Osteoporosis

After the age of 50 years old, 1 out of 4 women and 1 out of 8 men will get osteoporosis, also known as “brittle bone disease.” Learn how to take care of your bones and prevent falls now so that you can avoid osteoporosis fractures in the future.

What is osteoporosis?

Osteoporosis occurs when the bones become fragile. People with osteoporosis gradually lose their bone density and get fractures more easily.

The disease often has no symptoms, and people with osteoporosis may only find out they have the condition when they get a fracture. In people over 60, more than 80% of fractures are due to osteoporosis. The most common fractures are hip, spine, femur (thighbone), wrist and forearm fractures. After getting a fracture, some people will need a wheelchair or walker to get around, while others may not be able to live alone and will need to be placed in a long-term care facility.

You need to know how to maintain or regain bone health and avoid falls before you break a bone!

Osteoporosis causes and risk factors

People reach their greatest bone density around the age of 30. Due to aging and decreased hormone production, bones start to become weaker around the age of 50. Many factors increase the risk of osteoporosis, and the good news is that you can avoid many of them.

Modifiable risk factors

• A diet low in calcium, or malnutrition in general.
• An insufficient intake of vitamin D.
• A lack of exercise, or conversely, excessive exercise.
• Smoking.
• Drinking more than 4 cups per day of caffeinated beverages (coffee, tea, colas or energy drinks).
• Drinking more than 2 alcoholic beverages per day.

Non-modifiable risk factors

• Being over the age of 65.
• Getting a fracture after falling from a low height or without falling (after the age of 40).
• Having a family history of osteoporosis.
• Having a thin frame or a low weight.
• Suffering from certain diseases (e.g., rheumatoid arthritis, cystic fibrosis, inflammatory bowel disease, or celiac disease) or taking certain medications for a prolonged period (e.g., prednisone). Note: Consult your doctor or your pharmacist to find out if your condition or medications increase your risk of osteoporosis.
• Women who have gone through menopause before the age of 45 or have had a hysterectomy  or removal of the ovaries.
• Men with low testosterone levels.

If you have more than 5 of these risk factors, talk to your doctor. After the age of 50, you should have your osteoporosis risk factors checked by your doctor every 2 or 3 years.

If need be, your doctor can have you take a bone mineral density (BMD) test, which assesses bone density and quality. If you test positive for osteoporosis, you should get your BMD tested once a year or every other year to ensure that your osteoporosis treatment is effective.

Osteoporosis in men and women

Osteoporosis is more common in women because their bones are less dense  and they experience greater bone loss at menopause. However, men are not immune to this disease and have to take care of their bones too!

It’s easier to prevent osteoporosis than to treat it

By adopting a healthy lifestyle, you can avoid modifiable risk factors and keep your bones healthy.

Exercise regularly

Physical activity promotes good bone density. It also helps prevent falls by strengthening muscles and improving balance and posture. It is recommended that you do 30 minutes of moderate physical activity at least 5 times a week.

Don’t smoke and limit your intake of alcohol and caffeinated beverages

If you need help to quit, ask your pharmacist or doctor for advice.

Get enough calcium and vitamin D

To prevent the consequences of decreased bone mass, it’s recommended that you get your daily requirement or more  of calcium (1000 mg to 1500 mg) and vitamin D (400 IU to 1000 IU if you are under 50 and 800 IU to 2000 IU if you are over 50).

• During sunny weather, expose your face and forearms to the sun for a maximum of 20 minutes a day without sunscreen. This is a natural way for your body to produce vitamin D. If you aren't able to spend time in the sun  (e.g., during the winter), you should take vitamin D supplements. Talk to your pharmacist or doctor  for advice.
• Every day, eat plenty of calcium-rich foods. The calcium in food is better absorbed than the calcium in over-the-counter supplements, which can complement your dietary calcium intake. 

Some dietary sources of calcium

Food	Serving	Content in mg of elemental calcium
Firm cheeses (Cheddar, Gouda, Swiss)	50g	300
Soft or semi-soft cheeses (Mozzarella, Camembert, Feta)	50g	250
Cottage Cheese (1% or 2%)	125ml	75
Plain yogurt, 1% or 2%	175g	330
Milk (1%, 2%, chocolate)	250ml	300
Sardines with bones	6 medium-sized	250
Salmon with bones	½ box	250
Almonds (dry, grilled)	½ cup (125ml)	186
Cooked soy beans	125ml	100
Tofu (made with calcium sulfate)	100g	150
Broccoli (raw or cooked)	125ml	50
Medium-sized banana	175g	10
Kale	100g	130

Space out your medication, calcium and vitamin D for maximum effect

Some medications are better absorbed if you take them at least 2 hours after taking dietary calcium or calcium/vitamin D supplements. Check with your pharmacist to find out if this applies to you.

Osteoporosis treatment

Osteoporosis can’t be cured, but you can strengthen your bones and prevent them from becoming weak. In addition to getting an adequate intake of calcium and vitamin D in your diet or with supplements, some medications can be prescribed to prevent bone loss. Bisphosphonates  are most often used to treat osteoporosis. They can help strengthen bones and reduce the risk of fractures.

Other types of treatment, such as hormone replacement therapy, can be prescribed for women who also have other symptoms of menopause.

Injectable medications are also available that are administered every 6 months or even once a year.

Although osteoporosis symptoms  don’t usually include pain, some people may feel pain, for example, in the lower back. This symptom is generally treated with painkillers and rest.

Tips to prevent falls

Seniors are particularly prone to osteoporosis-related fractures. Here are some precautions to help you reduce your risk of falling.

• Make sure your home is safe. Keep rooms uncluttered and well lit and make sure all rugs are anchored to the floor. Use a night light at night.
• Wear comfortable and solid shoes with slip-resistant soles.
• If you need to, don’t hesitate to get a walking aid, such as a cane or walker.
• Use the banister while going up or down the stairs.
• Get up slowly from a seated position.
• Use a bench in the bath or shower.
• Watch out for icy patches in the winter, and be careful while walking over uneven land, such as lawns. 
• Use caution if you’re taking medications that affect alertness.
• Have your eyes checked every year by an optometrist and make sure you wear glasses that effectively correct your vision.

Resource:
Osteoporosis Canada