Osteoporosis and broken bones do not need to be a  normal part of aging… you can take charge of your bone health and longevity. 

Not many of us spare a thought for our hardworking skeletons, until of course, we experience a bone fracture. Only then do we realise how much we appreciate each and every one of the 206 bones of the skeletal system. Our bones provide protection just like body armour, keeping our essential organs safe, such as the skull for the brain and the spinal column and the rib cage. Our bones also allow the body movement, through the leverage of the muscles and are also magnificent storehouses of minerals, such as calcium and also work as factories to produce blood cells. As we age, our bones change, break down, repair and rebuild themselves throughout our lives, which makes it a necessity to understand the ins and outs of optimising our bone health. Charlene Yared-West speaks to Life Healthcare Orthopaedic Surgeons and brothers, Dr Duwayne Vermaak and Dr Slade Vermaak on the topic and finds out how to achieve this lifelong goal.

Your bones are alive and changing
Skeletons conjure up images of Halloween, where bones are dry and stiff. However, this idea couldn’t be further from the truth of the bones which are in your body. In truth, your bones are made of tough, healthy, living tissue. “When bones crack or fracture, they are able to recover through rebuilding themselves and are usually restored to their original strength,” says Dr Duwayne Vermaak, Orthopaedic Surgeon at Life Healthcare Little Company of Mary. “However, the age and general health of the person must be taken into account – as this can affect the healing and regeneration process, which happens all the time – even when there is no injury.” Dr D Vermaak points out that there are often little or no warning signs that one can pick up on that could indicate a problem. “Bones don’t tell you much until it is too late – and then they break… Only then does the patient seek advice – and in most cases, some form of pain relief, as fractures can be very painful,” he says. 

What is osteoporosis?

The body uses calcium to rebuild bones and 99% of the 1kg calcium in our bodies is located in the skeletal system. “If there is a shortage of calcium in the body, there is less building material available to the bones for rebuilding, repair and maintenance, which can mean more brittle, weaker and fragile bones; a condition known as osteoporosis. The word literally means ‘porous bone’,” explains Dr Slade Vermaak, Orthopaedic Surgeon at Life Healthcare Little Company of Mary. “Healthy bones can look like a honeycomb, but when you have osteoporosis, the holes in the spaces of the honeycomb comparison, are much bigger.The bigger holes indicate that your bones have lost density or mass, which means that your bones are weaker and more likely to break as you age.” Dr  S Vermaak recommends going for a bone density test to assess your bone health. 

Who is affected the most?

Worldwide, over 200 million people are affected and one in three women and one in five men over the age of 50 will suffer from a fracture due to osteoporosis. An osteoporotic fracture occurs every three seconds and by 2050, the worldwide incidence of hip fracture in men is projected to increase by 310% and by 240% in women. At the age of menopause, women experience a reduced level of oestrogen, which simultaneously causes a rapid reduction in their bone mass. In men, bone loss occurs at the age of 70 years old. Broken bones can occur anywhere in the body, but most commonly occur in the wrists, spine and hips. 

When it comes to bone health… prevention is better than cure 

Bone health begins in the womb, where good maternal nutrition ensures the healthy development of the baby’s skeleton in utero, which continues into later life, through living a healthy lifestyle and eating right, explains Dr S Vermaak. “The focus for children and adolescents is on building the maximum bone mass, which happens until the age of around 25, where about half of our bone mass is accumulated. Thereafter, as adults, the emphasis is on maintaining healthy bones and avoiding premature bone mass loss, which can occur through unhealthy lifestyles,” he says, adding that gastrointestinal disorders also affect the nutrient absorption – especially calcium, in people of all ages – and they can be at risk of bone disease, and therefore, may need to supplement with calcium and vitamin D. “When in doubt, consult your GP,” adds Dr D Vermaak. 

How can you prevent osteoporosis?

There are certain risk factors which increase a person’s susceptibility to bone disease and these are a sedentary lifestyle and poor nutrition, smoking and alcohol use. In addition, the age is taken into account, previous injuries, the body mass index and existing metabolic and health conditions, such as arthritis. “Smoking and alcohol use should be avoided as much as possible and exercise, including weight bearing and muscle strengthening is important for building strong, healthy bones. This applies to both men and women,” says Dr S Vermaak. “A well-balanced diet cannot be emphasised enough – and one that is high in calcium-rich foods, vitamin D and proteins, as well as other micronutrients, including vitamin K, magnesium, zinc and carotenoids – can reduce the risk of osteoporosis.” 

  Six top tips to get bone healthy…

1. Soak up the sun! Get 600 IU of vitamin D per day. Sunlight has become the enemy in the last few years, as consensus tells us to cover up with sunscreen… Also, young people spend less time outdoors, as computers, mobile phones and television take centre stage. All that is required is 10 to 20 minutes of sun exposure on bare skin, outside of peak sunlight hours (before 10am and after 2pm), without sunscreen, while taking care not to burn. 
2. Ensure sufficient calcium, vitamin D, protein and micronutrient intake daily. 
   • Calcium-rich foods: Milk, yoghurt, cheese, broccoli, dried figs, almonds, tofu. 
   • Vitamin D-rich foods: Salmon, sardines, tuna, shitake mushrooms, egg yolk.
   • Protein-rich foods: dairy products, meat, fish, poultry, lentils, beans, nuts. 
   • Micronutrient-rich foods: green and leafy vegetables, cabbage, kale, liver, seeds, carrots, red peppers. 
3. Avoid smoking and excessive alcohol and caffeine. If you love your coffee, or other caffeine-heavy beverages, drink less than four cups per day, as more than three cups could be associated with a 20% increase in the risk of osteoporotic fractures… and make sure you are getting enough calcium! 
4. Include daily exercise and muscle strengthening into your regime. 
5. Identify your risk factors.
6. Take prescribed medication if necessary.

<Sidebar>Are you getting enough calcium?

Calculate your average daily calcium intake in three easy steps. Available online and on mobile devices. http://www.iofbonehealth.org/calcium-calculator

<Sidebar> Knowing your risk factors

Take the International Osteoporosis Foundation One-Minute Osteoporosis Risk Test to find out whether you may have specific factors which place you at higher risk of osteoporosis and fractures.

www.iofbonehealth.org/iof-one-minute-osteoporosis-risk-test

<CASE STUDY>
May Lubbe (75)

(Daughter – carina – 0824664368 carinavd@mweb.co.za)

“One day, like any other day, I was making my bed and as I lifted the corner of mattress slightly, I heard something crack in my back. I lay down on the half-made bed and prayed that when I got up, I would be able to walk. Luckily I could walk after a rest and so I continued with my day, not giving the niggling sensation in my back a second thought. The sensation became painful as it became evening and in the morning, I visited my GP, who prescribed pain medication. No medication seemed to work; it only got worse. Two weeks later after seeing numerous doctors and having an XRAY, I was diagnosed with osteoporosis, a condition I had never heard of. I am a diabetic and have been living with the condition since 1957, so it was bad news that I now had to contend with another ailment. One thing I didn’t know was that as a diabetic, it is even more important to consume calcium-rich foods, which is now a priority in my diet. I have since been on medication to treat the osteoporosis and have made certain lifestyle adjustments and thankfully, I am pain-free and living a full and happy life.”