Bone health

Contents

• Bone health     
• Avoiding broken bones    
• Avoiding falls     
• Enjoying a well-balanced diet   
• Having a healthy lifestyle    
• Talking to your doctor    
• Useful contacts 

It is very important to keep our bones healthy throughout our lives. The skeleton isn't a dead coat hanger - it's a living tissue which needs to be nourished and exercised to keep it strong. Like other parts of the body it has to be protected from disease. This leaflet provides advice on how to keep bones strong and healthy as we get older. 

Bone health

Bones are alive and constantly changing, with new bone being made and old bone lost throughout our lives. In adults, the entire skeleton is completely replaced every seven to ten years. Bones continue to grow in strength until the age of about 35, when old bone starts to be lost at a faster rate than new bone can be formed to replace it.

In some men and women this bone loss is so severe that their bones become weak, fragile and liable to break very easily. This condition is known as osteoporosis. Fortunately, we can take measures to reduce the risk of developing this disease, enabling us to maintain strong bones through to old age. 

Avoiding broken bones

One in two women and one in five men over 50 will experience a broken bone, mainly as a result of osteoporosis. The most common bones to break are bones in the hip, spine or wrist. Women are particularly at risk because during and after the menopause they experience rapid bone loss when the ovaries stop producing the female hormone oestrogen.

As well as being very painful, coping with a broken bone can make independent living difficult and may cause long-term problems with mobility. With approximately three million people living with osteoporosis in the UK alone, it is now a serious health problem.

But whatever your age, there are some simple measures you can take to prevent yourself from experiencing broken bones.

• Avoid falls.
• Eat a well-balanced diet with plenty of calcium and vitamin D.
• Make sure you get enough vitamin D from the sun by taking short breaks outside during the spring and summer months.
• Take regular weight-bearing exercise, such as brisk walking, gardening, bowls and dancing.
• Avoid smoking or excessive alcohol intake.
• Seek advice from your doctor.
  

Avoiding falls

As you get older, you are more likely to have a fall, so it is important to take a look at your home to make it as safe as possible. Some simple, practical steps you could take include:

• Keep an eye out for anything that could cause you to trip or slip. Remember to keep the floor clear of trailing flexes and rucked-up or fraying carpets that you might trip over or slip on. Make sure your stairs and floors are free of clutter.
• Be particularly careful when children are visiting. They may leave toys where you don't expect them, which could easily trip you up.
• If you have a pet, be careful they don’t get under your feet. Keep pet food dishes in a corner, where they can’t be tripped over.
• Try to store objects you use every day at a reasonable height to avoid reaching or bending. You could also try using reaching aids, such as handle extensions and a pick-up tool, to pick up items which are light. The Disabled Living Foundation can give advice on gadgets which make everyday activities easier. See the Useful contacts section for their details.
• Make sure that stairways are well lit and think about installing a hand rail for extra safety. Regular eye tests will reassure you that your sight is as good as it can be. See our free advice leaflet Better Sight for more information.
• A rubber mat in the bath and a grab rail make it much easier to get out of the bath without slipping.
• You may need to take extra care outside in winter when slippery and uneven pavements and kerb stones may cause you to trip and fall.
• Wear well-fitting shoes with a strap or laces. Try to avoid shoes with high heels, or mules. Our leaflet Fitter Feet has more advice on practical tips for caring for your feet.
• Some medicines can make you feel faint or unsteady. Let your doctor know if you ever feel like this after taking medication. They may want to change the dose or medicine.

For more information on improving strength and balance, and reducing the risk of falling, see our free advice leaflet Staying Steady.

Enjoying a well-balanced diet

A healthy, balanced diet is needed to supply the body with energy, essential nutrients and fibre. An adequate intake of calcium and vitamin D is important to maintain bone health, particularly as you grow older. Try to include the following foods in your daily diet:

Foods containing calcium:

• milk, cheese, yoghurt and other dairy products
• tinned sardines and pilchards – including the soft bones!
• beans such as baked beans, kidney beans and lentils
• okra, spinach, kale and broccoli
• nuts and tahini
• tofu
• dried fruit such as figs, prunes, raisins and dates

Foods containing vitamin D:

• oily fish such as mackerel, herring or salmon
• margarine
• breakfast cereals
• egg yolks

For more information on diet, write to the National Osteoporosis Society and ask for their Healthy Eating for Strong Bones booklet priced £3.00. (see the Useful contacts section for their details).

As you get older, your body is less efficient at absorbing calcium. Experts recommend that older people have an intake of 700 mg of calcium and between 400 and 800 international units (IU) of vitamin D a day. A third of a pint of milk contains 225mg of calcium and a 5oz pot of yoghurt has 240mg.

Vitamin D is needed for calcium to be properly absorbed. Even in the UK climate, most people gain sufficient vitamin D by being outside for part of the day in summer (sunshine is a natural source of vitamin D), or from their diet. However, if you have a limited diet or are not able to get out, you may need calcium and vitamin D supplements. Ask your doctor or practice nurse if you are not sure whether you are getting enough of these essential nutrients. 

Having a healthy lifestyle

• Try to take regular exercise. Exercise keeps bones strong so try to take a little exercise every day. Even simple exercise such as walking to the shops will help keep your bones healthy. It also improves your balance and co-ordination which helps to prevent falls. Our free advice leaflet Staying Active and Independent suggests how you can keep active.
• Keep the amount you drink within the recommended limits. The Department of Health runs a campaign called Know your Limits which gives advice and information about drinking sensibly. Visit its website at www.units.nhs.uk  or call Drinkline on 0800 876 6778. If you smoke, consider giving up. Contact the NHS Quit Smoking helpline on 0800 022 4332 for information and help to give up smoking Or visit http://smokefree.nhs.uk Too much alcohol and tobacco is harmful to bones. 

Talking to your doctor

If you are worried that you may have fragile bones (for example if you have fallen over recently and broken a bone, or you've noticed that you are losing height and developing a stoop), talk to your doctor. Your doctor will be able to assess whether you are at risk of developing, or have, osteoporosis. If you already have fragile bones, your doctor will be able to advise you on suitable treatments which will prevent further bone loss. 

Useful contacts

Disabled Living Foundation
380-384 Harrow Road
London W9 2HU
Helpline: 0845 130 9177
Web: www.dlf.org.uk

The Disabled Living Foundation can give you information about gadgets and adaptations which make everyday life easier and may help prevent falls.

National Osteoporosis Society
Camerton
Bath BA2 0PJ
Tel: 01761 471771
Helpline: 0845 130 3076
Web: www.nos.org.uk 

The National Osteoporosis Society is a charity set up to improve the diagnosis, treatment and prevention of this disabling disease. The Society provides advice and information on all aspects of osteoporosis through its medical helpline and information booklets, as well as offering people with osteoporosis support through its network of local groups.