What is osteoporosis? Bone up with our guide

Osteoporosis affects around three million people in the UK, with one in two women over the age of 50, and one in five men, suffering from fractures due to the bone-thinning condition. Experts warn younger women are now starting to be diagnosed – A-lister Gwyneth Paltrow has revealed she suffers from osteopenia, a precursor to the disease – but there are steps you can take to build stronger bones, inside and out.

Osteoporosis: the facts

The word osteoporosis literally means 'porous bones', where bones become riddled with tiny holes, lose their density and become fragile, leading to painful and sometimes fatal fractures, particularly of the wrist, hip and spine. With an ageing population, experts are predicting more cases of this ‘silent epidemic’, silent because there tends to be no obvious osteoporosis symptoms until you break a bone.

Our bones are made up of a thicker outer shell and an inner honeycomb mesh. Old bone is removed by cells called osteoclasts and replaced by bone-building cells called osteoblasts in a continual cycle. Osteoporosis occurs when this cycle is imbalanced and the honeycomb mesh becomes thin – a bit like a dodgy builder leaving out essential bits of scaffolding. The outer shell develops tiny holes and, overall, the bone becomes thinner and more liable to break.

What causes osteoporosis?

Some bone thinning is due to ageing. We build up a ‘bone bank’ during adolescence and by the age of 25 you’ll have around 98 per cent of your bone mass. It stabilises in your 30s and 40s, and then starts to decline. Women are particularly at risk because they have smaller bones than men, and also lose the bone-protecting effects of oestrogen after the menopause.

Some diseases, such as rheumatoid arthritis or an overactive parathyroid gland, which controls the amount of calcium in our blood, can increase our osteoporosis risk, as can conditions that affect the absorption of food, such as Crohn’s or coeliac disease.

Our genes are also though to affect our bone health, so the condition tends to run in families.

Protect yourself against osteoporosis

Factors such as diet and exercise can make a big difference to bone health:.

  • Cut down or quit smoking and drinking – alcohol and cigarettes have a direct toxic effect on bone cells

  • Up your intake of calcium-rich foods – many young women shun dairy (the greatest source of calcium) as they mistakenly think they’re fattening.

  • Try a vitamin D supplement – vitamin D is needed to help us absorb calcium properly. We make vitamin D in response to sunlight but in our climate we may not produce enough.

  • Take regular, weight-bearing, exercise – good osteoporosis exercises include brisk walking, dancing, tennis, anything that encourages the muscles to ‘pull’ on the bones, stimulating new growth and encouraging the uptake of calcium into the bone, making them stronger. Over-65s should focus on more on balance to strengthen muscles and reduce risk of falls; try tai chi.

  • Talk to your GP if you think you’re at risk – osteoporosis is usually confirmed when a patient is referred for DXA (dual energy X-ray absorptiometry), which measures bone density, and shows whether your bones are abnormally thin and if you need treatment for osteoporosis.

This article has been adapted from longer features appearing in Healthy, the Holland & Barrett magazine. Advice is for information only and should not replace medical care. Please check with your GP before trying any remedies.