Osteoporosis

A balanced diet with enough calcium and vitamin D is essential.

Calcium plays a crucial role in our bones, and we must get enough calcium in our diet.

We should have around 700 mg/d of calcium in our diet. If you are still determining how much calcium you are getting from food, then use this handy calcium calculator to work it out.

University of Edinburgh calcium calculator

You may need to take a supplement if you are not getting enough calcium and cannot increase this quickly.

Vitamin D is vital for calcium absorption. We get 90% of our vitamin D from sunlight exposure and usually only 10% from diet. The sunlight exposure must be solid in the midday sun at regular intervals.

The climate in the UK is such that we will need more sun exposure to have adequate vitamin D levels all year round. We have usually run out of vitamin D stores by around Christmas.

It is advisable to take a vitamin D supplement through the autumn and winter months or, if you are at high risk (dark-skinned, clothing that covers skin all the time, stay indoors).

Foods that contain vitamin D include oily fish, eggs, and cod liver oil

Calcium and vitamin D alone are not adequate to treat osteoporosis.

Exercise to stay strong, our bones need to be stressed with weight-bearing exercise- anything that exerts pressure through our bones. Even relatively short periods of immobility- a few days lying in bed when ill, have been shown to influence bone density, and whilst early changes such as these can be quickly reversed by becoming active again - more extended periods of immobility will start to have a significant effect on bone mass.Osteoporosis can be a frightening diagnosis, and the older we get, the more worried we may become about breaking something by exercising.

But like other lifestyle factors, exercise is a scale- from passive to high-intensity, high-impact aerobic exercise. And the further you get away from immobility, the better. Even standing up is better than sitting and is a good start. You don’t have to suddenly start playing basketball three times a week if you have been relatively inactive beforehand. Start with walking and build this up over time as your confidence grows. Find something fun that suits your lifestyle.

Don’t forget your muscles- we need healthy muscles to support our bones. With good muscle strength, we are less likely to fall, more likely to be able to stop ourselves falling if we trip, can get up more quickly if we do fall, and if a bone is broken, we are much more likely to have a quick recovery with good strong muscles supporting our injured bone.

So, any exercise that strengthens muscles is essential- things like cycling and swimming- whilst they are not weight bearing are also vital for healthy bones and should not be discouraged as being ‘the wrong type of exercise’.

The Royal Osteoporosis Society has excellent guidance on the amount and type of exercise to best benefit our bones.

Use of cigarettes and alcohol are known to increase the risk of developing osteoporosis.

Maintain a healthy BMI - being underweight is a major risk factor for osteoporosis.

HRT is effective at preserving bone density around the menopause and significantly reduces the risk of having a fracture related to osteoporosis.

Women with premature ovarian insufficiency or early menopause should take HRT until natural menopause to protect their bones from osteoporosis.

HRT is now a first-line option for osteoporosis in menopausal women under 60.