The following steps are simple and can save

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you the cost, the pain and the inconvenience of having a hip replacement in the latter part of your life:

• Calcium is king. Make sure that you take in sufficient calcium. All young people from age 14 upwards need between 1000 and 1500 mg of calcium daily in order to build up maximum bone density. That means having between three and four cups of milk (skim milk if you tend to be overweight), yogurt or cottage cheese every day.
• Supplement solution. Postmenopausal women over 40 should take in about 1500 mg of elemental calcium per day. If it is difficult to make this part of your daily diet, a good calcium supplement, that contains at least 500 mg of elemental calcium per tablet, should be considered. Milk, cheese, sardines, tofu and green vegetables are all rich in calcium.
• Minerals and men. Men between the ages of 30 and 50 need 800 - 1000 mg of calcium daily and men over 50, 1200 mg of calcium per day.
• Feast on phosphates. Talk to your pharmacist about using biphosphonates (such as alendronate or alendronic acid), which delay the breakdown of bone cells. Grains, legumes, fish, meat and dairy products are rich in phosphates. There is still no sufficient proof that plant oestrogens or progesterone creams can give protection against bone density loss. I would not advise patients to use bisphosphonates prophylatictally without consulting a physician – only indicated in special cases i.e. cortisone users.
• Sunlight strategy. Make sure that you get enough vitamin D. Most South Africans are exposed to sufficient sunlight in order to produce vitamin D. However, older people who spend a lot of time indoors often need additional vitamin D. Use a soft margarine that contains a vitamin D-supplement or take an oral Vit D supplement – usual requirement 600 – 800 IU daily and contained in many calcium tablets.
• Magnesium magic. Additional magnesium may be needed by diabetics, alcoholics and people who take diuretics. Nuts, seeds and grains are all rich in magnesium. Chicken, fish and red meat increase the absorption of magnesium and other minerals.
• Lose the alcohol and the cigarettes. Reduce alcohol intake and stop smoking. Research has shown that between 20 and 25 percent of men who drink four or more units of alcohol per day, suffer some from of bone loss.
• Get moving. Exercise at least twice per week. Weight-bearing exercises such as running, and resistance training, where you have to push against your body weight or against weights, apparatus or elastic bands, are essential for building strong bone structure.
• Walkers are winners. Exercise moderately three times a week. Walking is an excellent and easy means of exercise and provides the necessary skeletal protection and benefit. Brisk walking for 30-45 minutes three times a week is adequate. Resistance training may also enhance muscle and skeletal strength, but must be performed cautiously in the patient at high risk for osteoporosis.

(Reviewed by Dr Magda Conradie, Tygerberg Hospital, Department of Endocrinology and Metabolism)

National Osteoporosis Foundation of South Africa
PO Box 481
Bellville
7535

Tel. (021)-931 7894

Read more:
Visit Health24's Osteoporosis Centre

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