Healthy Bones

 

Osteoporosis is a condition in which calcium is lost from bones causing them to become thin and brittle and liable to break easily.  In severe cases, fractures occur following only slight knocks or normal activities of daily living such as lifting or bending.  The onset of osteoporosis may be delayed by reducing or eliminating factors which enhance its development.

 

Calcium—building up the bone bank

Calcium regulates many of the chemical reactions and plays an important role in many body processes such as:

· Contraction and relaxation of muscles

· Transmission of nerve impulses

· Clotting of blood.

All of these functions are vital for our bodies to function properly.  We gain and lose calcium from our bones everyday.  If we fail to consume more calcium than we lose each day we are in a state of negative balance.  This deficit causes the amount of calcium in the circulation to drop and so the body immediately draws on its stores of calcium—the bones.  If this process continues, the condition of osteoporosis can develop.

Due to the risk of osteoporosis, it is very important for each individual to maintaining a ‘positive calcium balance’ our bones each day. This is achieved by ensuring an adequate daily calcium intake and by reducing other risk factors that leech calcium from our bones.

Peak bone mass

There are two major factors which determine the potential for osteoporosis.

Peak Bone Mass:

Our bones reach their peak strength and maximum calcium store by about 18–20 years.  This is called Peak Bone Mass.  The more bone you have at Peak Bone Mass, the greater the deposits of calcium you have to call on later in life.

The Rate of Bone Loss:

At about 35 years, the bones slowly start to lose calcium.  Men and women may lose up to 1% of bone every year .  For women the rate of bone loss increases dramatically as natural oestrogen levels fall, as occurs during menopause and menstrual irregularities.  This is when special attention must be paid to osteoporosis risk.

Calcium needs

The National Health and Medical Research Council recommends the following daily intake of calcium:

Are you at risk of developing osteoporosis?

The longer you live, the more likely you are to develop osteoporosis. 

· Osteoporosis occurs most frequently in postmenopausal women of Caucasian or Asian race, and in the elderly.

· It is estimated that one in two females and one in three males  over 60 years will develop osteoporosis.

How do I prevent osteoporosis?

There are a number of things you can do now to maintain or increase strength of bones and help protect yourself against osteoporosis.  These habits should start in childhood and continue throughout life.  

Maintain adequate daily calcium intake

Milk, cheese, yogurt, some soy milks, tinned salmon with bones are valuable sources of calcium to have daily.

Reduce alcohol consumption Maintain adequate daily calcium intake

· Limit yourself to 2 or less standard drinks per day and have at least 2 or 3 alcohol free days per week.  Alcohol in excess can decrease the absorption of calcium from the intestine.

 Keep up regular aerobic exercise (especially weight bearing)

· e.g. walking, jogging, tennis, dancing or lawn-bowls.  Weight bearing exercise creates a positive stress on bones, helps to increase peak bone mass in younger people and to maintain or increase bone in older adults.  Swimming is not a weight-bearing exercise, but will be of some benefit because of the pull of muscle on bone.

Limit your intake of caffeine to 4 or less cups of tea/coffee/cola per day

· Because calcium is lost from the body continuously through the skin and normal body excretions, a high caffeine diet can act as a diuretic increasing the amount of urine (and therefore calcium) lost.  Taking milk in high caffeine drinks may give some protection.

Don't smoke

· Smoking is a bone robber: it lowers oestrogen levels and, as a result, less calcium is deposited and more is withdrawn.

Limit your salt intake

· A high intake of salt causes calcium loss.  Moderate amounts do not appear to be a major osteoporosis risk factor.

If you are a woman, ask your GP about:

· Hormone Replacement Therapy (HRT) after menopause.

· Bone density measurement around the time of menopause.  This may help you if you are having difficulty in deciding whether or not HRT is appropriate.

· Effective therapy other than HRT is available.

Disclaimer

This Fact Sheet is provided for your information only and does not replace qualified medical advice. The
information provided may not apply to every person or all situations. A medical practitioner should be consulted for all treatment and medication.

