Sticks stones may break your bones, but good nutrition will never harm you

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October 20^th is World Osteoporosis Day, and as is the aim of any national health day, the Good Life Dietitians wish to increase awareness on the prevention, treatment, and management of osteoporosis.

What is osteoporosis?

Osteoporosis is the most common bone disease in humans and occurs when there is an imbalance between the amount of new bone formed and the amount of old bone broken down.

In osteoporosis, a person’s bone mineral density (essentially the internal make-up of the bone) is decreased, and the architecture of the bone deteriorates leading to an increased risk for bone fractures.

What are the signs and symptoms of osteoporosis?

Bone fractures are an obvious sign of osteoporosis. It is a disease that very often abruptly presents itself generally after heavy a fall (the increased risk of falling associated with factors of ageing such as loss of sight and balance put the elderly at risk.)  Osteoporosis can be severely disabling. Spinal and vertebral fractures may lead to loss of height, severe back pain, and spinal deformations. Hip fractures may require hospitalisation and major surgery.

There are also several diseases and conditions that may put a person at an increased risk for developing osteoporosis. These diseases include AIDS/HIV, celiac disease, diabetes, haemophilia, inflammatory bowel disease, liver disease, multiple sclerosis, rheumatoid arthritis, and any malabsorption syndrome.

Are there risk factors that cannot be changed?

Unfortunately, there are some non-modifiable risk factors that may put a person at an increased risk for developing osteoporosis. These include:

Gender

Females are four times more likely to get osteoporosis than men. Also, post-menopausal white woman are the most prone to osteoporosis.

Genes

A family history of osteoporosis is a significant risk factor, with about 30 genes associated with osteoporosis already identified by the scientific world.

Being thin or having a slender frame

The smaller your frame the more likely you are to have fractures

Race

While osteoporosis can occur in all race groups, white (especially Northern European) and Asian populations are at a higher risk to black and Latin populations.

Advanced age

As age increases, so does the risk for developing osteoporosis. For women, osteoporosis risk is higher because of the oestrogen deficiency that comes with menopause.

Are there any risk factors that can be changed?

It is good to know that despite there being some factors that cannot be changed, there is still much that can be done to help prevent or at least delay the onset of osteoporosis.

Low calcium intake and vitamin D           

As bones are composted of calcium, a high calcium intake is essential for bone health. Good food sources of calcium include milk, yoghurt, cheese, dark green leafy vegetables (e.g. broccoli, cabbage, Brussels sprouts), oranges, baked beans, oatmeal, almonds, sardines and pilchards (eaten with bones), clams, oysters, and salmon. 

Use a calcium supplement if dairy product intake is not tolerated or sufficient. Dietary supplementation of 1200mg of calcium and 800-1000 IU of vitamin D reduces bone loss and the incidence of bone fracture.  Post-menopausal women need a supplement of 1500mg per day.

Magnesium and potassium

A good intake of fruits and vegetables is associated with a decreased risk of osteoporosis. Aim for a 5-a-day intake of fruits and vegetables to ensure good magnesium and potassium intake.

Sodium

Excess intakes of sodium 9particularly when calcium intake is low) can increase the excretion of calcium, so limit your salt intake (for more on decrease salt intake, go to our previous post: a salt with a deadly weapon).

Caffeine

For those at an increased risk for osteoporosis, excessive caffeine intakes affect bone mass density. Limit to 3 cups of coffee per day and 5 servings of caffeinated soft drinks and teas.

Vitamin C

Vitamin C is involved in collagen production, which supports a healthy bone structure. Be sure to include good sources of vitamin C in your diet such as citrus fruits, kiwi, strawberry, sweet peppers and tomato.

Obesity

It is advised to maintain a weight within a healthy BMI range. Be sure that any weight loss diet includes sufficient protein, calcium vitamins and minerals.

Alcohol

High intakes of alcohol are associated with a lower bone mass density. Also, excess alcohol intakes are generally accompanied by a poor diet as well as cigarette smoking (see below). Limit your alcohol intake to one drink per day for woman and two drinks per day for men.

Smoking

Cigarette smoke inhibits the activity of osteoblasts, the bone cells responsible for building new bone.

Poor physical activity          

A good physical activity regimen will help build bone mass. Do weight-baring and muscle-strengthening exercises instead. Aerobic and stretching exercises are beneficial, as is walking and running. However, avoid excessive weight-bearing exercise which can lead to constant damage to bone.

For more information on osteoporosis, visit the National Osteoporosis Foundation website. 

Sources

Escott-Stump, S. Nutrition and diagnosis-related care. 2008. 6^th Edition. Lippincott Williams and Wilkins.

Mahan, LK and Escott-Stump, S. Krause’s Food and Nutrition Therapy. 2008. 12^th Edition. Lippincott Williams and Wilkins.

National Osteoporosis Foundation www.nof.org.