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Condition - Osteoporosis – "the silent disease"

By Jenny Bodenham BA (Hons) DipION MBANT

June 2011 has been designated National Osteoporosis month to raise awareness of this increasingly prevalent and potentially debilitating disease. 

The term osteoporosis literally means “porous bones”. It is a disease where bones lose mass and density, becoming more fragile and susceptible to fracture. The hips, spine and wrists are most commonly affected. Fractures may cause pain, loss of height and spinal curvature and may result in disability and dependency. Osteoporosis has been labelled “the silent disease” as it generally progresses with no early warning signs prior to fracture. 

Currently, osteoporosis affects an estimated three million people in the UK, but, with increasing life expectancy of the UK population over future decades, this figure is expected to increase. One in two women and one in five men over the age of 50 will suffer a fracture. Post-menopausal women are at greatest risk of developing the disease due to a decline in protective levels of oestrogen.

Bone is a complex living tissue, containing collagen, calcium, phosphorous and a range of other minerals, including magnesium, boron, zinc, copper, silicon and manganese. It is constantly being renewed in a process called “remodelling”, where bone cells called osteoclasts dissolve old weak bone (resorption) and osteoblasts synthesise new bone. When these two processes are in balance, healthy bone is maintained. Loss of bone density occurs when there is an accelerated breakdown of bone that overtakes the formation of new bone.

Build up your bones

It is never too early to invest in bone health! A poor diet and lack of exercise during childhood and the teenage years may sow the seeds for brittle bones in later life. Unfortunately, many youngsters aspire to an unhealthy body image at the very time when they should be building bone mass. Peak bone density is achieved around the age of 25 years, after which time, bone density gradually starts to decline. Women may lose up to 20% of their bone mass in the five to seven years after the menopause, whereas men do not usually experience a large hormonal fluctuation until they are older. 

Osteoporosis, however, is not inevitable. While there is a genetic component to osteoporosis risk, the development of good dietary and lifestyle habits can make a substantial difference to the strength and quality of the bones.

Risk factors for osteoporosis include:


  • Increased age
  • Early menopause (before the age of 45)
  • Early hysterectomy
  • Family history of osteoporosis
  • Eating disorders, such as anorexia and bulimia
  • Small frame
  • Irregular periods
  • Female hormone imbalance
  • Over/under exercise


  • Heavy smoking
  • Increased alcohol and caffeine intake
  • Long-term stress
  • Lack of natural daylight
  • Poor nutrition
  • Malabsorption problems
  • Lack of weight-bearing exercise
  • Use of certain medications
  • Immobility
  • Over-acidity


Bone up on nutrition!

While calcium is essential for the skeletal system, dairy products may not be well tolerated and are not the only calcium source. The mashed bones found in tinned oily fish,such as mackerel, sardines and salmon, provide a rich source of calcium. Calcium is also found in green leafy vegetables, such as curly kale, watercress and spring greens. Dried figs, almonds, ground sesame seeds and tahini are also good sources. Magnesium is a crucial mineral, needed to enhance absorption of calcium from food and to promote mineralisation of the bones. It is found in beans, lentils, tofu, almonds, walnuts, pumpkin seeds, green leafy vegetables and wholegrains. Additionally, oily fish, nuts and seeds, as well as eggs, beans and lentils, are all sources of healthy protein, which is an important component of bone tissue. Eat a diet high in alkalising fruits and vegetables and avoid sugary and refined carbohydrates, which may increase urinary calcium loss. 

Vitamin D facilitates calcium and phosphorous absorption. Sometimes referred to as “the sunshine vitamin”, it is produced in the body from the action of the UV-B rays in sunlight on 7-dehydrocholesterol on the skin. However, latitude, climate, clothing, skin pigmentation and use of sunscreen may all affect this process. Vitamin D is only found in significant amounts in a small range of foods, such as egg yolk and oily fish, and a number of studies have shown the positive effects of vitamin D supplementation on bone health. 

In the Far East, the diet is traditionally high in foods made from fermented soya, such as natto and tempeh, which are relatively unknown in the West. Studies have shown that soy isoflavones may help to inhibit bone resorption and this may be a factor in the lower incidence of osteoporosis experienced in Asian countries. Natto is also a rich source of vitamin K2, which is needed to promote proper uptake of calcium into the bones. Due to the relatively low consumption of vitamin K2 in the Western diet, it may be beneficial to supplement this important vitamin.

Take steps to support strong bones!

Stop smoking – smoking is associated with lower bone mineral density and increased fracture risk in postmenopausal women. 

Exercise – regular weight-bearing exercise helps to promote bone formation and bone health. Exercise such as rebounding, tennis, dancing, resistance training, yoga and brisk walking may be beneficial. 

De-stress –stress weakens digestion and produces hormones, such as cortisol, that increase urinary calcium loss. Meditation may be helpful, as well as supplementing B vitamins and rhodiola. 

Get some sunshine– regular, sensible sun exposure helps boost vitamin D levels.

Avoid alcohol – keep alcohol consumption to moderate levels and reduce to a minimum if suffering from osteoporosis.

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