Osteoporosis: 3 ways to prevent it

I am reading the information leaflet of the International Osteoporosis Foundation, that "a sneeze can be a cause of fracture in people who have already developed severe osteoporosis". And yet...you read that right!

Osteoporosis: What is it?

Osteoporosis is the most common bone disease, characterized by a change in the architecture of the skeleton and the gradual appearance of "pores" in bones, a "sponge-like" appearance. It develops silently, as it does not warn us with pain or other symptoms, but it can first come to our attention with a fracture, which will occur after the age of 45-50 years, from a movement that we would not imagine could cause a fracture, such as a sudden movement, lifting a heavy object or even..a tight hug. The appearance - therefore - of an osteoporotic fracture is a fairly common way that someone may become aware that they have osteoporosis.

Is everyone in danger? Who is most likely to develop osteoporosis?

Everyone - without exception - after the age of 50 is more likely to develop osteoporosis. Age is one of the factors we cannot influence. Non-modifiable risk factors include female gender, as well as white race. Women compared to men are in a more vulnerable position as the hormonal changes that take place during perimenopause and menopause can have a negative impact on women's bone health, with the gradual decrease in estrogen, increasing the excretion of the main component that shapes the skeleton, calcium, and contributing to the vulnerability of bone health.

Osteoporosis and lifestyle changes

However, as we tend to mention in the majority of our articles, in addition to the non-modifiable factors (yes, we can't stop growing older...), there are factors that we can modify and turn in our favor, especially if:

We have passed the age of 50 (men & women).
We are women, especially at the climacteric and menopausal stage.
Our parents or grandparents suffered from osteopenia/osteoporosis.
We suffer from diabetes, thyroid disorders, lactose intolerance or rheumatoid arthritis. A number of diseases have been associated with an increased likelihood of developing osteoporosis.
We have suffered at least one fracture after the age of 45-50 years.
We do not consume adequate calcium and vitamin D.
We do not exercise.
We smoke.
We have a particularly low body weight (BMI < 20kg/m2).
We take certain types of medication, such as glucocorticoids, in the long term.
We drink a lot of alcohol (more than 1 drink a day for women and more than 2 for men).
We are fans of salty food (too much sodium increases the rate of calcium loss).
We consume more than 3-4 cups of coffee a day (excessive caffeine intake also increases calcium loss).

If you agree with 2 or more bullets, take immediate action as osteopenia and osteoporosis can be prevented!

While there are medication recommendations suggested in osteopenia (a stage before osteoporosis) and osteoporosis, we are given the opportunity to prevent these conditions. So why not take preventative action to ensure that they do not occur?

Below are 3 suggested lifestyle changes that can help prevent the onset of osteopenia and osteoporosis, as well as help reduce bone loss in patients with osteoporosis, by helping to protect the structural integrity of our skeleton.

Exercise. Exercise is the greatest enemy of osteoporosis. A simple 30-minute daily walk, combined with muscle strengthening exercises are an integral part of bone protection...especially as we age!
Alcohol, caffeine and salt...in moderation! While you can find most of our nutritional tips in step 3, taking particular care of alcohol, caffeine and salt (sodium) consumption helps the body not to excrete more calcium than desired, maintaining the integrity of our bones.
Diet and osteoporosis. Moderation in salt, caffeine and alcohol is important to be accompanies by an increased calcium intake, as well as vitamin D, vitamin K and magnesium.

Calcium. The No1 ingredient that we need to make sure we take in sufficient quantities. Rich dietary sources of calcium include dairy products (full fat or low fat), fish with small bones, broccoli, unsalted almonds (hence almond butter), sesame seeds (including tahini), legumes such as beans, broccoli and green vegetables, dried figs and calcium-fortified vegetable milk substitutes. The required calcium intake for a post-menopausal woman - not on hormone replacement therapy - (or a man over the age of 65) is 1200mg per day, the equivalent of 4 cups of milk!

Extra tip: Avoid completely non-fat dairy (0%) as the presence of fat is required for vitamin D to be absorbed!

Vitamin D. In order for the calcium we consume to "make it" to the bones, it must be bound by vitamin D and transported with the help of vitamin K. 80% of vitamin D is produced through sunlight, while only 20% can be obtained through diet, from specific sources such as egg yolk, mushrooms and oily fish. However, a very large proportion of the Greek population is deficient in vitamin D, which is a risk factor for osteoporosis. See our article on vitamin D for more!

Calcium and vitamin D supplements are a well-tolerated and effective option for people who find it difficult to reach the recommended intake. The recent review by Albani and colleagues noted that the use of calcium and vitamin D supplements significantly reduced the risk of hip fracture, while the scientific team of Rossini and colleagues from Italy reported that supplementation with 1200mg calcium & 800 IU vitamin D₃ significantly reduced the rate of bone loss, due to use of glucocorticoids.

Vitamin K. The "guide" vitamin for calcium, which directs it to the bones where it will be absorbed with the help of vitamin D. The richest dietary sources include dark green leafy vegetables, broccoli and cauliflower.
Magnesium. The mineral with a multitude of functions in the body, which also plays a key role in bone health, as it is a component of bone, as well as vitamin D metabolism co-factor (in other words, we need to get enough of it for vitamin D to do its job!). Learn more about magnesium here.

Finally, promising data is noted in the administration of collagen peptide supplements, an ingredient with infinite health benefits, as we have discussed in a previous article. It seems, therefore, that collagen peptide supplementation supports bone strength and may provide an additional protective parameter against osteopenia and osteoporosis, as it has been positively associated with increased bone density in a recent review that studied the effect of collagen supplementation on osteoarticular structure.

Learn more about collagen here.

In conclusion

Osteoporosis is a very common disease, with postmenopausal women being one of the most vulnerable groups. However, it is a condition that we can prevent it from occurring, by taking the appropriate measures, so that our quality of life is the best possible. Our allies in this effort include incorporating exercise, taking care of salt, caffeine and alcohol intake, as well as increasing calcium and vitamin D consumption. In conjunction with the tactics we have discussed, supplementation to enhance bone health, particularly calcium and vitamin D₃, is a safe and well-tolerated option that will complement our efforts to keep our foundations strong.

Scientific References

Campos, L. D., Junior, V. D. A. S., Pimentel, J. D., Carregã, G. L. F., & Cazarin, C. B. B. (2023). Collagen supplementation in skin and orthopedic diseases: A review of the literature. Heliyon, 9(4).

Eleni, A., & Panagiotis, P. (2020). A systematic review and meta-analysis of vitamin D and calcium in preventing osteoporotic fractures. Clinical rheumatology, 39(12), 3571-3579.

IOF, International Osteoporosis Foundation, 2019

Kling, J. M., Clarke, B. L., & Sandhu, N. P. (2014). Osteoporosis prevention, screening, and treatment: a review. Journal of women's health, 23(7), 563-572.

Rossini, M., Adami, S., Bertoldo, F., Diacinti, D., Gatti, D., Giannini, S., ... & Isaia, G. C. (2016). Guidelines for the diagnosis, prevention and management of osteoporosis. Reumatismo, 68(1), 1-39.