Osteoporosis

Why should I care about having strong bones?

Your bones are made up of hard, living tissue that requires calcium and other minerals to give them the strength and thickness (bone mass or density) they need.

Developing osteoporosis, where your bones become brittle due to mineral loss, means you more likely to break or fracture – even as a result of a minor bump or fall, or even without an injury. And, once you’ve had an osteoporotic fracture, your risk of further fracture is greatly increased. This can be severely debilitating.

Osteoporosis is common, affecting one in two women and one in three men over the age of 60. However, some simple lifestyle measures that you can do at any age can help boost your bone density, keep your bones strong, and decrease your risk of osteoporosis to prevent fractures.

Am I at risk of developing osteoporosis?

You may be at risk of developing osteoporosis without knowing it. Many people discover they have osteoporosis only after experiencing a fracture. A good starting point is to discuss the risks factors for osteoporosis and fractures with your doctor when you next visit.

Understanding your fracture risk can help you and your doctor decide on what you can do to minimise your risk, such as changes to your lifestyle habits or calcium and vitamin D supplementation.

How can I reduce my osteoporosis risk?

• Eat a healthy, well-balanced diet with enough calcium for your needs
  Osteoporosis Australia recommends that you aim for three serves of low-fat milk, yoghurt or hard cheese a day. If you can't eat dairy, you may need a supplement and/or to choose the calcium fortified breads, soy milk and juices now available.
• Balance sun protection with getting enough vitamin D
  Vitamin D is essential for healthy bones and muscles. The body requires ultraviolet (UV) radiation to manufacture vitamin D as there aren’t many natural food sources of this vitamin. Most people in Australia will achieve adequate vitamin D levels through their usual day-to-day activities. The amount of exposure needed for healthy vitamin D levels will vary, partly depending on your skin type (darker skin requires longer exposure), the time of year and which state you are in. For more details about this, and to check UV levels in your area and at different times of day, visit your state’s Cancer Council website.
• Get enough weight-bearing exercise
  Like muscles, bones need to be used to maintain their strength. Regular exercise, particularly when you’re under 35, but at any age is a great way to help protect your bones. Go for activities that are "weight-bearing"; that is, involves carrying weight (walking) or involves resistance (pushing against a force eg. push ups or using weights). Aim for at least three 30-minute sessions a week.
• Watch out for substances that reduce your calcium absorption
  For better bone health, give up smoking, limit your alcohol intake to two standard drinks a day and watch the caffeine content in your food and drink (eg. coffee, soft drinks, energy drinks).

How much calcium do I need?

The daily intakes (RDIs) of calcium for adults as recommended by the National Health & Medical Research Council:

How can I know if I have osteoporosis?

Your doctor may recommend having your bones tested check if you have osteoporosis.

Experts agree the most accurate and useful test for osteoporosis is to have the density of your bones checked by a type of X-ray known as a DXA (“dual-energy X-ray absorptiometry” or DEXA) scan, which tests the bone mineral density of multiple bones in the body.

This test is usually suitable if you are over 60, have reached menopause and not had a menstrual period for six months (for women), are losing height (shrinking) or suffered a fracture even though the cause seems relatively slight (a stumble or fall from a standing height, for example). The test is painless and involves a very low dose of radiation.

Talk to your doctor to see if this test is right for you.

Ask your doctor about osteoporosis if you have:

• lost more than 3cm in height
• developed a distinct "hump" at the top of your spine
• sudden severe unexplained back pain
• a family history or other risk factors for osteoporosis.

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What treatments are available for osteoporosis?

There are medications that can help reduce bone loss and reduce your risk of breaking a bone. Doctors usually start by prescribing one of the medications in a class known as bisphosphonates, or other medicines called denosumab and strontium ranelate. If these are not suitable for you, there are less-commonly used medicines your doctor may recommend.

Each medicine causes different side effects, and depending on the person, some are more effective than others in lowering the chance of future bone breaks. Whichever medication you and your doctor choose, it’s recommended you combine it with calcium and vitamin D supplements for it to work best.

How can I avoid a fracture if I already have osteoporosis?

About 50 percent of people with one fracture due to osteoporosis will have another. As well as following dietary and medication guidelines, the following could help you avoid fractures:

• Ask your doctor or a physiotherapist about specific exercises that improve your strength and balance to reduce your risk of falls. The weaker your bones the greater the care you need when doing exercise so it is important to get good advice as to what exercise works to strengthen the bones without posing too much risk.
• Have your eyes checked regularly and always wear your glasses when you need them. Poor eyesight significantly increases your risk of falls and other injuries.
• Wear comfortable, supportive, non-slip shoes to help reduce your risk of falls and injury.
• Check your home for hazards that might cause a fall or bad bump: loose rugs or mats, hard corners on tables, trailing cords, slippery surfaces in bathrooms or on mossy entryways.
• Make sure all areas in your home are well lit, and that stairs have rails. Consider bright safety strips to mark stair edges and make them easy to see.

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Further information

Osteoporosis Australia

www.osteoporosis.org.au

Garvan Institute Fracture Risk Calculator
This Fracture Risk Calculator was developed using data from a long-running Australian study on how fracture risk can impact on quality of life and even survival, and helps to estimate your risk of fracture.

www.fractureriskcalculator.com.au

Sources

Australian Bureau of Statistics. 4364.0 - National Health Survey: Summary of Results, 2007-8 (Reissue) [online]. Canberra, ACT: Commonwealth of Australia. 2009 [Accessed 15 Aug 2012] Available from: http://abs.gov.au

Better Health Channel. Bone Density Testing [online]. Melbourne, VIC: State Government of Victoria. [Last reviewed Aug 2011, accessed 15 Aug 2012]. Available from: http://www.betterhealth.vic.gov.au

Better Health Channel. Osteoporosis [online]. Melbourne, VIC: State Government of Victoria. [Last reviewed Jul 2011, accessed 15 Aug 2012]. Available from: http://www.betterhealth.vic.gov.au

Garvan Institute. Osteoporosis [online]. Sydney, NSW: Garvan Institute. Available from: http://www.garvan.org.au

International Osteoporosis Foundation (IOF). Osteoporosis [online]. Nyon, Switzerland: IOF. [Accessed 15 Aug 2012] Available from: http://www.iofbonehealth.org/

National Health & Medical Research Council. Nutrient Reference Values - Calcium. [online] Canberra, ACT: Commonwealth of Australia. [Accessed 15 Aug 2012] Available from: http://www.nrv.gov.au

Osteoporosis Australia. About osteoporosis [online]. Glebe, NSW: Osteoporosis Australia. [Last updated Jul 2011, accessed 15 Aug 2012] Available from: http://www.osteoporosis.org.au/

Pocock N. Osteoporosis [online]. Canberra, ACT: National Health Call Centre Network. [Last reviewed Mar 2007, accessed 15 Aug 2012] Available from: https://www.healthdirect.gov.au/osteoporosis

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Disclaimer
This information has been developed and reviewed for Bupa by health professionals. To the best of their knowledge it is current and based on reputable sources of medical research. It should be used as a guide only and should not be relied upon as a substitute for professional medical or other health professional advice.

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