Health
Osteoporosis is a condition that results in loss of bone mass and weakening of the bones, increasing the risk of fractures, such as a broken hip, crushed vertebra (spine), or fractured wrist. Osteoporosis-related fractures are often called fragility fractures because they happen with little or no trauma.
More than 1.4 million Canadians suffer from osteoporosis. Although the onset of osteoporosis can begin at any age, it is more common in older adults. The Osteoporosis Society of Canada reports that one in four women over the age of 50, and one in eight men in the same age group have osteoporosis. There are three stages of bone loss:
Like every other part of the body, bone cells go through the cycle of removal and replacement by new bone cells. Adults reach their peak bone mass by the late teens or early 20s, but by the mid-30s the cells that build bones are less efficient and bone mass is gradually lost. Bone loss that is greater than the normal rate can lead to osteoporosis. Some people have a greater risk of developing osteoporosis than others. For example, women are at greater risk after menopause, because their estrogen levels fall significantly and the rate of bone loss is accelerated. Risk factors include:
Other more serious medical conditions are considered major risk factors for developing osteoporosis. These factors include, among others:
Talk to a health care professional if you have questions about your level of risk for developing osteoporosis.
You can decrease your risk of developing osteoporosis by choosing life habits that help to build and maintain healthy strong bones. A well-balanced diet with sufficient calcium and intake, along with regular physical activity during childhood play important roles in developing and maintaining good bone health.
If you are at risk of developing, or have been diagnosed with osteoporosis, the Osteoporosis Society of Canada recommends a dietary intake of 1500 mg/day of calcium and 800 IU/day of vitamin D. In addition, to optimize bone health, they recommend exercising 30 minutes or more at least three times a week. Here are some ideas for enjoyable ways to get the required amount of exercise:
Physiotherapists can help reduce the risk of developing osteoporosis. They can also help you manage problems related to osteoporosis including problems with balance and fractures.
Once you have been diagnosed, appropriate exercise can help improve bone mass or slow down the rate of loss of bone mass. A well-designed exercise program will help maintain optimal function and help work towards optimal bone health. Weight bearing aerobic training, and / or strength training contribute to bone health as the mechanical stresses put through the bone during exercise can affect bone density and stimulate bone remodeling. Exercise has also been shown to slow down some of the functional losses that are often associated with aging.
Research has shown that exercise can help you maintain optimal function as you age. For example:
Osteoporosis is still very common. The 2023 Osteoporosis Canada guideline notes that more than 2 million people in Canada live with osteoporosis and that about 150 in every 100,000 people break a hip each year. Falls are a leading cause of fractures in older adults (Morin et al., 2023).
The guideline found high-certainty evidence that balance and functional training reduces both the number of falls and the number of people who fall. Resistance (strength) training improves quality of life, physical function, and bone mineral density, and when it is combined with balance training it also reduces falls (Morin et al., 2023).
A Cochrane review of 108 trials with more than 23,000 older adults living in the community found the same pattern. Exercise lowered the rate of falls by 23%, balance and functional exercise lowered it by 24%, and programs that combined several types of exercise, usually balance plus strength training, lowered it by 34% (Sherrington et al., 2019).
Advice on calcium, vitamin D, and medication is updated as new research comes out, so check the current recommendations with your doctor or pharmacist.
Related reading: how to prevent seniors from falling and postural kyphosis (rounded shoulders).
Exercise is only one part of a healthy lifestyle for optimal bone health. For complete information about the prevention and management of osteoporosis, contact the Osteoporosis Society of Canada either through their web site www.osteoporosis.ca or by mail or phone:
Osteoporosis Society of Canada
33 Laird Drive
Toronto, ON M4G 3S9
Telephone: 416-696-2663
Toll-free (English) 1 800-463-6842 (in Canada only)
Toll-free (French) 1 800-977-1778 (in Canada only)
Morin, S. N., Feldman, S., Funnell, L., Giangregorio, L., Kim, S., McDonald-Blumer, H., Santesso, N., Ward, W., & Osteoporosis Canada 2023 Guideline Update Group. (2023). Clinical practice guideline for management of osteoporosis and fracture prevention in Canada: 2023 update. CMAJ, 195(39), E1333-E1348. https://doi.org/10.1503/cmaj.221647
Sherrington, C., Fairhall, N. J., Wallbank, G. K., Tiedemann, A., Michaleff, Z. A., Howard, K., Clemson, L., Hopewell, S., & Lamb, S. E. (2019). Exercise for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, (1), CD012424. https://doi.org/10.1002/14651858.CD012424.pub2
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