For more information

Wesley Corporate Health

Level 2 / 46 Edward Street

Brisbane  Qld  4000

Phone:  07 3234 2600

Cancer Screening

Cancer & Australian Statistics

Cancer is a leading form of death in Australia with an estimated 39 000 deaths per annum.  1 in 2 men,  and 1 in 3 women will be diagnosed with cancer before the age of 85.  However the survival rate for many common cancers has increased by more than 30% in the past two decades.  Today the most common cancers in Australia (excluding non-melanoma skin cancer) are prostate, colorectal (bowel), breast, melanoma, and lung cancer.

Colorectal Cancer

More than 14 000 Australians are diagnosed with colorectal cancer each year.  1 in 10 men, and 1 in 14 women will be diagnosed by the age of 85.  More than 4 372 deaths annually are attributed to colorectal cancer. 

Causes and Prevention

· Genetics, age, inflammatory bowel disease, obesity and smoking are all known risk factors.

· The best prevention is to quit smoking, maintain a healthy body weight, and eat a healthy diet including plenty of fresh fruit and vegetables.

Symptoms

· Changes in bowel habits i.e. diarrhea, constipation or feeling of incomplete emptying.

· Thin bowel movements.

· Bloating, cramping, or blood in the motions.

Screening

· Can be screened by a FOBT (faecal occult blood test).

· Abnormal tests are followed up with a colonoscopy.

Lung Cancer

9 700 new cases of lung cancer are diagnosed each year.  Lung cancer accounts for 9% of all diagnosed cancers, and 18% of deaths attributed to cancer.

Causes and Prevention

· Smoking is a the largest cause of lung cancer.  Risk is also increased with exposure to asbestos, radon, hydrocarbons and metals.

· The greatest preventative measure is to not smoke.

Symptoms

· Wheezing, shortness of breath, coughing producing blood in sputum, chest pain.

Screening

· No routine screening test.

· Abnormal tests are followed up with a colonoscopy.

Melanoma

Melanoma presents as 9.5% of all cancers, with nearly 10 300 new cases diagnosed each year.  More than 1 430 deaths annually are the result of melanoma cancer. 

Causes and Prevention

· Risk is increased with exposure to UV, particularly with episodes of sunburn.  Additional risk exists for people with fair skin, a family history, those with previous melanoma, a dysplastic naevi (a mole of  unusual appearance), or depressed immune system.

· Prevention entails avoiding sunburn, UV exposure particularly between 10am and 3pm, and when the UV alert is above 3.  Avoid tanning salons.

Symptoms

· Usually asymptomatic, but a skin lesion that is asymmetrical, has uneven boarders, is changing, has a diameter > 6mm, or is evolving, may be associated with melanoma.

Screening

· Self-examination of the skin surface for skin lesions that are irregular and changing.

· Annual checks by a dermatologist especially people with dysplastic naevi.

Breast Cancer

Approximately 12 700 new cases of breast cancer are diagnosed each year in Australia. In 2007 there were 2 680 deaths in Australian women  and 26 Australian men due to breast cancer.

Causes and Prevention

· Genetics and age are known risk factors, excess alcohol consumption, as well as exposure to female hormones (natural and administered), obesity and exposure to past radiation.

· No specific method of prevention.  High risk women may benefit from certain hormones i.e. tamoxifen.

Symptoms

· New lumps or thickening of breasts under arms, rash or red swollen breasts, nipple sores, skin of breast dimpling or discharge, pain is rare.

Screening

· Mammographic screening every two years is recommended to women from the age of 40.

· MRI or ultrasound is used for high risk younger women.

Ovarian Cancer

More than 1 200 new cases are diagnosed each year.

Causes and Prevention

· Age and genetics, as well as no oral contraception, first child after 30 or childlessness or infertility, early menarche (before 12 years) or late menopause.

· No proven prevention.

Symptoms

· Cramps and bloating, persistent abdominal pain, tiredness, painful intercourse, pelvic or back pain.

Screening

· No proven screening methods.

Cervical Cancer

175 new cases are diagnosed in Queensland each year.

Cause and Prevention

· 80% caused by Human Papilloma Virus.  Women who have had several pregnancies or several sexual partners are at higher risk.

· Prevention for young women is through a new vaccine.  For all other women, early detection is the key.

Symptoms

· Asymptomatic in early stage therefore regular pap smear.

· Late stage cancer can be accompanied by irregular bleeding between periods, unusually heavy bleeding after intercourse, unexpected bleeding, or prolonged bleeding.

