Risk Factors for Osteoporosis

Bed rest
Bed rest leads to rapid loss of bone so it is best kept to a minimum if possible. If it is necessary to stay in bed for extended periods of time, physiotherapy and simple exercises will help reduce bone loss.

Caffeine intake
Drinking copious cups of coffee or strong tea during the day has been linked to osteoporosis. It is difficult to state a maximum level of intake, although a ceiling of two to four cups a day is generally recom­mended. Beware of caffeine in other products, partic­ularly canned colas and some health drinks.

Diet lacking in calcium

Adequate amounts of calcium in the diet are essential to maintain bone strength. Women over the age of 40 need about 1,500 milligrams per day if they are not taking HRT. Women taking HRT have a lower requirement of 1,000 milligrams per day as the oestrogen itself helps strengthen bone. After the age of 60, daily requirements fall to 1,200 milligrams.

History of amenorrhoea
Amenorrhoea, when menstrual periods cease, is associated with insufficient oestrogen to maintain the normal menstrual cycle, leading to oestrogen deficiency. In primary amenorrhoea, the first menstrual period occurs several years later than the usual age of 13 but subsequent menstruation is normal. In other cases, secondary amenorrhoea, menstruation starts at the normal age, but then the periods stop. Anorexia nervosa, an increasingly common cause, leads to a marked loss of weight and altered body image.

Young gymnasts are also at risk from over-exercising. More recently, treatments for conditions such as endometriosis (when the womb lining is found in tissues outside the womb) stimulate a ‘medical menopause’ by switching off the ovarian production of oestrogen with a consequent drop in oestrogen levels. All these factors can increase the individual woman’s lifetime risks of oestrogen deficiency illnesses.

Hyperthyroid disease
An overactive thyroid increases the resting metabolic rate, speeding up the normal process of bone formation and breakdown which can lead to osteoporosis. Hyperthyroidism also puts an extra burden on the heart, which beats faster and more forcefully.

Sunlight
Elderly women often stay indoors and get little sunlight on their skin. In certain cultures women are heavily covered in dark clothing and, particularly if they live in Europe, minimal daylight reaches their skin. Sunlight is very important because it stimulates the production of vitamin D in your skin. This vitamin aids the absorption of calcium from food, helping bones to stay strong. Only 15 to 30 minutes in daylight each day is necessary.

Pregnancy
The more times you have been pregnant, the lower your risk of osteo­porosis, because each pregnancy produces a surge in oestrogen. Women who have never been pregnant will not have had this oestrogen surge and their lifetime exposure to oestrogen will be lower, increasing long-term risks of osteoporosis.

Previous fracture(s)
Previous fractures can suggest existing osteoporosis, increasing your chances of further broken bones.

Racial origin
Women of black racial origin achieve a 10 per cent greater peak bone mass than white women, so white racial groups are more likely to develop osteoporosis.

Use of steroids
Prolonged use of oral steroids, over 5 milligrams each day, is linked to osteoporosis. Steroids are usually prescribed for conditions such as severe asthma or autoimmune diseases. In these conditions the body’s protective mechanisms are disrupted and normal tissue is seen as a foreign body which should be destroyed. Short-term courses of steroids, for one or two weeks, are not associated with increased risks unless frequently required.

If you are on long-term steroid therapy, speak to your doctor to discuss possible alternatives and ways in which you can prevent osteoporosis developing.

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Benefits of the Menopause Dietstyle

When you incorporate the Menopause Dietstyle into your life, your entire being benefits. It is not a quick weight-loss diet. It is a wonderful beginning with no end in sight. It makes allowances for mistakes and transgressions, and it enables you to celebrate with a gourmet meal on occasion knowing that you can face yourself, your family, your friends, and your scale without having to face the music tomorrow!

Studies are just beginning to show that better nutrition, increased weight-bearing exercise, and HRT that is appropriate for you may work to arrest the decline in bone mass that puts women at risk of osteoporosis in midlife and later. Such studies also show the benefits of supplemental calcium in the diet. Earlier we believed that bone loss was permanent, but new studies point toward a more hopeful path for women with osteoporosis. Thus, as women grow older, the balance between the various food groups—carbohydrates, proteins, and fats— the types of calories eaten, and the nature and amount of exercise to offset calorie intake become increasingly important. Calories are en­ergy, and regular exercise doesn’t just burn more calories when you are doing it; it also gears your body to burn more calories for hours afterward.

Appropriate nutrition is a natural pathway toward healthy bone. Bone requires a healthy foundation of protein, in which minerals— especially calcium—are deposited. Successful bone-building requires a diet of well-balanced foods containing adequate calcium.

If you are premenopausal, you need at least 1,000 milligrams of calcium per day. After menopause, your need rises to 1,400 milli­grams daily. The average woman in the United States between the ages of forty-five and sixty-five receives far too little calcium: between 460 and 650 milligrams per day. You need to double that amount.

Research is underway to study whether increasing calcium intake during the formative adolescent and young adult years will increase the amount of bone in the later reproductive years. The facts are not in, but it appears that there are no disadvantages to trying that ap­proach.

There have been no studies that prove that a decrease in osteoporo­sis-related bone fractures can result from dietary changes alone. Nor. can calcium supplements alone reduce the incidence of fractures. Mak­ing new bone requires the presence of estrogen in your system. This process is enhanced by adequate weight-bearing exercise and a good diet that provides the right amount of calcium. Diet and exercise alone will not prevent bone loss!

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Facts about Food and Lifestyles

Eating is social; it’s pleasurable; it’s soothing. All cultures use food to celebrate the special occasions of life. Food, in our society, is less synonymous with our body’s survival than it is with the concepts of celebration and reward.

At midlife, you should be seeking a balanced life and beginning a lifestyle that will enhance and ensure your good health. You are looking forward to living longer and living better. Therefore, it becomes necessary to create a balance between overindulgence in food and quasistarvation, and to create within this balance room for the celebrations of life. It is time to replace both the Rubenesque image of the too well-rounded female of the seventeenth century and Tom Wolfe’s image of the “social x-rays” of the late twentieth cen­tury. In order to foster long-term health, a dietstyle has to be practical and useful.

The Menopause Dietstyle means the end of yo-yo dieting, in which you can’t win for losing. With each upswing of the diet yo-yo your body becomes comprised of more fat and less muscle. It is a metabolic fact, proven time and time again. Here’s how your metabo­lism sabotages you. Let’s say you go on a strict diet and you lose twenty pounds quickly. Of the twenty pounds you’ve lost, fifteen pounds were fat and five were muscle. Once off the highly restrictive diet, you regain the weight, faster than the last time because your body has slowed down its metabolism in order to make the most of the very few calories you have been allowing it. It cannot handle the sudden in­crease in postdiet calories. Now that twenty pounds regained is com­prised of about eighteen pounds of fat and two pounds of muscle. Each time you yo-yo you become fatter. It’s a no-win, or perhaps we should say, a no-lose weight situation.

To make matters worse, medical research has demonstrated that as a woman ages, her percentage of body fat goes up and the percentage of lean body mass or muscle tends to go down. Women often decline in size following menopause. It is lean body mass or muscle mass that is shrinking. As much as 10 percent to 20 percent can be lost through the aging process alone. This percentage increases substantially for the longtime yo-yo dieter. Statistics show that a decrease in size plus a decrease in exercise requires a substantial decrease in the number of calories you eat as you get older, if you want to keep from gaining weight. You must exercise to keep and build lean muscle mass and to fight the body’s natural desire to store fat.

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