Most people don’t know they have the condition until it’s too late and suffer a fracture. While genetics play a role, Danica Yau, Medical Affairs Specialist at Wyeth Nutrition Hong Kong, tells us there are things we can do to prevent the painful outcome and how important it is to keep our bones healthy and strong – no matter how old we are
By Christina Choi
biz.hk: How big of a problem is bone health, particularly in the Asian population?
Yau: Asia will have 57 percent of the world’s population over 65 years old by 2025. With the expected population ageing also comes the concern of osteoporosis, a chronic disease that is often associated with the elderly. As defined by the World Health Organization (WHO), osteoporosis is a systemic skeletal disease characterized by low bone mineral density and an increased risk of bone fracture. Over the past 30 years, there has been a two- to threefold increase in hip fractures across many Asian countries.
In Hong Kong, bone health has actually improved during the last decade, with an increase in bone mineral density and decrease in age-adjusted fractures. However, the risk of osteoporosis is still highly prevalent. A recent study found Hong Kong women had a higher overall prevalence of osteoporosis (24.9 percent) than that in Beijing women (20.3 percent), according to the National Institutes of Health.
biz.hk: Why is bone health important?
Yau: Optimal bone health is important in reducing the risk of osteoporosis and any associated bone fractures. The most common fractures are those of the spine, hip and wrist. Apart from pain, fractures may also be associated with increased risk of deformity, reduced independence, further fractures and increased mortality, where a five-week hospital stay is needed on average.
biz.hk: What are the major risk factors for bone health?
Yau: Osteoporosis can affect many people of both genders and all ethnicities, and its prevalence will increase with age. However, some risk factors for reduced bone health include:
- Over 50 years old
- Postmenopausal women
- Family history of osteoporosis
- History of broken bones or loss in height
- Low in body weight
- Insufficient intake of calcium and vitamin D
- Inadequate amount of fruits and vegetables in daily diet
- Excessive consumption of protein, sodium, caffeine and alcohol
- Inactive lifestyle
biz.hk: When should people start paying more attention to bone health?
Yau: Bone health is important throughout different life stages. During childhood and adolescence, bone mass increases as the skeleton grows in both size and density. About 90 percent of peak bone mass is acquired by the age of 18 in girls and 20 in boys. It’s suggested that the higher the peak bone mass accumulated at a young age, the more an individual can afford to lose later in life without getting a fracture.
Peak bone mass in adults is normally reached at around the age of 30, and although bone mass cannot be increased after, it is still important to slow the rate of bone loss and prevent osteoporosis by maintaining positive lifestyle habits.
Yau: Although up to 80 percent of bone mineral density would be genetically determined, several lifestyle factors such as avoiding smoking, limiting drinking of alcohol and caffeine, taking calcium-supplemented drinks if needed, regular physical activity and exposure to sunlight as well as consuming a healthy balanced diet can help to improve bone health.
Calcium and vitamin D are the two essential nutrients well-known for their positive effects on bone health. Current evidence suggests a balanced diet should be emphasized instead of individual nutrients in the prevention of osteoporosis. In addition to foods that provide calcium and vitamin D, generally a diet rich in fish oil, fruit, vegetable and herbs will contribute to optimal bone health.
biz.hk: Let’s talk about some common myths surrounding bone health. Is bone broth a good source of calcium?
Yau: This is false. Calcium in pork and fish bones can’t dissolve in water, so the calcium content in bone broth is low.
biz.hk: The more calcium I consume means I will have more health benefits?
Yau: This is not necessarily true. There are no additional benefits to taking more calcium than your body needs. In fact, it may impose certain adverse effects such as constipation, kidney stones and interference of iron absorption. Calcium supplement pills should only be considered when you’re not able to obtain adequate calcium through your daily diet.
biz.hk: Is joint pain a sign of osteoporosis?
Yau: This is also false. Osteoporosis is a silent disease in most people which is often not realized until a bone fracture occurs. However, one visible sign may be the gradual formation of a hunchback due to deformity in the spine resulting from reduced bone mineral density.
biz.hk: Do you have any suggestions to workers who spend most of their time in the office sitting?
Yau: Small changes to your routine will help to optimize bone health. Choosing reduced fat milk, fortified soy milk with less sugar, or a calcium supplemented drink instead of coffee; walking outside to get lunch and some sunlight instead of ordering delivery; adding a portion of vegetables to your lunch; taking the stairs and walking that extra distance – all these things will make a difference.
Danica Yau graduated from the University of Sydney with a Bachelor of Science (Honors) in Nutrition. She is an Accredited Practicing Dietitian and Nutritionist (Dietitians Association of Australia) and Accredited Dietitian (Hong Kong Dietitians Association) with interest in pediatric nutrition, obesity, diabetes and bone health.