Screening

· Women who have ever been sexually active should have a Pap smear every 2 years (even if no longer sexually active).

Prostate Cancer

More than 19 400 new cases each year, accounting for 30% of all male cancers. In 2007 there were  2 938 deaths reported in Australian men resulting from prostate cancer.

Causes and Prevention

· Age (particularly 50+), and genetics, as well as diets high in fat and low in fresh fruit.  There is also an association with high testosterone levels.

· No proven prevention.

Symptoms

· Can include: frequent urination, pain while urinating, blood in the urine, a weak stream of urine or unexplained weight loss.

Screening

· PSA blood test (prostate specific antigen) can detect cancer early, however it doesn’t detect all prostate cancers and elevated PSA  levels are not always indicative of cancer.

· DRE (digital rectal examination), performed by a GP.

Testicular Cancer

More than 700 new cases each year.  More than half of these are under the age of 35.

Causes and Prevention

· Causes and predisposition include genetics, personal history of undescended testicles, and atrophied (wasted) testicle.

· No proven prevention.

Symptoms

· Swelling, a small hard lump, difference in shape and texture between testicles, often painless.

Screening

· Monthly self examination to detect lumps, swelling or discomfort on the surface of the testicles.

References

The Cancer Council Australia: www.cancer.org.au

The Queensland Cancer Fund: www.qldcancer.com.au

www.medicalonline.com.au/medical/cancer/cervical.htm

www.health.qld.gov.au/cervicalscreening/

For More Information

Wesley Corporate Health

Level 2 / 46 Edward Street

Brisbane  Qld  4000

Phone:  07 3234 2600

Email: info@weshealth.com.au

Disclaimer

This Fact Sheet is provided for your information only and does not replace qualified medical advice. The information provided may not apply to every person or all situations. A medical practitioner should be consulted for all treatment and medication.

Changes in Male Body Composition with Age

Why Does My Metabolism Seem to be Slowing Down?

As we get older our muscle mass reduces with inactivity.  Given that muscle is a highly active tissue that burns a lot of energy, a reduction often leads to weight gain.  This makes resistance training imperative to curb the decline and possibly restore muscle mass/tone. 

The age old adage still applies - If you don't use it, you’ll lose it!

How Much Muscle Am I Loosing?

That all depends how old you are.  A 70 kg Male will have approximately 25 Kilograms, or 38% of muscle at the age of 25.  For every 10 years of inactivity your muscles will decline by 1.9 kg or 8%¹!  So that means if you don’t do any significant resistance training between the ages of 25 and 55 years old you will loose approximately 5.7 kg or 24% of your lean muscle! 

How Much Fat Does My Muscle Burn?

Your muscles will burn approximately 25 calories of fat each day³, per kilogram. That’s 750 calories per month!

Lets go back to the original example.  If you are 55 years old and have lost 5.7 kg of muscle;

· This means that your metabolism has slowed down by 4275 calories per month!

· The average person that runs a marathon (5 minutes per km) uses approximately 2000 calories. You would need to run more than 2 marathons a month to burn the same amount of energy  as when you were 25!

References

1. Epidemiology of Sacropenia among elderly in New Mexico

2. Skeletal muscle mass and distribution in 468men and women

3. Predictor of skeletal muscle mass in elderly men and women

4. A new predictive equation for resting energy expenditure in healthy individuals

Osteoporosis and Bone Health

What is Osteoporosis?

Osteoporosis is a condition in which your bones become fragile and brittle due to the degeneration of the structures that give our bones support and strength. Osteoporosis increases the risk of fractures and falls. It is estimated that one in two women, and one in three men will develop osteoporosis during their lifetime. As we age, the risk of osteoporosis is multiplied. Osteoporosis is a serious health concern. A simple fracture can mean loss of mobility, long-term disability, loss of independence and even death.

Any bone can be affected by osteoporosis, however the most common sites are: hip, spine, wrist, ribs, pelvis and upper arm. Osteoporosis is termed a “silent disease” because there are usually no signs of osteoporosis until a fracture occurs. The onset, however, may be delayed by reducing or eliminating factors which enhance its development.

