World Osteoporosis Day 2023: why it’s important we ‘Build Better Bones’

Posted: 17/10/2023

According to a report submitted to the International Osteoporosis Foundation (IOF), nearly four million people in the UK are estimated to have osteoporosis, a bone disease that arises when bone mineral density and bone mass decreases, or when the quality or structure of the bone changes. There are also many millions more suffering from osteopenia, the pre-osteoporotic loss of bone density, which can lead to the development of osteoporosis.

Osteoporosis is thought to be responsible for around 500,000 bone fractures each year in the UK. While this is a very real and unpleasant risk of the condition, ultimately, if those with osteoporosis are diagnosed early enough, and are dedicated to promoting bone health, they can live healthily and happily, with it remaining very much in the background, without causing any active symptoms.

This year’s World Osteoporosis Day campaign, called ‘Build Better Bones’, is focusing on the importance of a bone-healthy lifestyle in preventing the onset of the condition or limiting its impact for those who are already diagnosed. For more information, visit the IOF’s website.

Many celebrities have spoken out about their experiences of osteoporosis and osteopenia, including Gwyneth Paltrow, Joan Rivers and Anthea Turner, and how healthy lifestyle choices have helped them limit the impact of these conditions on their lives.

This article aims to shed light on the causes, diagnosis, and treatment options for osteoporosis, to help people understand how to ‘build better bones’ so that they can prevent the condition or, if they are already diagnosed, mitigate its impact.

Causes of osteoporosis:

Osteoporosis occurs when the body loses too much bone, makes too little bone, or both. Although there can be various factors contributing to its development, the primary causes include:

Hormonal changes: Lowered sex hormone levels often lead to loss of bone density and, as a result, osteoporosis. As a result of hormone levels playing a big factor in the development of the condition, older individuals and women are at a much greater risk. Levels of sex hormones in men and women decrease as we age and postmenopausal women in particular experience a sharp decline in oestrogen levels. In addition to ageing, treatments for prostate cancer and breast cancer can also cause reduced sex hormone levels and therefore accelerate bone loss.

Dietary factors: A poor diet can limit the absorption of important nutrients that promote bone health, such as calcium and vitamin D. This can also occur as a result of gastrointestinal surgery which reduces the size of your stomach or removes part of the intestine, therefore limiting the amount of surface area available to absorb vitamins and minerals required for good bone health.

Lifestyle: Certain lifestyle choices and habits can increase the risk of osteoporosis, such as excessive alcohol consumption, smoking, a sedentary lifestyle, and a lack of weight-bearing exercises.

Medical conditions: Some conditions (and their associated medications) can interfere with the bone-rebuilding process and lead to an increased risk of osteoporosis, for instance kidney or liver disease, cancer, multiple myeloma and rheumatoid arthritis.

Diagnosis of osteoporosis:

Typically, individuals do not display any symptoms in the early stages of bone loss. As such, many people with osteoporosis will not know they have the condition. However, once the condition is more advanced, the following signs and symptoms might arise:

• back pain, caused by a broken or collapsed bone in the spine;
• loss of height over time;
• a stooped posture;
• a bone that breaks much more easily than expected.

Early diagnosis of osteoporosis is crucial for effective management and prevention of fractures. As such, if you notice any of the above symptoms, it is important to consult a healthcare professional.

If a doctor suspects osteoporosis, the principal method to confirm or rule out a diagnosis is by using a dual-energy X-ray absorptiometry (DEXA) scan. This non-invasive test measures bone mineral density (BMD) at the hip and spine. DXA results are reported as a T-score, which compares an individual's BMD to that of a young, healthy adult of the same gender. The T score defines whether your bone mass is in the normal range, or whether you have osteopenia (a T-score of between -1 and -2.5) or osteoporosis (a T-score of -2.5 or lower).

Another method which can be deployed to detect osteoporosis is a fracture risk assessment. Doctors can use various tools to assess an individual's risk of fracture, and the most commonly used is the FRAX tool. The result of your FRAX assessment will give you a percentage likelihood of a major osteoporotic fracture within the next 10 years, and helps guide treatment decisions.

Concerned you may be at risk?

To become aware of any potential risk factors, you can take the IOF’s Osteoporosis Risk Check. If you are over the age of 50 and you have one or more risk factors, you should discuss these with your doctor and ask for an assessment of your bone health status.

Treatment of osteoporosis

While osteoporosis cannot be reversed or ‘cured’, there are many ways a person diagnosed with the condition can effectively manage it to reduce the risk of fractures. These include:

Lifestyle modifications: Engaging in weight-bearing exercises, quitting smoking, limiting alcohol consumption, and ensuring proper nutrition is crucial to limiting the effects of osteoporosis. In particular, exercising regularly and maintaining a diet with the right amount of calcium, protein, and vitamin D is essential.

Medications: Various medications can be used to help slow down bone loss, such as:

• bisphosphonates - which slow down the cells which break down bone;
• selective oestrogen receptor modulators (SERMs) - which mimic oestrogen and thus slow the rate at which bone is broken down;
• hormone replacement therapy (HRT) – which helps maintain oestrogen levels and thus, again, slows the rate at which bone is broken down; and
• biological medicines - which are proteins that are injected into the body once a month to slow the rate at which bones break down and speed up the rate at which cells build bone.

Fall prevention: Preventing falls is also crucial for individuals with osteoporosis to reduce the risk of fractures. Once the condition is diagnosed, it is important to remove tripping hazards, ensure proper lighting, have regular eye check-ups and use mobility aids if required.  

Conclusion

On World Osteoporosis Day 2023, we encourage people to take a moment to think about their bone health. In the UK, it is estimated that 21.9% of women and 6.7% of men aged 50 years or over have osteoporosis. In addition, some 4.8% of men and 13.8% of women who are aged 50 are likely to suffer from a hip fracture in the remainder of their lifetime. Bone health is therefore a very real public health concern. At Penningtons Manches Cooper, we hope that with better education for individuals and a stronger policy framework for diagnosis and treatment, the numbers of people affected by osteoporosis will reduce.

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