What is Osteoporosis? (and why does it happen?!)

Bone is living tissue that is constantly being broken down and replaced. Osteoporosis occurs when the creation of new bone doesn't keep up with the loss of old bone. Pretty simple right? Osteoporosis is not some strange beast, but rather, the inability of our body to keep up with new bone production. The overall net bone loss leads to bones that become brittle and weak, meaning a fall or even knock can lead to fractures or breaks.

When you're young, your body makes new bone faster than it breaks down old bone and your bone mass increases. After the early 20s this process slows, and most people reach their peak bone mass by age 30. As people age, bone mass is lost faster than it's created. How likely you are to develop osteoporosis depends partly on how much bone mass you attained in your youth. Peak bone mass is partly inherited and varies also by ethnic group. The main risk factors are: sex (women), race (white, asian), age (older), family history, and frame size (smaller).

How Does This Affect Long-Term & Overall Health?

Bone fractures, particularly in the spine or hip, are the most serious complications of osteoporosis. Hip fractures often are caused by a fall and can result in disability and even an increased risk of death within the first year after the injury. In some cases, spinal fractures can occur even if you haven't fallen. The bones that make up your spine (vertebrae) can weaken to the point of collapsing, which can result in back pain, lost height and a hunched forward posture. Now, whilst bone loss in the early stages might be invisible, back pain can be a common result, and if you do have fractures, healing time and long-term pain are likely to increase, which in turn can affect mobility and quality of life.

Another issue is arthritis - the inflammation of the joints. In some cases, osteoporosis can be a result of arthritis if you don't get the physical activity you need to keep your bones strong, so there is a link between these two conditions.

How Are Osteoporosis & Estrogen Linked?

Lowered sex hormone levels tend to weaken bone, and women generally are more at risk than men. The fall in estrogen levels in women at menopause is one of the strongest risk factors for developing osteoporosis. Treatments for prostate cancer that reduce testosterone levels in men and treatments for breast cancer that reduce estrogen levels in women are likely to accelerate bone loss.

More specifically, estrogen regulates bone metabolism. It is essential to bone health because it promotes the activity of osteoblasts, which are the cells that make new bone. Thus, as estrogen declines, this activity also declines, and resorption of bone overtakes creation of it.

Does Estrogen Supplementation Help?

Yes. Studies like this have shown that this is a good option, "Since low estrogen levels are the main cause of postmenopausal osteoporosis, menopause hormone therapy is considered as the first line choice for prevention of osteoporosis and its effectiveness has been demonstrated by various studies."

Further studies are looking into the fact that transdermal (topical) is an effective - and safer - way to administer this estrogen to help women live their best, and healthiest, lives post-menopause.

How Does Diet Play A Role?

Whilst supplements like calcium and vitamin D are good options, getting these from a healthy diet is the best way to ensure maximum health (and vitamin and mineral absorption). A good quality diet, high in fruits, vegetables, legumes, and whole grains is a great place to start. Calcium, from salmon/oily fish, calcium fortified cereal, tofu and dark leafy greens should be added to one's diet. Vitamin D, from trout and salmon, or fortified foods - as well as sun exposure, is also key.

What About Exercise?

Exercise is a fundamental aspect of protecting yourself from osteoporosis. Strength training helps strengthen muscles and bones in your arms and upper spine. Weight-bearing exercises — such as walking, jogging, running, stair climbing, skipping rope, skiing and impact-producing sports — affect mainly the bones in your legs, hips and lower spine. Balance exercises such as tai chi can reduce your risk of falling especially as you get older. Flexibility exercises, like Yoga, can help with joint mobility, as well as incorporate both weight and balance aspects.