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Osteoporosis is characterised by reduced bone mass and a porous bone structure. Both can result in the bones fracturing more easily. Particularly at risk are the spine, femoral neck and the forearm. But you can do your bit to help your bones remain strong and robust into old age: eat foods rich in calcium and vitamin D and get adequate exercise.
From bone formation to bone deterioration
Our bones are subject to a continuous process of regeneration. This bone regeneration is governed by vitamin D and the hormones calcitonin and parathormone. Vitamin D and the thyroid hormone calcitonin store calcium in the bones. In contrast, the parathormone from the parathyroid extracts it from the bones. We primarily build up bone mass before the age of 30, the age at which maximum bone mass is achieved. After this, a certain amount of bone substance is lost continuously. In a person suffering from osteoporosis, this loss of bone mass happens too quickly. If too little calcium is provided by food, the body resorts to the calcium stores in the bones as our body needs calcium, for instance for muscular activity and activation of enzymes and hormones. The bones are thus deprived of this mineral. In the long term, this causes the bones to become porous and the risk of fractures increases. A long-term consequence in the area of the thoracic spine, is the so-called ‘widow’s hump’, a curvature of the entire spinal column. But it’s not just too little calcium which has a bearing on the development of osteoporosis. Other important risk factors are genetics, a lack of oestrogen, being female and getting older. Little physical activity and various dietary factors, for instance the supply of protein, vitamins D and K and fibre, influence the risk of disease, as do the stimulants alcohol, nicotine and caffeine. Some medications can also have a negative effect on bone structure.
Men clearly fare better
Our hormonal balance changes as we get older. The female hormone oestrogen protects women from bone deterioration. During the menopause, the function of the ovaries declines, less oestrogen is formed and the level of oestrogen falls. The result: bone deterioration caused by old age is speeded up and the risk of osteoporosis increases considerably. Men clearly fare better: the male hormone testosterone also provides protection from bone deterioration. In men, hormone production only starts to decline later and at a very much slower rate. For this reason, men only usually develop osteoporosis after the age of 70 (if at all).
What helps to strengthen the bones?
Exercising regularly strengthens and trains the muscular system, but also encourages bone formation. A diet rich in calcium is also necessary to reduce the risk of porous bones. The German Nutrition Society’s (DGE) <> recommendation for adults is 1g of calcium per day. Anyone at an increased risk of osteoporosis, or who already suffers from osteoporosis, should take 1.2-1.5g of calcium per day. Milk and dairy products are the most important sources of calcium. Wholegrain products and some vegetables such as broccoli, green cabbage and herbs, as well as nuts and seeds, also contain calcium. Vitamin D supports calcium metabolism. You should also ensure sufficient intake of vitamin D for this reason. At the same time, sunlight on our skin stimulates the formation of vitamin D. The DGE <> recommends 5mg of vitamin D per day. Patients themselves don’t notice at first that their bones are becoming more and more fragile. However, an experienced doctor can recognise the bone atrophy at an early stage and commence the necessary treatment. Those affected can also take steps to help. The following tips can help to strengthen fragile bones and ward off osteoporosis, as part of a balanced diet:
- Every day, include low-fat milk and dairy products such as cheese and yoghurt in your meal plan and opt for vegetables such as broccoli, fennel, green cabbage and leeks. You can also enrich foods with skimmed milk powder, for instance thickened soups, creams and mashed potato.
- In individual cases, for instance for elderly people with restricted food intake, dietary supplements containing
- calcium are useful. Taking supplements should be discussed with your GP.
- Eat two meals that include fish every week, as sea fish such as herring, salmon, tuna and sardines contain a lot of vitamin D.
- Plenty of exercise in the fresh air promotes the formation of vitamin D.
- The earlier you start an exercise programme, the better. Suitable forms of exercise include walking, cycling, golf, swimming, dancing and gymnastics.
- Wear comfortable shoes with a good, non-slip tread (to prevent falls).
Moreover, people who developed strong bones in their youth by taking part in sport and by eating a healthy and calcium-rich diet have only a small risk of developing osteoporosis in old age.