Why we need to look after our bone health in midlife
How much do you think or worry about your bone health? Although some people are at higher risk of bone breaks than others, fractures or the fear of a fall rises as we age.
In fact, millions of older people worry about falling over, with 4.3 million (36%) saying it topped their list of concerns (source: Age Concern).
And with just cause as falls are a leading cause of injury as we get older.
In 2017/18 nearly 100,000 older people (aged 65+) suffered hip fractures (NHS Digital) and such injuries strip elderly people of both independence and confidence. To help prevent this from happening we need to understand the impacts of lifestyle and ageing on our bone health.
We reach our peak bone mass by our mid-twenties and then start to lose bone density as we age. Men have a higher peak bone mass than women – as their bone width and size is greater – meaning women are far more likely than men to develop osteoporosis, a condition where our bones become less dense and weaken, causing them to break or fracture more easily.
Additionally, women undergo more rapid bone loss during menopause as our levels of oestrogen falls. One study estimates that about half of the lifetime loss in bone mineral density for women occurs during the short period of menopause in midlfe (source). And the impacts of menopause on bone health are stark: about three-quarters of all broken hips happen to women and one in two women over the age of 50 fracture their hip, wrist, wrist or spine due to osteoporosis (source).
Nevertheless, there are other factors other than menopause that can increase the risk of osteoporosis that affect both men and women as we age (source). These include:
Hormone imbalances: Low thyroid hormone levels or too much thyroid hormone, and low testosterone levels can all cause a loss of bone mass.
Low dietary calcium: Our bones are our body’s storage bank for calcium. If we do not get enough calcium from our diet to support our bodies, it is removed from our bones.
Sedentary lifestyles: People who are physically inactive have a higher risk of osteoporosis than do those who are more active.
Tobacco and alcohol: Research suggests that tobacco use or regularly having more than one alcoholic drink a day for women (2 for men) contributes to weak bones.
Race and family history: You are at a greater risk of osteoporosis if you’re white or of Asian descent, and/or have a parent or sibling who has osteoporosis.
Size: Having a body mass index of 19 or less or have a small body frame puts you at a greater risk of osteoporosis as you have less bone mass to draw from.
Specific health conditions: Weight-loss surgery and inflammatory bowel diseases such as coeliac disease can affect the body's ability to absorb calcium.
Certain medications: Long-term use of corticosteroid medications and other drugs used to treat serious health conditions such as cancers and seizures might also increase the risk of osteoporosis
How will you know? Signs of osteoporosis
In its early stages, there may be few noticeable symptoms but there are subtle signs to look out for such as recurring back pain or aches, loss of height and rounded shoulders or a stooped posture. Late-stage symptoms of osteoporosis include back and neck pain and spine fractures (source).
Taking control
Those who develop a higher peak bone mass when younger are better protected from bone issues such as fractures and osteoporosis as they age. However, we still have a lot more control to protect our bone health than we may may think. We need to be more aware of the factors that are detrimental to bone health, such as those listed above, as well as take on board protective measures such as exercise - particularly resistance or weight bearing, a good diet with lots of calcium and vitamin D, and , for women with a high risk of osteoporosis, hormone replacement therapy (HRT). With greater knowledge we can be better forearmed and equipped to help keep our bones healthy and prevent or slow bone loss as we age.
Further reading:
Royal Osteoporosis Society
Great article: VeryWellHealth
Sources: