How strong are your bones
Are the older women in your family standing tall - or are they stooped over at the shoulders, or even bent over? Have older family members suffered fractured bones as a result of only a minor injury - just bumping into something, for instance? Have any of them broken a hip?
If you answer yes to any of these questions, you may have a family history of a bone-thinning disease called osteoporosis. It's a common problem, particularly in women past menopause, although it can affect elderly men too. Many older people don't realise they have it until they break a bone - at least 50 per cent of women over 60 and up to 30 per cent of elderly men will fracture a bone because of osteoporosis. But it's never too late to do something - even if you already have osteoporosis, there are ways to improve it. As for preventing it, it's never too early to start - even children and teenagers, especially girls, should know how to keep their bones healthy.
Most of us know that plenty of calcium in the diet helps prevent thinning bones - but other things that are equally important include regular weightbearing exercise, not smoking and avoiding too much alcohol. Examples of weightbearing exercise are walking, exercise classes, running, exercising with handweights, dancing, gardening and team sports. (Swimming and cycling aren't weightbearing). Good calcium foods include dairy products, soymilk (but check the label to make sure it's fortified with calcium), fish with soft edible bones (eg canned salmon; sardines;) fresh crab; green leafy vegetables (especially Asian green vegetables). Calcium is also found in dried shrimp, sesame oil and sesame sauce; chickpeas, tahini, hummus, almonds, dried figs, and continental parsley. Some tofu (the type which is set with calcium during processing) contains calcium. But, apart from contacting the manufacturer, you can't tell which tofu is made this way. Firm tofu is more likely to have been set with calcium, but you can't be sure.
If you don't get enough calcium in food, try a calcium supplement (especially if you're a woman over 50). A good calcium supplement should say on the label that it contains between 400mg and 600mg of elemental calcium. If you have difficulty finding the right supplement, ask your doctor's advice.
It's easier for your body to absorb calcium if you get enough vitamin D. We get most of our vitamin D from sunlight - and most people get enough of this vitamin. But there are some exceptions. Anyone who always wears clothes covering almost all of their body or who spends very little time outdoors, may not get enough. If you think you're not getting enough vitamin D, ask your doctor about a vitamin D supplement.
Another important factor for women is the female hormone oestrogen which helps protect against thinning bones - that's why osteoporosis is more common after menopause when the body produces less oestrogen.
How do you know if you have osteoporosis?. The only way to be sure is to have a bone density test which your doctor can arrange. This test, which
is like an X-ray, shows how strong - or weak - the bones are in the spine and hip. The test is free to anyone who has had a fracture caused by a minor injury, or who takes medication which may affect bone health (see below). It's important to have this test if you think you have a family history of osteoporosis, or if you have already had a fracture or broken hip. Some prescribed drugs can also increase the risk of osteoporosis, including medication for rheumatoid arthritis, thyroid disease, and for some bowel problems, and drugs prescribed to people who have had organ transplants.
How is osteoporosis treated? One treatment is hormone replacement therapy (HRT) which replaces the hormones women stop producing at menopause. But it's not the only one - your doctor can explain other options.
Drug treatments are used in combination with a calcium-rich diet and exercise.