Osteoporosis - Reduce Your Risk
Osteoporosis is a chronic condition defined by low bone mineral density, which results in the bone structure deteriorating. Bones start to lose minerals such as calcium and become fragile. This leads to an overall weaking of the skeleton, thereby increasing the risk of fractures and breakages.
Osteopenia is a condition where the bone mineral density values are lower than normal range, however not low enough to be diagnosed with osteoporosis. However, Osteopenia can progress to Osteoporosis.
In 2022, it was estimated that 3.4% of Australians were living with either osteopenia or osteoporosis. 29% of falls were linked to low bone mineral density and osteoporosis accounted for 1.4% of all deaths. When a fracture occurs due to osteoporosis, this can result in chronic pain, reduced independence and premature death.
Reduced bone mass is commonly found in:
- women after menopause
- older people
- lifestyle/dietary factors such as: smoking, excessive alcohol intake, and sedentary lifestyle
- low vitamin D levels
- long term corticosteroid use
- Individuals living with some disabilities: people with schizophrenia, people taking certain anti-epileptic medications, people with down syndrome, people with reduced/nil mobility
Diagnosis
Osteoporosis diagnoses requires bone mineral density testing. A DXA (dual energy x-ray absorptiometry) scan is used to gauge a person’s bone mineral density and therefore assess their risk of fractures.
Osteoporosis management
Prevention and treatment of osteoporosis includes maintaining bone density and reducing overall fracture risk. Interventions may include:
- optimising calcium intake: increase calcium rich foods and calcium supplements if recommended
- vit D supplementation (if recommended)
- limiting alcohol/caffeine intake and avoid smoking
- weight bearing exercise (if able)
- speak to your General Practitioner regarding medications to reduce the risk of broken bones.
- fall reduction strategies e.g. home modifications and addressing vision if applicable
Dietetics involvement
Improving calcium intake is a primary focus for managing low bone mineral density. The recommended daily calcium intakes are:
- 500mg daily for children 1-3 years of age
- 700mg daily for children 4-8 years of age
- 1000mg daily for children 9-11 years of age
- 1300mg daily for teenagers 12-18 years of age
- 1000mg daily for adults >19 years of age
- 1300mg daily for women >50 years of age
- 1300mg daily for men >70 years of age
HIGH CALCIUM FOODS
FOOD/DRINK - CALCIUM AMOUNT (in mg)
Cows milk - 240mg per 200ml
Fortified plant milks - 240mg per 200ml
Dairy Yoghurt - 200mg per 150ml
Cheese - 120-240mg per 30g of cheese (hard cheese, soft cheese, feta, mozzarella)
Calcium fortified cereals - 200mg per cup
Bok choy - 84mg per ½ cup
Broccoli - 110mg per 120g (raw amount)
Tofu - 126mg per 120g
Eggs - 27mg per egg
Tuna/salmon with edible bones - 200mg per 90g (small tin)
Sardines - 240mg per 60g of sardines in oil (canned)
Chickpeas - 99mg per 200g (cooked amount)
Almonds - 75mg per 30g of almonds
Oranges - 60mg per 150g
Dried figs - 96mg per 60g
If you are unsure if you are reaching your calcium targets, please consult with an Accredited Practising Dietitian.
References
Healthy Bones Australia, Calcium & Bone Health, https://healthybonesaustralia.org.au/your-bone-health/calcium/
Australian Institute of Health and Welfare, Osteoporosis and minimal trauma fractures, https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoporosis\
Queensland Government, Bone density and osteoporosis, https://www.qld.gov.au/health/conditions/screening/bones
British Journal of General Practice 2022; 72 (716): 100 101. DOI: https://doi.org/10.3399/bjgp22X718553
Geijer et al. (2014) Bone mineral density in adults with Down syndrome, intellectual disability, and nondisabled adults Am J Intellect Dev Disabil. 2014 Mar;119(2):107-14.
Stubbs et al. (2014) A meta-analysis of prevalence estimates and moderators of low bone mass in people with schizophrenia. Acta Psychiatr Scand . 2014 Dec;130(6):470-86