Understanding Osteoporosis: risk factors

There are quite a number of risk factors that may increase your chances of developing osteoporosis. The key word here is ‘may’. In fact, merely because your profile might reflect one or more of these factors does not mean you’ll get osteoporosis, either in old age or otherwise.

Osteoporosis can arise from a number of circumstances and is often uniquely individual to each person. Nevertheless, it can be traced to a range of possibilities that should be noted and definitely not dismissed as you take measures to ensure a healthy life for as long as possible. We are who we are – and we choose how we live. What we can’t choose, and what we can choose – are both areas that present risk factors.

Taking things personally

Your age: You can’t help growing old, and mostly we associate osteoporosis with aging. We know for a fact that bones build to their peak strength by the thirties and then may decline as each subsequent decade passes. Bones lose density over time, becoming progressively thinner and more fragile, transforming from solid mass to a more lacy structure with a tendency to easy breakage. So some attention should be paid to the condition of your bones as you get older. Regular bone density tests should be done to ascertain the state of your bones. Keeping active and vigilant as you age, is important, but knowing how to keep within the bounds of aging bones – and protect them – is equally important.

Your gender: While women are more susceptible to osteoporosis as a result of hormone loss after the menopause, men are not entirely safe. With advances in medical science, men are living longer, and therefore bones are aging; and aging bones can develop osteoporosis. 1 in 5 men may also get osteoporosis. Nearly 25% of all hip fractures are now reported in men, who have a lower recovery rate due to their greater tendency to have underlying issues such as cardiovascular diseases.

Hormonal issues: Postmenopausal women, and those who have had their ovaries removed or who have experienced early menopause before the age of 45 years, are particularly vulnerable to declining bone health. Once the hormone estrogen is reduced, rapid bone loss may begin. Hormone therapy may help with this problem, especially if affected before the age of 60, or within ten years of menopause.

Your ethnicity: Differences in bone structure and peak bone mass may exist between different races, but osteoporosis can strike at anybody. Caucasian, Coloured and Asian people may be marginally more susceptible to osteoporosis than black populations, although vertebral fractures can be prevalent in all groups. Vigilance is a key tactic in maintaining good bones, no matter your background.  

Family history: Genetics, shared with lifestyle and dietary factors, will contribute to your peak bone mass and rate of bone loss at an older age. If one of your parents or grandparents has had a broken bone, especially a broken hip, you may be at higher risk of osteoporosis. Check out your grandparents – their mobility, falls, injuries, etc. Even without bone density tests, this could give you an example of a family history you should be wary of.

Previous fracture: People who have already sustained an osteoporotic fracture are almost twice as likely to have a second fracture compared to those who are fracture free. Anyone who has fractured after the age of 50 years must be assessed for osteoporosis. There are preventative measures one can take to avoid the likelihood of further fractures. Medications: Before taking medication, check with your doctor about possible side effects affecting the development of osteoporosis. Some may have side effects that directly weaken bone or increase the risk of fractures due to falls.

 Lifestyle

 Smoking: Smoking affects your bones – and the effect only shows up years in the future. Smoking leads to a loss of mineral content in the bones, which weakens bone density. It also weakens collagen, thus reducing regeneration capacity. And it reduces the supply of blood to the bones – all of which is vital to maintaining healthy bones.

Alcohol: Too much too continuously is never good. Alcohol has been shown to have a direct toxic effect on bone cells. It’s the volume you have to be aware of…moderate drinking may not be harmful to your bones.

Poor nutrition: If you are underweight due to poor nutrition or a low intake of bone nutrients such as calcium, protein and Vitamin D, you are moving into dangerous territory with regard to your bones. Without the right foods to build bones, you can experience rapid bone mineral loss. Young women in particular, who suffer anorexia or bulimia, are vulnerable because these conditions lead to lower oestrogen levels, which are also dangerous for the development of osteoporosis much sooner than might normally be the case.

Vitamin D deficiency: Vitamin D is drawn from direct sunlight on our skin. It helps the body to absorb calcium which is vital for our bones. We rarely get it from food, and supplements are not always satisfactory. Our lifestyle, either work or aging, sometimes finds us avoiding sunlight altogether – and sunlight itself is unreliable, especially in the long winters in the northern hemisphere. Always try and get a little sunlight on bare skin whenever you can. Frequent falls: Ninety percent of hip fractures occur as a result of a fall. That’s a scary statistic. Loss of balance as we age, coupled with poor eye sight and lack of exercise increases the risks of falls leading to fractures. To avoid falls, have your eyes tested regularly, wear sensible shoes, remove small carpets, and improve the strength in your legs by walking regularly or doing muscle exercises while sitting. Practicing standing on one leg helps to improve control over your balance.

Diet: A diet rich in calcium, protein, fruit and vegetables will benefit bone health at any age. For seniors, diet becomes even more important because often they may be left with less mobility and unable to get out and shop sensibly, and therefore more susceptible to falls and fractures.

Exercise: The less you move, the less mobility you will have. It’s important to engage in regular weight-bearing and muscle-strengthening exercises. A sedentary lifestyle will ensure bone density loss, and place you at greater risk of a hip fracture.

Love your bones! But risk manage! Know what is beneficial and what is harmful.   

NOFSA (National Osteoporosis Foundation South Africa)

NOFSA is the only non-profit, voluntary health organisation dedicated to promoting lifelong bone health. We focus on reducing the widespread prevalence of osteoporosis while working to find a cure for the disease, and by supporting research and developing programmes of education and advocacy.