A greater cause of immobility in women than strokes or heart attacks, osteoporosis, also known as brittle bone disease (when your bones become weak and fracture easily), results in disability, pain, loss of independence and even death.

The most common cause of osteoporosis is having too little calcium and other minerals in your diet and poor absorption of calcium and other minerals from your diet. But your risk also increases with age, especially after the menopause.

Other important risk factors are a slight build, family history of the disease, early menopause and chronic bowel problems like irritable bowel syndrome and diverticulitis. Some of these risks, like family history, can’t be changed but you can lessen the risk and there are many others that you can change and plenty of ways you can defend yourself against the onset of this disease. It’s never too late to start because diet and lifestyle changes can slow and reverse the symptoms at any age. The recommendations that follow can all help reduce your risk of osteoporosis:

• Change your lifestyle: Women who sit for more than nine hours a day are twice as likely to have hip fractures than those who sit for less than six hours a day. So if you have a sedentary job or lifestyle you should build more exercise into your life. Activity is crucial because it helps build strong bones and muscles, so make sure you follow the menopause diet and exercise guidelines. Don’t become a gym junkie though – excessive exercising as well as dieting and overeating can increase the likelihood of developing the condition.
• Avoid faddy diets: Without enough vitamin D and calcium and other minerals your body cannot defend itself against osteoporosis. Obsessive, crash and yo-yo dieting is a bad idea as it deprives your body of the nutrients it needs to keep your bones healthy.
• Stop smoking and drink in moderation: Women smokers generally have lower bone density and after the age of 40 they lose bone faster than non smokers. Excessive alcohol consumption interferes with the way your body handles minerals including calcium, increasing the amount you get rid of and decreasing the amount you absorb.
• Eat for strong bones: Calcium is an important mineral for the formation and continuing strength of your bones and teeth and a diet rich in it is your first step in protecting yourself against osteoporosis. There are many foods besides dairy products that contain calcium and you can obtain good supplies by consuming a variety of different foods. Tinned pilchards and sardines eaten with their bones contain more calcium weight for weight than milk and they are also rich in Omega 3 essential fatty acids. 200g (7oz) of cooked kale or 350g (12oz) of cooked broccoli contain the same amount of calcium as 225ml (8fl oz) of milk.
• A sufficient calcium intake is only half the story though as you also need to absorb it. To do that successfully you need to avoid foods too high in protein or salt or too many fizzy drinks as these foods can all leech calcium from your bones. Tofu, soya milk and beans contain silicon and natural plant hormones that are protectors of bone health as women approach menopause.
• In addition to calcium you also need to get plenty of vitamin D as without it your body can’t put calcium into your bones. Your body manufactures its own vitamin D when your skin is exposed to ultraviolet light from the sun and 10 to 15 minutes daily exposure without sun block is perfectly safe in the early morning or late afternoon. The best dietary source is oily fish, although there are small amounts in eggs and cheese. If you don’t go out into the sunlight at all you should take a bone supplement containing vitamin D.
• A strong skeleton also needs omega 3 fatty acids from flax seeds and fish oil and vitamin K from green vegetables which is vital for hardening calcium in your bones. magnesium, found in nuts, seeds and peanut butter, is another vital mineral because it helps your body absorb calcium and vitamin D.
• Lose excess weight but don’t get too thin or exercise too much: Your body needs some fat to produce oestrogen which is produced in fat cells; thin women, especially those who diet and over exercise, are more likely to suffer from osteoporosis and/or menopause symptoms.
• Finally, watch your stress levels: When you are anxious your adrenal glands pump out a number of hormones including cortisol which can increase your risk of brittle bones and fractures.

Q: I have recently been diagnosed with osteoporosis and wondered what advice you can offer?

A: Calcium is the most prevalent mineral in the bone but other nutrients are involved in calcium absorption with magnesium playing a crucial role in the prevention and reversal of bone loss.

Include mineral rich foods in your diet; calcium, magnesium and silica are found in tinned salmon, chlorophyll rich greens, pulses, almonds and sunflower seeds. Vitamin D aids absorption of calcium and good dietary sources include egg yolk and oily fish; 20 minutes of daily sunshine will also help. Avoid fad diets and eat a healthy diet with sufficient protein, especially if you are a vegetarian.

