Approachable Fitness & Physical Therapy

Living well with osteoporosis

How to live well with Osteoporosis (OP)

What is Osteoporosis?
In simple terms it means porous bones.  Bones, which are breaking down and rebuilt throughout your life, are less efficient at rebuilding as you get older so they become weaker and lose density.

Are you at risk?
If you are female and over age 45 then probably yes.  If you meet any of the following factors then you will be at higher risk:
A parent had osteoporosis, was hunched, had fractures or shrank considerably with age
You are of Caucasian or Asian descent
You’ve ever had an eating disorder, have been extremely slender or are under weight
You’ve had irregular periods
You smoke (or have ever smoked) or drink alcohol above national guide lines
You’ve been on long term medication ( steroid/laxative/thyroid/antacid)
You don’t exercise or over exercise
You have digestive problems or are coeliac, or have Crohn’s disease.
You’ve never had children
You had an early menopause
You are getting shorter or have already suffered a broken bone

Testing and drug therapy for Osteoporosis.
If you are concerned about osteoporosis then you may have already consulted your GP, had tests and been given medication.  Research in this area is ongoing so it is definitely worth seeking your GP’s advice as to the medical treatment available.  
I am not giving advice in this area, but aim to help you manage your condition, or delay the onset through food and exercise.

Theory’s about the body’s acid/alkaline balance.
Scientists and experts do not agree on what we should eat to reduce our risk of OP. This makes it extremely difficult for the general public to make an informed decision as to the best diet to follow.  There seems to be two main views on limiting the effect of OP.
One is to follow an alkaline diet, the other to follow a balanced diet including all food groups.
Key points from those recommending an alkaline diet: 
·        The acid/alkaline balance of our body plays a large part in much of the media coverage of OP.
·        It is claimed that calcium neutralises the body’s ph so it uses up reserves to counter the acidity caused by eating acidic food.
·        If your diet is acid (more of this later) then your bones will give up calcium to balance the ph.
·        With age our bodies do not excrete acid as efficiently so our bodies become more acidic.
·        We should aim to eat an alkaline diet.
·        Limit intake of acid protein (see list below). Unlimited vegetable protein is fine.
·        Limit dairy as the acid level can cause more loss of calcium than gain
·        Proteins with high acidic levels include red meat, chicken, eggs, cheese, most nuts
·        68g of protein daily is much better than consuming over 95g (Tracking your food intake over a few days and using a nutrition calculator such as MyFitnessPal will give you a good idea as to where your protein intake level is)

This advice is at odds with the recommendations of the UK National OP Society for a balanced diet with all food groups.  They do not reference the body’s acid/alkaline balance at all.  I have not, so far, been able to find any scientific basis for this balance.
For more on the myths about acid/alkaline balance check out:
For the UK National OP Society advice check out:
https://nos.org.uk/information/healthy-living-and-risk/healthy-eating-for-strong-bones/

As a sport nutritionist I follow the latest research and have a particular interest in eating for good health.  In my opinion, a healthy eating plan will ensure that your weight is stable and by adding in a few tweaks for specific issues we can address health issues without ever following ‘a diet’.  Find an eating pattern which suits you and which you can follow for life, then you can make changes permanent and, as a result, you will gain the most benefit.

My advice for managing Osteoporosis
Having looked at much material and research I think that a balanced approach is required.  Doctors know much more about the science behind our bodies so rely on them for medication.  They may not be as knowledgeable about diet and exercise so that is where you need to make your own decisions.

My key dietary points:
·        Avoid fizzy drinks, processed food, artificial sweeteners and stress
·        Cut down on caffeine, sugar, salt and alcohol
·        Be aware that spinach and rhubarb contain oxalic acid which prevents absorption of calcium.  I’m not sure how much evidence there is to support this is but there are so many other sources of calcium it seems sensible not to rely on these.
·        Increase your intake of green leafy vegetables (list below) they are seen in all the ‘good lists’ for calcium and other vitamins
·        Increase your intake of chickpeas, kidney beans, lentils, soya beans and tofu
·        Note that many products use soya extract, this is not the same as actual soya beans.
·        Include cider vinegar in your diet
·        Include a range of fruit and vegetables
·        Include seeds such as pumpkin, flax and sunflower
·        Include nuts, especially almond, hazelnuts and brazils

My key lifestyle points:
·        Vitamin D from sunlight is essential so spend time outside all year round
·        Walking is great exercise and gets you out in the sunlight
·        Stick to exercise where your weight is on your feet, walking is ideal
·        Work on your balance, it deteriorates with age and a fall can start a downward spiral in your activity level
·        Reduce your stress levels, try mindfulness, relaxation and regular exercise
·        Choose exercise with a social element as it will be easier to maintain


This blog will be added to as I continue my research and any comments are welcome.
This article was first published on the blog 'how to feel good'
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