STRONG BONES, STRONG LIFE:
ESSENTIAL TIPS FOR BEATING OSTEOPOROSIS

Osteoporosis means porous bone and it is a ‘silent disease’ that develops overtime and people may not know it until a bone breaks.  This happens when bone mineral density and bone mass decreases that lead to a decrease in bone strength.

Causes
  • Hereditary
  • Removal of ovaries before menstruation period stopped naturally
  • Lack of physical activity
  • Insufficient calcium and/or vitamin D 
  • Smoking
  • Excessive alcohol intake
  • Aging

Diagnosis
Do not wait for accidents to happen to determine if you have osteoporosis.  It is recommended for women >65 years old and for women who are 50 to 64 who have a history of a broken bone after age 50 or a family history of broken bones or osteoporosis to be tested for osteoporosis.

  • Dual energy X-ray absorptiometry (also known as DXA scan) - This is a special x-ray of the hip and spine and is widely available in Singapore. It should be the method of choice for the diagnosis of osteoporosis
  • Ultrasound of the heel - This is an alternative method used on postmenopausal women.
  • Quantitative CT scan - The CT scans are compared with a standard reference to calculate the bone mineral density equivalents.

Treatment
There is no cure to osteoporosis but treatment can help to slow down or stop the process and prevent bone fractures.
  • Get enough calcium: Calcium is crucial for maintaining strong bones. Aim to consume calcium-rich foods such as; 
    • Leafy green vegetables - include kale, spinach, collard greens and broccoli in your meals. These greens are not only rich in calcium but also provide other essential nutrients.
    • Fortified plant-based milk - Many plant-based milk such as almond milk, soy milk, and oat milk, are often fortified with calcium. Check the labels to ensure they contain adequate amounts of calcium.
    • Canned sardines and salmon - when eaten with their soft bones, are good sources of calcium. They also provide omega-3 fatty acids, which are beneficial for overall health.
    • Tofu - Tofu made with calcium sulfate is a plant-based source of calcium. Incorporate tofu into stir-fries, salads, or smoothies for a calcium boost. 
    • Nuts and seeds - Almonds, chia seeds, and sesame seeds are calcium-rich options. Enjoy them as snacks or add them to your meals, such as sprinkling seeds on salads or using almond butter as a spread.
    • Legumes - Beans and lentils contain calcium along with other valuable nutrients. Include chickpeas, black beans, and lentils in soups, stews, or salads.
 
  • Ensure adequate vitamin D intake: Vitamin D helps the body absorb calcium.
    • Spend time outdoors to get natural sunlight, as it promotes vitamin D synthesis.
    • Include the following foods in your diet:
      • Fatty fish - Salmon, mackerel, sardines, and trout are excellent sources of vitamin D. 
      • Cod liver oil
      • Mushrooms - Shiitake and maitake mushrooms, can produce vitamin D when exposed to sunlight or ultraviolet light. Check the packaging or consult the producer to ensure the mushrooms are specifically exposed to UV light.
      • Fortified plant-based milk - soy milk, almond milk, and oat milk are frequently fortified with vitamin D. Look for fortified versions to supplement your vitamin D intake.
      • Eggs - Egg yolk contains a small amount of vitamin D. However, keep in mind that the vitamin D content varies depending on the chicken's diet.
 
  • Regular exercise: Consistency is key when it comes to reaping the bone-strengthening benefits of exercise.
    • Weight-bearing exercises - Engaging in weight-bearing exercises such as walking, jogging, dancing, stair climbing, and hiking can help stimulate bone formation and reduce the risk of bone loss. These exercises place stress on the bones, prompting them to become stronger.
    • Resistance training - Strength training exercises using weights, resistance bands, or bodyweight can improve bone density and muscle strength. This type of exercise puts additional stress on the bones, promoting bone growth and minimizing calcium loss.
    • High-impact activities - Activities that involve jumping, such as jumping rope or certain sports like basketball or volleyball, can be beneficial for bone health. The impact forces generated during these activities stimulate bone cells to lay down new bone tissue.
    • Balance and coordination exercises - Exercises that focus on balance and coordination, such as yoga, tai chi, and Pilates, can help improve stability and reduce the risk of falls and fractures. By preventing falls, these exercises indirectly contribute to maintaining bone health.
 
  • Fall prevention
    • Keep the home environment safe - Make sure the living space is free of hazards. Remove clutter, secure loose rugs or carpets, use non-slip mats in the bathroom, install handrails on staircases, and ensure good lighting throughout the house.
    • Wear appropriate footwear - Choose well-fitting, comfortable shoes with non-slip soles that provide good support. Avoid walking in socks or slippers, as they can increase the risk of slipping.
    • Be cautious with wet or slippery surfaces: Take extra care when walking on wet or slippery surfaces. Wipe up spills immediately and consider using non-slip mats or grab bars in areas prone to moisture, such as bathrooms or kitchens.
    • Be mindful of pets: Be aware of pets' presence and movement to avoid tripping or falling over them.
    • Use assistive devices: If necessary, utilize walking aids such as canes or walkers to provide stability and support during mobility.


References
MOH Clinical Practice Guidelines on Osteoporosis
National Institute on Aging on Osteoporosis
Agency for Care Effectiveness on Osteoporosis
Medications to Treat Osteoporosis
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