Risk Factors

Osteoporosis occurs most frequently in individuals with the following risk factors

· Age: Osteoporosis increase significantly with age

· Post Menopause: particularly in Caucasian and Asian women

· Loss of bone density or failure to achieve normal bone density during adolescence

· Low estrogen levels

· Amenorrhea (loss of normal menstruation)

· Early menopause (before 45 years)

· Hysterectomy (removal of the ovaries)

Prevent osteoporosis

Increase Calcium intake

Calcium regulates many of the chemical reactions and processes that are vital for our body to function. The recommended daily intake of calcium is 1000mg.  An average serve of dairy contains 300mg of calcium (eg. 1 glass of skim milk, or 2 pieces of cheese). Therefore, approximately 3-4 serves of dairy per day is the recommended daily requirement. Additional sources of dietary calcium include:

· One cup of plain yoghurt (400 mg)

· 1/4 cup almonds (90mg)

· One cup of cooked beans (100 mg)

· 90g of sardines (375 mg)

· 1/2 cup of cooked broccoli

If you are unable to tolerate dairy foods, consult your GP or dietitian for advice on calcium supplementation.

Magnesium

Magnesium provides structure for bones. It is also needed to help the absorption of  calcium in the tissues. Magnesium is therefore an important mineral that aids in osteoporosis prevention. Sufficient amounts of magnesium can be found in:

· Nuts, especially almonds and cashews

· Whole grains such as brown rice, buckwheat and rye

· Green vegetables

· Bananas

· Seafood

· Legumes, lentils and split beans

Vitamin D

Vitamin D, like magnesium, helps the body absorb calcium. It is found in milk, butter, liver and oily fish. In addition, moderate levels of sunlight cause Vitamin D to be formed in our skin.

Exercise

Being active increases bone strength, muscle strength, improves peak muscle mass and assists with posture and balance. It is important to perform weight bearing activities which are performed in the standing position and involve loads (forces) being placed through the feet and transmitted up the leg bones and spine. Examples  of weight bearing activities include walking, running, tennis, a light weights program or even aerobics.

The good news is that the majority of bone is formed before the age of 21, which for most of us, is the time we are most active. After the age of 35 we start to lose approximately 1% of our bone density every year. 

Another important time to remember your bone’s health is in the years immediately proceeding menopause.  During these years, there can be a drop in estrogen levels that can lead to a fall in bone mineral density.

What else can I do?

Quit Smoking

Smoking reduces the bodies ability to absorb nutrients (this includes calcium). It also reduces estrogen levels. Therefore women who smoke have lower levels of estrogen and absorb less calcium from their diets.

Limit your intake of alcohol and caffeine

Alcohol in excess can decrease the absorption of calcium in the intestines. Limit alcohol to 2 or less standard drinks a day, and no more than 4 standard drinks on a single occasion.

Caffeine is a diuretic and can also cause higher excretion levels of calcium from the body. Therefore limit caffeine to less than 300mg per day.

Get Regular Bone Density Checks

Check the density of your bones throughout your life. You can therefore monitor the changes in your bones density and the level of your risk of osteoporosis.

 

Why Do We Need to Test Bone Density?

Dexa Scan

It is important to test bone density to ensure that the strength and structure of our bone is not compromised.  A simple scan can evaluate the risk of developing bone related diseases such as osteoporosis, or  discover if you are already showing signs of degeneration. The best way to test bone density is through a DEXA scan. DEXA stands for “Dual-Energy X-ray Absorptiometry”

The test is non-invasive and completely pain free and will provide you and your doctor with the information needed to make a suitable plan for future bone health.

QFracture Score

Researchers from the BMJ (British Medical Journal)  have recently developed and validated two new algorithms' that predict the risk of osteoporotic fracture in primary care populations without the need for laboratory measurements. The fracture risk algorithms (QFractureScores)  provide a means of estimating the individual future risk of osteoporotic or hip fracture over 10 years (www.qfracture.org). Please discuss with your GP for further information.

 

Calcium needs

The National Health and Medical Research Council

recommend the following daily intake of calcium:

For more information

Wesley Corporate Health

Level 2 / 46 Edward Street

Brisbane  Qld  4000

Phone:  07 3234 2600

Email: info@weshealth.com.au

QLD Osteoporosis Society  07 3831 4183

Disclaimer

This Fact Sheet is provided for your information only and does not replace qualified medical advice. The information provided may not apply to every person or all situations. A medical practitioner should be consulted for all treatment and medication.