Reduce your intake of acid-forming foods such as coffee, tea and salt which can disrupt the calcium-magnesium natural balance in your body. Developing stronger muscles through weight bearing exercise and yoga will also help protect your bones.

Take a good bone supplement containing boron to help reduce urinary excretion of both calcium and magnesium. (Osteoplus is a good combination containing calcium and magnesium citrate, zinc, boron, vitamin D3 and digestive enzymes).

This month’s case study: ‘Susan’ – a woman with no physical signs of osteoporosis found that she already had low bone density but still in time to take action …

Susan’s Story:

“Having read, ‘Osteoporosis the Silent Epidemic’, I decided to book an appointment with the Dr Marilyn Glenville clinic in order to get a more tailor-made programme. I attended the clinic when I had just turned 42 for an ultrasound heel scan. Although I had no physical signs of osteoporosis, I was keen to check my bone density because I suffered with amenorrhoea (absence of periods) for three years during my twenties.

“I understand now, (but I didn’t at the time), that the amenorrhoea had put me at a greater risk of developing osteoporosis because of the lack of the hormone oestrogen. Oestrogen is an important hormone in bone turnover regulation. If oestrogen is low bone breakdown can increase, which is why the risk of osteoporosis develops after the menopause and during amenorrhoea. The ultrasound scan I had measures the ‘T score’, which compares the bone density with that of the average 30 year old woman (30 is the age when peak bone mass is reached).

“My T score was —1.8, which put me into the category of osteopenia. Osteopenia is pre-condition to Osteoporosis and indicates a softening or lack of calcium in the bone. If I hadn’t taken action I would be at a higher risk of developing osteoporosis after the menopause. I decided that I wanted to improve my bone density as much as I could while still having regular periods through exercise, diet and supplementation.

“Before coming to the Dr Marilyn Glenville Clinic, I was drinking 7 cups of tea and coffee a day and missing the odd meal. My Nutritional Therapist advised me to stop the tea (as the tannin in tea binds to calcium in the foods and limits absorption) and the coffee (as this may increase the excretion of calcium and magnesium in the urine). She also told me not to miss meals and gave me advice on increasing calcium and magnesium rich foods and she also suggested alternative healthy drinks that I could try. We also discussed outdoor weight-bearing exercises (such as walking and running) to stimulate bone renewal.

“She recommend that I take some nutritional supplements, incorporating Meno Plus (multi-vitamin and mineral with good levels of calcium and magnesium), Osteo Plus (calcium, magnesium, vitamin D and boron), Vitamin C Plus and Mega EPA 1000mg (high strength fish oil).

“A year on and I have repeated the ultrasound scan that shows that my T score is now —1.5 (just osteopenic). Not only am I feeling healthier generally, my bone density has increased. I am so glad I made the decision to have a consultation rather than putting it off until it was too late.

“All I can say to anyone reading this, if you have any concerns at all about your bone health, do get it checked because Osteoporosis is a ‘silent’ disease.”

My Comments:

What people need to be aware of is that osteoporosis is a preventable illness affecting many more women 1 in 3 women over the age of 50 in the UK and 1 in 9 men are sufferers. Public awareness and understanding of the illness, however, remains woefully limited: osteoporosis is not just a matter of brittle bones; it can kill — in fact it kills more women than ovarian, cervical and uterine cancers combined. Susan’s story is a good example of how the risk of developing osteoporosis can be minimise by taking action sooner rather than later.

Clearly something in our modern lifestyle is affecting the density and strength of our bones, and only now are we beginning to understand what that might be. The biggest concern is the next generation of girls, whom many will not even reach their peak bone density by the age of 25 because of lifestyle factors such as smoking, lack of exercise, poor diet and dieting due to media pressure to be stick thin.

There are a number of tests available that are extremely useful, giving you invaluable insights into understanding what is going on in your body at the moment and can tell you what vitamin and mineral deficiencies you may have and how rapidly you are losing bone density. Please follow this link if for more information on osteoporosis tests.