Our bones are constantly renewed through a natural process in which new bone cells replace old bone cells. As we age, however, this process becomes less efficient, and we begin to gradually lose bone tissue.
Osteoporosis is a bone disease where bone loss occurs more rapidly than normal causing bones to become very thin and weak over time. While osteoporosis is more common among older individuals, it can affect people of all ages.
When bones become severely weakened by osteoporosis, a simple movement such as bending over to pick up a bag of groceries, or a minor trauma, such as a fall from standing height or less, can lead to fracture (breaks or cracks in the bone). The most common places for these fractures to occur include the wrist, shoulder, spine and hip. Such fractures, particularly fractures of the hip, are a significant cause of disability, health care costs, and premature death in Canada.
According to the 2009 Canadian Community Health Survey, the Public Health Agency of Canada estimated that approximately 1.5 million Canadians aged 40 years and over (10%) have osteoporosis. Of these people, women were four times more likely to report having osteoporosis than men. Women are more at risk of developing osteoporosis than men because they start with lower bone density, and they lose bone mass more quickly as they age
Risk factors for osteoporosis
Several factors play a role in the development of osteoporosis and the more risk factors you have, the greater your risk. Since bone loss occurs without symptoms, determining if you have osteoporosis requires a bone mineral density test. Your doctor may want you to have a bone mineral density test if you have the following risk factors:
Younger adults (age < 50 years):
Older adults (age > 50 years):
Reduce your risk of developing osteoporosis
It's possible to prevent, delay or reduce bone loss through a healthy lifestyle. Assessing your risk for osteoporosis and related fractures can help you identify lifestyle factors that you can change.
Basic bone health for all individuals includes regular weight bearing and resistance type exercise as well as adequate vitamin and mineral intake.
Exercise/physical activity
Regular exercise that involves weight-bearing aerobic exercise and resistance training is beneficial to bone development and maintenance.
Exercises that focus on balance (e.g., Tai Chi, yoga and/or exercises in standing) are beneficial for people who are at risk of falling.
Vitamins and minerals
Calcium
A diet rich in calcium is essential for healthy bone development. Good sources of calcium include milk products (such as milk, cheese and yogurt), fish products containing bones (such as canned salmon and sardines) and calcium-fortified beverages such as soy beverage or orange juice. Other food sources of calcium include calcium-set tofu, leafy greens and legumes such as soybeans or chickpeas. It is important to know how much calcium you need each day. For individuals who are unable to obtain enough calcium through their diet, calcium supplements are often recommended. For specific recommendations, speak to a health professional.
Vitamin D
Vitamin D is also essential for bone development because it supports the body's ability to absorb calcium. Vitamin D can be made in the skin following exposure to the ultraviolet (UVB) rays in sunlight. However, many factors such as winter season, use of sunscreen, darker skin tone, older age and extensive clothing coverage can reduce the amount of vitamin D our skin makes. Since too much sunlight can be harmful and cause skin cancer and eye damage, recommendations for vitamin D are made assuming minimal exposure to sunlight.
In Canada, it is required that cow's milk and margarine be fortified with vitamin D. Vitamin D may also be found in fortified goat's milk, plant-based beverages (e.g., soy-based), calcium fortified orange juice and some cheeses and yogurts made with vitamin D fortified milk. Vitamin D is found naturally in fatty fish, fish liver oils and egg yolk. It is important to know how much vitamin D you need each day.
To ensure you get enough vitamin D, a supplement is sometimes recommended. Health Canada has advised that everyone over the age of 50 take a daily supplement of 400 IU in addition to following Canada's Food Guide. For specific recommendations, speak to a health professional.
Living with osteoporosis
There are a number of things you can do if you have osteoporosis to help prevent further bone tissue loss:
Adopt a bone-healthy lifestyle
A bone-healthy lifestyle includes regular exercise/physical activity and ensuring that you get the necessary vitamins and minerals to prevent, delay and/or reduce bone loss.
Drug therapy
Your doctor may recommend one of a variety of drugs to help you with osteoporosis. These include:
The primary aim of these drugs is to reduce your risk of fractures. You and your doctor should review the options, assess the risks and benefits of each, and choose the most suitable one based on current scientific evidence.
You may also need to explore several treatment options as some people can have side effects while taking certain medications.
Fall prevention
If you have osteoporosis, preventing falls and fractures is an important concern. Some tips on reducing your risk include:
Information and text reprint courtesy the Public Health Agency of Canada, a Government of Canada agency.
