Why NOW is the time to think about your bones
Like getting into gardening or buying one of those giant slippers for both feet, osteoporosis might be something that you don’t think you need to worry about until you’re much older. And it’s true that, for most people, the bone-weakening condition is unlikely to reach a stage where you actually break a bone until you’re around retirement age. But, from our 30s onwards, all of us are starting to lose bone density.
And the sooner you do something about it, the better. Because, although around three million people in the UK have osteoporosis, very few of them actually know they have it until they break a bone. So there is this army of fragile-boned women, walking around narrowly avoiding fracturing their spine every single day. And there are more women, because our risk is greater thanks to hormonal changes after menopause. Half of all women over 50 (compared with 1 in 5 men) will break a bone because of osteoporosis.
If you follow me on Instagram then you might have seen that I was recently diagnosed with osteoporosis in the base of my spine. At 42, I’m young to have it, but it’s common in women who have had breast cancer. The most obvious reason is that, when chemo stopped my periods, my oestrogen levels dropped off a cliff.
‘Oestrogen plays a key role in bone metabolism,’ explains Abby Armstrong, senior physiotherapist at Nuffield Health. ‘Our body is constantly repairing bones by breaking down the old bit and building up the new bit, and that's regulated by hormones. If chemo has affected the ovaries, that can mean there's more bone breakdown than build up.’ Then there are other elements of cancer treatment that are bad for your bones, such as the steroids and radiotherapy, which Abby describes as ‘a triple whammy’.
But I’m trying not to feel too sorry for myself about this because, on the bright side, I’m glad the importance of bone health has been brought to my attention. It’s not something I ever used to think about, but it turns out there is a lot that can be done to protect your internal scaffolding.
Here are Abby’s top tips for bone health:
Time to invest in that standing desk
‘Weight-bearing exercise is vital, because the bone responds to physical stress. Doing anything standing up is going to physically stress the bones. Even better if you add lifting weights or doing impact work like running, hopping, skipping or jumping.’Really push yourself
‘Strengthening the muscles targets the attachment points and stimulates density that way, too. But it has to be physically tiring. You're only really building muscle if you’re getting fatigued. So if you do ten squats with weights, but you feel like you could do hundreds more, then you need a heavier weight. Three sets of ten is a is a good rule of thumb.’Stand on one leg more often
‘Balance is really important because, obviously, the better your balance, the less chance there is of falling and having a fracture. This might take the form of something like Tai Chi, yoga or Pilates.’Get enough calcium
‘Cow's milk is the best source of calcium so, if you’re dairy intolerant, make sure you’re eating things like sesame seeds, broccoli, and green leafy vegetables. Although not spinach because that's got oxalate in it, which means the calcium isn't released into your bones. Spinach is great in lots of ways, but not for calcium.’And don’t forget vitamin D
‘You can't build the bone with calcium, unless you've got the vitamin D as well, they work together. In Australia, they've actually got an osteoporosis epidemic because people are so covered in sunscreen all the time, they’re not absorbing enough vitamin D. In the summer, you should be able to get enough from having the sun on your face but, in the winter, you’ll need a supplement.’
My oncologist told me to cut out caffeine and alcohol as they’re bad for your bones. While I don’t drink much alcohol anyway, I shuddered at the thought of losing my daily caffeine. The good news, says Abby, is that you don’t have to cut it out entirely; just don’t have too much, and don’t have it with your calcium supplement.
‘It can inhibit absorption of calcium,’ she says, adding, ‘but if you love it, then it’s good for the soul.’ As for alcohol: ‘Any more than three units becomes an issue, because of liver metabolism and its role in bone building’.
So with some simple tweaks, building stronger bones is totally doable. This might not have been high on your list of wellness concerns but, when you’re taking care of your body, mind and skin, don’t forget to show some love to the bones of you, too.
This week I’m…
Taking inspiration from The Light We Carry: Overcoming In Uncertain Times by Michelle Obama
Starting to feel Christmassy with Scrooge: A Christmas Carol on Netflix and Spirited on Apple TV+
Enjoying Helen Whitaker’s latest romantic dramedy novel, Single in the Snow, out on Kindle this week and in paperback from 29 December
Finally wearing tights. I try and hold off for as long as possible every year, but it’s cold and I’ve given in. These are the best I’ve found.