Harry Gough

Main points:

  • Osteoporosis is a condition where bones become less dense, fragile, and weaker
  • Around 1 in 5 women and 1 in 10 men have osteoporosis 
  • Recommended calcium and vitamin D intake may help to reduce the risk of osteoporosis
  • Aerobic exercise such as walking is unlikely to improve bone density
  • Resistance training and power training is a safe and effective way to improve bone density, combat age related muscle mass loss and reduce the risk of falls
  • Speak to a doctor/physiotherapist before starting a new exercise programme, this is especially important if you have pre-existing conditions

Osteoporosis is a condition characterised by bones becoming less dense which leads them to become weak and fragile. Osteoporosis has been regularly referred to as “brittle bone disease”, although I do not like this term as it could induce anxiety about using one’s bones (which is the best treatment for this issue). Osteoporosis is incredibly common with current estimates that around one in 5 women has the condition and 1 in 10 men have the condition. Where you live seems to matter to a great degree with one study finding a prevalence of 40% of women in Africa have the condition. Post-menopausal women are most at risk of osteoporosis.

 A silent killer
Osteoporosis tends to go hand in hand with another condition called “sarcopenia”. “Sarco” means muscle and “penia” means deficient, so sarcopenia is age related muscle loss. This is thought to occur due to many reasons but a main driver in this is inactivity with elderly people exercising less than young counterparts. Sarcopenia greatly increases the risk of falls. Fortunately (or I guess unfortunately in this case) osteoporosis has no symptoms and it regularly goes undiagnosed until someone has a fracture. Having a fall and having osteoporosis leads to a MUCH higher risk of hip fracture. Even with improvements in surgical treatment for this issue the risk of death following hip fracture is 25% (within a year). 

A lifestyle problem?
Thankfully osteoporosis awareness is generally increasing but unfortunately the condition remains likely, and the prevalence actually seems to be increasing. Although awareness is increasing, I do worry that the general understanding of how to treat and prevent this issue tends to be only dietary. It is recommended to get your recommended daily amount of both calcium and vitamin D to help reduce the risk of osteoporosis. Muscle strength and mass seem to be an independent risk factor for osteoporosis. The great thing about increased strength as well is that it greatly decreases the risk of falls and it directly combats sarcopenia, whilst also generally being a good predictor of mortality. 

Exercise does seem to be a very effective treatment for osteoporosis, however, not all exercise is created equally. Aerobic exercise such as walking and swimming is beneficial for several different reasons (heart health etc) but seems to do, well, not much for osteoporosis. Walking is not enough to prevent osteoporosis. Resistance training and power training seem to give the best results. Movements that involve multiple joints and more weight/loading are theorised to give the largest benefits. For example, one study found large improvements in fracture risks by training men and women to above 80% of their maximum lift in the squat and deadlift movement. This study also gave participants high impact exercises such as jumping and hopping which were also effective. It should be noted that these exercises were very safely performed in men and women with very low bone density, no adverse effects recorded in this 8-month study.  Another great thing about resistance training is that it is incredibly time efficient and great results can be gained from just 2 sessions per week at 30 minutes a time. 

 A personal story
Last year my mum fell off her horse and injured her leg badly. Her rehab was to perform resistance training exercises to the affected area. It turned out that she was rather good at that, so good in-fact that we entered a powerlifting competition. She ended up winning and setting several records in her age and weight class. Recently she has been crowned the British Drug Free Powerlifting Association champion. She currently can lift 135kg off the floor at age 64 and 57kg bodyweight which is a British record in any powerlifting federation. Lifting weights/resistance training has real undeserved stigma associated with it, but I can absolutely assure you, it is very safe and very healthy.