Muscle Strength and Bone Health

Osteoporosis is a metabolic disease of bone which leads to a reduction in bone density. The affected bones become thinner, and are more likely to break (fractures) which may result in pain and other complications, including loss of independence.

What are the symptoms and signs of osteoporosis?

Osteoporosis produces no symptoms on its own. If osteoporosis-related fracture occurs, there may be localized pain over the fracture sites. Common sites of osteoporotic fracture include thigh bone near the hip joint, spine (vertebrae) and forearm near the wrist. While hip fracture may occur after minor fall, spine can fracture without any trauma. Vertebral fracture can result in a hunched-back and a decrease in body height, and sometimes back pain.

Who are at higher risk?

1. Female: Osteoporosis is more common in women than in men, particularly in postmenopausal women due to estrogen deficiency.
2. Persons of small frame.
3. Having a family history.
4. Unhealthy lifestyle, for example
   • Smoking
   • Inadequate calcium intake
   • Inadequate vitamin D intake
   • Excessive caffeine intake
   • Consuming too much salty food
   • Doing little or no weight-bearing exercise
   • Excessive alcohol consumption
5. Diseases, such as
   • Estrogen deficiency, e.g. early menopause as a result of ovarian failure after chemotherapy, radiotherapy or surgical removal of ovaries
   • Testosterone deficiency
   • Endocrine diseases such as hyperthyroidism
6. Medications such as long term use of high dose steroid

How do I know if I am suffering from osteoporosis?

Those who are at risk may consult doctor for a test. The followings are common methods
of measuring bone density.

• Dual Energy X-ray Absorptiometry (DEXA)—for diagnosis and monitoring of treatment effect.
• Quantitative Ultrasound (QUS)—for screening purpose, not suitable for diagnosis.

Is osteoporosis preventable?

Adequate calcium and vitamin D intake, together with weight-bearing exercise are essential for normal bone growth. As it is necessary to build strong and healthy bones starting at an early age, everyone should maintain balanced diet and perform regular exercise over a lifetime to avoid osteoporosis later in life.

1. Balanced diet.
   • Eat calcium-rich foods, for example
   • Dairy products such as milk, yogurt, and cheese (low-fat milk and skimmed milk contain less saturated fat and are healthier choices)
   • Seafood eaten with bones or shells, such as whitebait, dried silver fish and dried shrimps
   • Soya bean products such as tofu, fortified soy milk, soy chicken, beancurd stick and beancurd sheet
   • Dark green leafy vegetables, e.g. white cabbage, broccoli and Chinese flowering cabbage
   • Nuts, e.g. almond and sesame
2. Ensure adequate vitamin D intake, such as egg yolk and fortified milk
3. Avoid salty food, such as salted fish and soy sauce which affects calcium absorption

2. Don’t smoke and don’t drink too much. Reduce drinks that contain caffeine such as coffee and tea.

3. Perform weight-bearing exercises, e.g. brisk walking, Tai Chi or gymnastic exercises, at least 3 times a week and for 30-60 minutes each time.

4. Perform outdoor activities to absorb sunlight which will help the body to produce more vitamin D in order to enhance the absorption of calcium. Beware of sunburn.

 

What can I do if I am suffering from osteoporosis?

The above lifestyle tips are also useful to slow down further bone loss in persons diagnosed with osteoporosis. Depending on individual conditions, doctors will prescribe medications for osteoporosis, such as bisphosphate, SERM, calcitonin, teriparatide, strontium ranleate and vitamin D and calcium supplement.

Fall prevention is of paramount importance in preventing fractures and other complications, especially for those who have osteoporosis. Everyone should pay attention to home safety and road safety, wear non-skid footwear, avoid medicines which cause dizziness and wear appropriate corrective eyeglasses.

Concluding remarks

Bone metabolism is a continuing process and bone loss starts as early as 35-years-old. Hence everyone should take steps to prevent osteoporosis.

 

How do I know if I am doing enough physical activity to stay healthy?

Scientists say as little as 30 minutes of accumulated moderate-intensity physical activity on most, preferably all, days of the week can provide a health benefit. Remember, every little bit counts, but more is even better if you want to achieve health benefits. Refer to Activity Chart.

For 30 minutes a day, they can be done in two 15-minute sessions or three 10-minute sessions; for 60 minutes, you can add up your activities in periods of at least 10 minutes each throughout the day to get that daily total.

Becoming more active is safe for most people. Answer the “Are you fit to get fit” questionnaire to make sure you are fit to do so. If you are in doubt, seek medical advice before starting.

 

What do the experts say I have to do?

To get the most health benefits, you need to try to do a variety of activities including: endurance activities, flexibility activities, and strength activities.

Take a look of the following examples and see which activities appeal to you. Choosing things you like to do is one of the best ways to build regular physical activity into your life.

Endurance activities	Flexibility activities	Strength activities
Help your heart, lungs and circulatory system stay healthy and give you more energy.	Help you to move easily, keeping your muscles relaxed and your joints mobile.	Help your muscles and bones stay strong, improve your posture and help to prevent diseases like osteoporosis.
Examples Walking Golfing Cycling Continuous   swimming Tennis Skating Dancing	Examples Tai Chi Yoga Bowling Mopping the floor Vacuuming	Examples Carrying groceries Climbing stairs Push-ups Abdominal curls Weight-training   routines

 

To avoid injuries during exercise, you should be prepared beforehand:

• Know the proper procedure and the potential risks of your choice of exercise.
• Do prior warm-up exercise such as muscle stretching.
• Examine the equipment and nearby area to see if they are suitable for exercise.
• Follow instructions from your coach.
• Wear appropriate protective gears such as knee pads and helmet.
• Drink adequate amount of water.
• Take a rest when you feel tired. If there is any discomfort, stop exercising at once. Seek professional advice when necessary.
• Do warm down exercise afterwards.

 

Source: Department of Health- Elderly Health Service