How to Prevent Osteoporosis

Contents

Introduction

Osteoporosis is a chronic medical condition that causes our bones to gradually break down, making them fragile and more prone to injury. According to recent statistics, approximately 200 million individuals suffer from this condition worldwide.1 As the condition does not normally display any prominently noticeable symptoms, it is often referred to as the ‘silent disease’ and is usually only diagnosed once an individual suffers a broken bone. The key to preventing osteoporosis is keeping our bones healthy and strong, but how do we do this? The following article will take a deep dive into the many ways we can help maintain optimal bone health, lowering the risk of osteoporosis.

Osteoporosis and Nutrition

The importance of maintaining a balanced diet is very well known, but did you know it can help maintain bone health? Let’s look at the most important vitamins, minerals, and nutrients for our bones.

Calcium

  • Function: The most important mineral in the development and maintenance of strong bones.
  • Sources: Milk, Yoghurt, Calcium supplements 
  • Recommended Daily Amount: 1200-1300 mg

Protein

  • Function: Makes up 50% of our bone volume and helps maintain bone mass.2
  • Sources: Chicken, Eggs, Soy
  • Recommended Daily Amount: 0.75 per kg of body weight

Vitamin D

  • Function: Helps the body absorb calcium.
  • Sources: Sunlight, Eggs, Salmon
  • Recommended Daily Amount: 15-20 IU

Magnesium

  • Function: Helps regulate vitamin D levels and calcium absorption.
  • Sources: Leafy greens, Seeds, Legumes
  • Recommended Daily Amount: 310-420 mg

Osteoporosis and Physical Activity

As well as maintaining a healthy and balanced diet, performing regular aerobic and resistance-based exercise is considered one of the most effective ways to reduce our risk of osteoporosis.

Aerobic Exercise 

Performing 150 minutes of moderate-intensity, weight-bearing aerobic exercises each week (e.g. walking, jogging, dancing) is an extremely effective way of reducing osteoporosis risk. Weight-bearing exercise stimulates the rate at which our osteoblasts (a specialised cell that builds bone) work, helping to increase bone density and sustain bone remodelling (the process in which new bone tissue replaces old bone tissue).

Resistance

Like weight-bearing exercises, research has found that performing two 30-minute resistance sessions (free weights, push-ups, squats) helps promote bone density and strength.3 As it stimulates our osteoblasts, causing them to work faster and thus increase bone density.

Osteoporosis and Smoking

Whilst hard for some, quitting smoking is essential to reduce our risk of osteoporosis. Research has shown those who smoke are 25% more likely to develop osteoporosis.4 The effects smoking has on our bones are extremely damaging and widespread, such that it:

  • Reduces calcium absorption
  • Reduces magnesium levels
  • Reduces oxygenated blood and nutrient delivery to bones
  • Slows bone remodelling and growth by killing osteoblasts

As a consequence of the above, bones are starved of the oxygen and nutrients needed to grow and heal. Subsequently, smokers’ bones become less dense, more brittle, and more prone to injury, increasing their risk of osteoporosis.

Osteoporosis and Alcohol

Limiting yourself to 2 to 3 glasses of alcohol a week can help significantly lower osteoporosis risk. Research has found that those who drink an alcoholic drink per day are 1.38 times more likely to develop osteoporosis, with this figure rising the more someone drinks.5 When excessively consumed, alcohol can disrupt our calcium levels, reducing bone density and the rate at which they can heal.6 Excessive alcohol consumption has also been shown to affect hormone levels, affecting different hormones in people assigned male and female at birth.7

Males - Reduces testosterone production, the hormone responsible for osteoblast production, reducing bone density and increasing osteoporosis risk.

Females - Reduces oestrogen production, which reduces osteoblast production, increasing the risk of osteoporosis.

Osteoporosis and Hydration

Water makes up approximately 60% of our overall weight and is essential in remaining healthy. To stay hydrated, the NHS recommend we drink between 6 to 8 glasses of water a day.8 As well as maintaining our overall health, water is also key for bone health. Water plays a vital role in the transportation and delivery of calcium and other nutrients to our bones, helping to maintain bone density and reducing osteoporosis risk. In addition to delivering vital nutrients to our bones, it also helps transport dangerous toxins away from them. Consistent dehydration allows these toxins to build up within our bones and displace the calcium, weakening our bones over time and eventually leading to osteoporosis.

Osteoporosis and Sleep

Whilst the exact reason is unknown, studies have recently established a potential link between the amount of sleep we get and our risk of osteoporosis. For example, a 2019 study published in the Journal of Bone and Mineral Research found that women who slept for 5 hours or less at night had much lower bone mineral density and, as a result, were 22% more likely to develop osteoporosis.9 If you regularly struggle to get a good night’s sleep, try some of the following tips:

  • Stick to a sleep schedule
  • Have a warm bath or shower shortly before bedtime
  • Perform daily physical activity
  • Eat a substantial meal a few hours before you sleep
  • Visit your local GP

Osteoporosis and Weight/BMI

The importance of maintaining a healthy weight/BMI in the fight against osteoporosis has been emphasised in recent years, but how do we maintain a healthy weight? Let’s look at some of the key lifestyle factors that can influence our weight:

  • Regular moderate-intense physical activity
  • Healthy and balanced diet
  • Limit time spent sedentary (inactive)
  • Maintain a good sleep schedule

While obesity places a higher load on our bones, which should technically increase bone mass; instead, obesity can increase our risk of osteoporosis. Research shows that as we gain weight, fat cells begin to replace bone marrow.10 Consequently, the structure of our bones becomes much weaker, increasing the risk of fractures and osteoporosis. 

