“It's not just about preventing falls by doing a particular exercise program. It's about maintaining your ability to do anything that you want to do throughout your life.”—Professor Belinda Beck, The Bone Clinic
Key points
- Osteoporosis is a chronic disease that causes bones to progressively become weaker and less dense, and therefore increasingly susceptible to fractures.
- It’s one of Australia’s most common health conditions, with 1.2 million people affected by osteoporosis and many more with low bone density. It is most prevalent among older people, and postmenopausal women in particular.
- Key ways to prevent osteoporosis include exercise, getting enough calcium and spending time in the sun. It’s also important to talk to your doctor if you think you’re at risk of the condition.
There’s a characteristically madcap cartoon by the cartoonist Gary Larson of The Far Side fame in which a group of floppy-limbed chickens are strewn over the ground in odd positions, totally unable to move. Towering above them is a sign that explains their lack of mobility. “Boneless Chicken Ranch”, it reads.
Professor Belinda Beck from The Bone Clinic mentions this cartoon as a light-hearted demonstration of why our bones are so fundamental to our health. “The primary function of your skeleton is to create a framework on which the muscles can pull so we can move,” she says. In addition, she explains, our bones provide us with a reservoir of valuable minerals that help with a host of functions from blood clotting to regulating our heart rhythms.
The crucial role played by our bones means that osteoporosis—a chronic disease that causes bones to progressively become weaker and less dense, and therefore increasingly susceptible to fractures—can have a significant effect on our health and wellbeing.
So what do we need to know about osteoporosis and how can we reduce our risk?
Osteoporosis: be aware of the signs
It’s difficult to know exactly how many Australians have osteoporosis, as the disease lacks obvious symptoms—which means that many cases go undiagnosed until a fracture occurs—but it’s certainly one of Australia’s most common health conditions. Associate Professor Peter Wong, Medical Director at Healthy Bones Australia, suggests that 1.2 million people are affected, “and there are many more with low bone density, which we need to monitor”.
The condition is particularly common among older Australians, thanks to the slow decline in bone mass that occurs from middle age onwards. According to the Australian Institute of Health and Welfare, an estimated 23 percent of women and 6 percent of men aged over 50 have osteoporosis, both diagnosed and undiagnosed. Women are especially vulnerable to the disease due to the rapid loss in bone mass that occurs around menopause.
But age isn’t the only factor that contributes to osteoporosis. Peter points to a range of risk factors for over-50s, including a previous fracture, family history of osteoporosis, smoking or excessive alcohol intake, certain medications, and medical conditions including coeliac disease, rheumatoid arthritis and diabetes.
Belinda also notes that “if your body type is small, your frame is small and you've always been underweight, there's every chance that you're going to have osteoporosis.”
But even if you’re one of the many Australians at risk of osteoporosis, the good news is there are a number of research-backed ways to help protect your bones.
Move your body
So how do you minimise your chances of being struck by this disease? Belinda is convinced that exercise can play a key role in helping to slow the loss of bone density. “My belief—and there is quite a bit of evidence for this—is that if you maintain your levels of high-intensity activity throughout your life you will be able to prevent, if not all, then quite a lot of that bone density loss.”
Belinda is well-versed in the benefits of exercise, having overseen a clinical study that confirmed that high-intensity exercise does indeed help to offset bone density loss in postmenopausal women. “Not only did we see gains in bone, but we also saw gains in muscle and in preventing all these risk factors associated with falling,” she says. As a result, Belinda developed Onero™, an evidence-based exercise program to stimulate bone development in at-risk individuals.
But Belinda believes the value of exercise when it comes to osteoporosis goes well beyond fall prevention. “It's not just about preventing falls by doing a particular exercise program,” she insists. “It's about maintaining your ability to do anything that you want to do throughout your life—maintaining the ability to keep hiking or mowing the lawn or getting your shopping out of the boot of your car. It’s about independence and having that strength of confidence that you don't have to depend on somebody else to be able to live your life. That's hugely psychologically important.”
Boost your calcium
A key risk factor for osteoporosis is having a low calcium intake, and both Belinda and Peter recommend reviewing your diet to ensure you’re getting enough calcium. Adults should aim for 1000 milligrams of calcium a day, while women over 50 years and men over 70 years should aim for 1300 milligrams.
“As a general rule dairy is absolutely the way to get that because it's very absorbable,” notes Belinda, while Peter suggests that a serve of cheese, a tub of yoghurt and a glass of milk every day should be enough to get your quota of calcium.
Enjoy some sun
The other vital supplement when it comes to bone health is vitamin D, which helps the body to absorb calcium and contributes to maintaining our skeleton. “There is actually a real vitamin D deficiency in Australia, because we are much more concerned about skin cancer than we are about getting vitamin D,” Belinda says.
This isn’t to say that you should start exposing yourself to harmful levels of UV rays or actively begin sunbathing for hours on end. But it is important to make sure you get some dedicated sunshine each day. The sweet spot, according to Peter, in order to balance the need for vitamin D with concerns about skin protection? Head outside with your arms and face uncovered for 15 minutes before 10am and after 3pm in summer, and for 30 minutes at midday in winter.
“I definitely grew up in an era where you slip-slop-slapped and covered yourself up,” Belinda says. “But I'm now consciously making the effort to get more sun on me.”
Know your risks
Early action can be vital when it comes to preventing osteoporosis or reducing your risk of breaking a bone. As a starting point, Peter suggests using the online Know Your Bones self-assessment tool, which was developed by Healthy Bones Australia and the Garvan Institute of Medical Research to help Australians understand their risk of osteoporosis.
If you do think you might be at risk, it’s important to talk to your doctor. They can help you to manage and monitor any risk factors, and may refer you for a bone density test. Knowledge really is power here—knowing that you have osteoporosis or low bone density means you and your doctor can take action to improve your bone health and prevent fractures. Want to know more? Healthy Bones Australia has a resource hub with a wealth of information about risk factors and treatment.
Osteoporosis might be common, but a healthy dose of preventative action can make a big difference. And what’s not to like about some sunshine, fresh air and exercise?
- An estimated 1.2 million Australians are affected by osteoporosis.
- It’s estimated that 23 percent of women and 6 percent of men aged over 50 have osteoporosis, including both diagnosed and undiagnosed cases.
- Osteoporosis affects one in four women aged over 75.
- Over 183,000 broken bones occur each year due to poor bone health.
- There were 6,838 hospitalisations for osteoporosis for people aged 50-plus in 2017–18.
- People aged 45-plus with osteoporosis were 2.7 times as likely to describe their health as “poor” compared to those without the condition. More than half of people aged 45-plus with osteoporosis experienced “moderate” to “very severe” pain.
Disclaimer:
Information provided in this article is not medical advice and you should consult with your healthcare practitioner. Australian Unity accepts no responsibility for the accuracy of any of the opinions, advice, representations or information contained in this publication. Readers should rely on their own advice and enquiries in making decisions affecting their own health, wellbeing or interest.
