of breaking a bone if you have a fall, and this is largely due to poor bone health. As well as taking our bones for granted, a recent study of 1,000 people revealed that many of us have little idea of the factors that increase our risk of poor bone health. “Only one in four correctly identified post-menopausal women as being at higher risk of bone health problems,” says Dr Ruxton, “while eight out of ten didn’t know drinking alcohol above the recommended limits was a cause for concern. Four out of five did not realise that constant dieting could deplete bone density.”
Are you at risk?
So how can you tell if your bones are healthy or not? Unless you get a bone scan, it’s difficult to know for sure. But there are some known risk factors and, to help you get a rough idea of your risk, these are outlined below.
How healthy is your weight in bone terms?
Being overweight – that means having a body mass index (BMI) of 25 or more –increases your risk of developing weak, fragile bones. One of the main reasons for this is that carrying excess body fat reduces the amount of vitamin D circulating in your blood. Vitamin D helps the body to absorb calcium so it’s vital for bone health.
“Like vitamins A and K, vitamin D is fat-soluble,” explains Dr Ruxton. “What happens is that fat cells grab some of the vitamin D and hold on to it so that it isn’t available to other parts of the body, including the bones.”
Being underweight isn’t good for your bones either – if your BMI is below 18.5 you are at greater risk of developing osteoporosis. Constant dieting has also been linked with poor bone health. A healthy body mass index (BMI) is considered to be between 18.5 and 24.9. You’ll find a handy BMI calculator, plus personalised diet plans, at www.yoursdietclub.co.uk
Do you do any weight-bearing exercise?
It’s important to exercise our muscles and research shows that regular physical activity is important for keeping bones strong too, particularly after the menopause. “Exercise challenges our bones,” says Dr Ruxton. “Just as with muscles, if we don’t do anything, they waste away so it’s a case of use it or lose it. Any exercise is good for bones, but strengthening or ‘weight-bearing’ exercise is particularly helpful.”
Weight-bearing exercise is any kind of exercise that helps to build up your muscles and bones. It includes: carrying heavy loads, such as shopping bags, heavy gardening, such as digging, exercises that use your body weight for resistance, such as push-ups and exercising with stretchy resistance bands. “Walking up and down stairs and anything that involves jumping around is also fantastic for bones,” says Dr Ruxton.
Government guidelines suggest adults do at least two sessions of weight-bearing exercise each week alongside at least 150 minutes of moderate-intensity aerobic activity, such as cycling or fast walking.
Are you eating a bone-friendly diet?
A bone-friendly diet is one that is varied, balanced and includes plenty of bone-boosting calcium, protein and vitamin D. Good sources of calcium include dairy foods, such as yogurt, cheese and milk, tinned fish with the bones in, green leafy vegetables and nuts. You should be able to get all you need from your diet. Good sources of protein, meanwhile, include lean meat, poultry, fish, eggs, lentils and beans.
The bone-strengthening nutrient that we’re most likely to lack in the UK is vitamin D – research shows that up to a quarter of us Brits have vitamin D levels that are too low to maintain bone health. This is partly because there are only a few foods that naturally contain useful amounts of vitamin D – oily fish and eggs are our two main sources. It’s also because we don’t get enough sun. “Eighty per cent of our vitamin D comes from sun exposure, but in recent years we’ve had it drummed into us to keep out of the sun because of the risk of skin cancer,” says Dr Ruxton. “All that’s needed is 15 minutes outside each day, with our face and arms exposed, during the summer months.”
Do you take a bone health supplement?
In an ideal world, we would all eat healthy, balanced diets packed full of the nutrients needed to keep our bones healthy. But, for various reasons, this isn’t always possible. As we get older, our appetites also tend to get smaller and we absorb nutrients from food less efficiently. Partly for these reasons, people over the age of 65 have a higher risk vitamin D deficiency. That’s why the Department of Health recommends that everyone in this age group takes a daily 10 microgram (mcg) vitamin D supplement. You’ll find these in most chemists.
If you prefer, you could take a supplement that contains a combination of vitamins and minerals specially formulated to support bone health, such as Osteo Complete from Healthspan (£13.95 for 240 tablets). This contains vitamin D and calcium, plus magnesium and other minerals to help maintain healthy bones.
If supplements aren’t for you, you could try some of the fortified foods that are now available in supermarkets to support bone health. Yoplait has a new dairy drink out called Cal-in+ (£2.99 for a pack of 6 bottles), which comes in strawberry and vanilla flavours. Cal-in+ is rich in calcium and contains 100 per cent of the recommended daily allowance (RDA) for vitamin D. Research shows that drinking it daily can help to slow bone loss.
Do you smoke?
There are plenty of good reasons to give up smoking, and preserving your bone health is one of them. Research shows that smoking weakens bones by interfering with the body’s bone-building system.
For help with giving up, speak to your GP or phone the stop-smoking charity Quit’s free helpline on 0800 00 22 00.
Do you drink?
While enjoying the odd glass of something may actually help to strengthen bones, drinking too much alcohol is known to harm bones and increase your risk of a fracture. Plus, of course, overdoing the alcohol can also make you unsteady and increase your risk of falling. Do your bones a favour and stick to no more than 2-3 units of alcohol a day – that’s roughly equivalent to a glass of wine or a pint of beer. For men the upper safety limit is 3-4 units a day.
"Exercise has been key for me”
A couple of years ago former HR manager Judith Paxton fell and broke her ankle. “I was referred to a fracture liaison service where they scanned my bones,” says Judith, 61, who lives near Paisley. “When they told me I had osteoporosis I just cried and cried. I think I was in shock. I live in the West of Scotland and we don’t get much vitamin D here! I was also working long hours indoors and didn’t get much exercise. But never in a million years did I think it might be affecting my bone health.” Judith was referred for a course of 12 free exercise classes run by physiotherapists to improve strength and balance. When they finished she found a similar class run jointly by her local authority and health board for a small fee.“I get out in to the daylight when I can and I eat oily fish, yogurts, cheese and nice, flavoured almonds instead of crisps. I also take Adcal, which contains vitamin D and calcium,” she says. “But I think the exercise has been key for me. My last scan showed that my bone density had improved by 14 per cent. If you have a fracture, make sure somebody checks you out. Then it’s up to you to do something about it – and you really can.”
The National Osteoporosis Society has an online quiz that helps you check your risk of osteoporosis – go to stopatone.nos.org.uk