Osteoporosis and Sex Assigned at Birth

Research has found that after the age of 50 – an age where many females begin menopause – females are 4 times more likely to develop osteoporosis than males.11 Postmenopausal osteoporosis occurs as a female’s ovaries begin to stop producing oestrogen, a hormone that promotes osteoblast production. Resultantly, postmenopausal females are less likely to perform bone remodelling at a sufficient rate. Therefore, this weakens their bones and increases the risk of osteoporosis. Fortunately, research has found that certain lifestyle choices can decrease a postmenopausal female’s risk of osteoporosis, many of which we have already discussed. A study found that regular physical activity and a balanced diet containing the correct nutrients increased postmenopausal female’s bone density, lowering fracture risk and overall risk of osteoporosis.12

Conclusion

If you believe you may have osteoporosis or are above the age of 65, visit your local medical facility for a bone density test. Even if you are not diagnosed with the condition, your doctor may be able to help you identify the areas of your lifestyle you could alter to help reduce your risk of developing osteoporosis. For those who do not currently fear they are at risk of osteoporosis, but feel their current lifestyle is not protecting them from developing the condition, take time to review the changes you could potentially make. Whether it involves getting more physical activity or increasing consumption of a specific nutrient, these changes could positively impact your overall health and lower your risk of osteoporosis.

References

  1. Zhu, Xiaowei, et al. ‘Twelve Years of GWAS Discoveries for Osteoporosis and Related Traits: Advances, Challenges and Applications’. Bone Research, PubMed Central. 2021;9:23. Available from: <doi.org/10.1038/s41413-021-00143-3>
  2. Sagari, Amalia. ‘Dietary Protein Intake and Bone Health’. Journal of Frailty, Sarcopenia and Falls, PubMed Central. 2020;5(1):1–5. Available from: <doi.org/10.22540/JFSF-05-001>
  3. Hong, A. Ram, and Sang Wan Kim. ‘Effects of Resistance Exercise on Bone Health’. Endocrinology and Metabolism, PubMed Central. 2018;33(4):435–44. Available from: <doi.org/10.3803/EnM.2018.33.4.435>
  4. ‘Smoking and bone health’. NCSCT. 2012, https://www.ncsct.co.uk/usr/pub/smoking_and_bone_health.pdf
  5. Heraghi, Zahra, et al. ‘The Effect of Alcohol on Osteoporosis: A Systematic Review and Meta-Analysis’. Drug and Alcohol Dependence, ScienceDirect. 2019;197:197–202. Available from: doi.org/10.1016/j.drugalcdep.2019.01.025>
  6. Míguez, María José, et al. ‘Hypocalcaemia, Alcohol Drinking and Viroimmune Responses in ART Recipients’. Alcohol (Fayetteville, N.Y.), PubMed Central. 2012;46(8):763–68.Available from: <doi.org/10.1016/j.alcohol.2012.07.004>
  7. Rachdaoui, Nadia, and  Sarkar DK. ‘Effects of Alcohol on the Endocrine System’. Endocrinology and Metabolism Clinics of North America, PubMed Central. 2013;42(3):593–615. Available from: <doi.org/10.1016/j.ecl.2013.05.008>
  8. ‘Water, Drinks and Your Health’. NHS, 2018 June 22, <https://www.nhs.uk/live-well/eat-well/water-drinks-nutrition/>
  9. Cauley, Jane A, et al. ‘Characteristics of Self-Reported Sleep and the Risk of Falls and Fractures: The Women’s Health Initiative (WHI)’. Journal of Bone and Mineral Research: The Official Journal of the American Society for Bone and Mineral Research, PubMed Central. 2019;34(3):464–74. Available from:<doi.org/10.1002/jbmr.3619>
  10. Shapses, Sue A, and Sukumar D. ‘Bone Metabolism in Obesity and Weight Loss’. Annual Review of Nutrition, PubMed Central. 2012;32: 287–309. Available from: <doi.org/10.1146/annurev.nutr.012809.104655>
  11. Alswat, Khaled A. ‘Gender Disparities in Osteoporosis’. Journal of Clinical Medicine Research, PubMed Central. 2017;9(5):382–87. Available from: <doi.org/10.14740/jocmr2970w>
  12. Geyer C. ‘Postmenopausal Osteoporosis’. American Journal of Lifestyle Medicine, PubMed Central.2016;11(2):125–28. Available from:<doi.org/10.1177/1559827616682938>
Klarity logo in white
Klarity is a citizen-centric health data management platform that enables citizens to securely access, control and share their own health data. Klarity Health Library aims to provide clear and evidence-based health and wellness related informative articles.