Osteoporosis - what is it and what can you do to avoid it?

It is common place for the food industry to push consumption of dairy products due to their supposed preventative properties against osteoporosis.  Osteoporosis, however, has many risk factors, with calcium intake being just one of the many avoidable risk factors and there are a number of non-avoidable risk factors also. 

So what exactly is osteoporosis? In simple terms, it is a disease of the skeleton which is recognised by low bone mass, causing bone thinning and an increased susceptibility to fractures.   The bone thinning in particular can be a chronically painful experience, and can particularly affect the back, whereas bone fractures can reduce mobility and lead to a loss of independence. 

In order to reduce the risk of developing osteoporosis in later life (from 45 onwards bones start to lose their structure) it is important to have good stores of calcium in bones.  That means consuming the recommended intake of 700mg per day of calcium from various different food sources.  But it also means recognising the other risk factors involved.  Smoking, for example, significantly affects the risk of fractures in premenopausal women and in men, and similarly, excessive alcohol consumption is a risk factor.  Body weight is positively associated with bone mass, and so maintaining a healthy BMI is important.  Intentional weight loss results in an increased rate of bone loss, particularly in cases where an eating disorder is present where it leads to low oestrogen levels. 

Vitamin D is important to help the body absorb calcium, and it can be made through exposure of the skin to sunlight.  It is also present in some food sources, such as eggs, dairy, fish and fortified cereals and orange juice.  If you don’t live in a country where you get regular sun exposure (about 10-15 minutes a day, free from sunscreen), then it might be worth considering a supplement of vitamin D.

Regardless of the above, even with the greatest intentions with diet and lifestyle, some people are at a higher risk of osteoporosis than others.  These are considered the non-avoidable risk factors, the most recognisable of which is gender.  Women simply are at a greater risk of developing osteoporosis than men.  But the risks also increase with age and can be influenced by the size of the frame of the individual, with smaller frame size tending to be at higher risk of developing the disease.  If there is a family history of osteoporosis, particularly a parent or sibling, an individual is considered to be in a higher risk category, and low levels of oestrogen at any time, but particularly during menopause increases the risk also.

So whilst it is important to be aware of adequate calcium intake, it is also good to understand the other factors that influence the risk of developing the disease.  As with all health related issues, a balanced diet and an active lifestyle, free from smoking and excessive alcohol consumption, is the best defence.  Ensuring that children and adolescents, in particular, also achieve optimum bone mass and that they maintain this during early adulthood will reduce future risk of bone loss in later life.