How To Have Healthy Bones

As I said before, I am simply exploring how to be healthy and I want to start with our bones. By exploring I mean that I shall be looking at the views and opinions of the experts and I shall also include the experiences and stories of people who have issues with their bones.
This section deals with the most important element of our body - the framework that holds the muscles, flesh and vital organs together. So it is of paramount importance that we have optimum bone health.

When we discuss exercise most individuals immediately think of losing fat and toning or gaining muscle. It is true that with regular exercise you will lose inches and gain strength in muscles but the importance of exercise on a regular basis really offers many more important health benefits then being able to fit into your skinny jeans or being able to flex an impressive looking bicep.

Another extremely important benefit from exercise which is often over looked until problems begin to occur is bone health. Most individuals do not give their bones much thought until they or a loved one is face with the reality of failing bones which can be detrimental because it will ultimately lead to immobility.

All of us reached our maximum bone mass in our twenties and if prevention is not a focus it is down hill from that point on. The important thing to remember is it is never to late to start.

Although there has been a focus on women's bone health in recent years with the discussion of osteoporosis men are not immune to the adverse affects of bone loss. Women are prone to increased bone loss or osteoporosis during and after menopause caused by the loss of estrogen; at the same time men as they age will also experience increased bone loss associated with the loss of testosterone. Although women in general are more prone to bone disorders such as osteoporosis men are by no means off the hook.

With that being said most bone loss actually occurs from disuse atrophy. Bone tissue is the same as any other tissue in the body; if you do not use it you will lose it. Your body does not waste energy maintaining something that is deemed important or necessary such as muscle or bone that is not worked. It is also important to recognize that the loss of muscle directly affects the health of your bones.

Maintaining lean muscle mass is essential to keeping our bones healthy because this lean muscle puts good stress on our bones that in turn causes them to strengthen or in other words signals the body that our bones are important and need to be maintained. The best way to do this is to incorporate resistance training into your life two or three times a week.

Weight training does fall into the resistance training category however if lifting weights does not appeal to you there are many different options that can be done inside or outside of your home. Resistance training includes any activity that works and strengthens your muscles which in turn put the much needed stress on your bones. The possibilities are endless your workout can include any of the following: Pilates, using resistance bands, using the now popular exercise ball, yoga or simply using your own body weight. Try doing a lunge or yoga pose; when you do you will see that you do not need a fancy gym or tons of equipment to get a workout. The important thing is to find an activity or activities that you enjoy, embrace it and make it a part of your life.

Other important steps that you need to take in order to ensure you have healthy bones are; quit smoking, avoid excess drinking and ensure you are getting adequate amounts of calcium, vitamin D and vitamin K2 in your diet. You are not getting your daily requirements of the necessary mineral and vitamins then take supplements.

Healthy bones are not always our top priority but by making a few changes to our lifestyle we can help assure we will not only live longer but can enjoy independence and mobility far into our twilight years.


Saturday, December 12, 2009

Taking A Fall


By ALLAN KOAY


The elderly do not just fall because of obstacles in their way.
IT IS commonly thought that when the elderly falls, it is caused by obstacles or hazards in their way, be they toys, pets, wires, cables or curtains. But studies have shown that there may be more to it than meets the eye.
There are other causes that may not be as apparent, such as problems with gait, balance and muscle function that come with age and affects those above 65.
Dr Erich Schacht: ‘Patients above 65 years of age have a reduction in neuromuscular coordination. In principal, they face a risk of falls.’
According to studies, about one-third of those aged above 65 experience one or more falls per year, and 90% of all non-vertebral fractures are from falls.
In the Rotterdamn Study, 20.7% of men and 44.1% of women with non-vertebral fractures had osteoporosis, and that suggests that low bone-mineral density may be less important in predicting non-vertebral fractures in the elderly. Rather, it is found that a combination of loss of bone strength and increased risk of falls that leads to osteoporosis-related fractures. Therefore preventing falls means preventing fractures.
“In the last decade, we were only talking about bones in osteoporosis – bone mass loss, bone strength loss, and bone quality loss,” said Dr Erich Schacht, an osteology and rheumatology expert from Switzerland who was recently in Kuala Lumpur to give a talk on the new drug alfacacidol that can help to prevent falls.
“In the elderly, there is another problem, which is that patients above 65 years of age have a reduction in neuro-muscular coordination – in muscle power or balance. In principal, they face a risk of falls.”

He concurred that more than 90% of hip fractures are caused by falls. Because the elderly have less muscle and fat, they have less protection at the hips. And because of neuro-muscular deficiency, they have slower or no reaction when they fall. And if they fall on an osteoporotic bone, the chance of the bone breaking is higher.
“There’s also a difference in the way young people fall and the way the elderly do,” said Dr Schacht. “The younger people more commonly fall to the front, and they have their arms in front of them to stop the fall. The elderly tend to fall sideways or backwards, and without reaction.
The loss of mobility, which increases with age, is a major threat to growing old successfully.
“The elderly have less possibility to react because of some changes in their bodies. Some types of muscle fibres which are responsible for fast reaction decrease in people with age.”
Dr Schacht said that while bone measurements are still very important in the field of osteoporosis, fall-risk assessment is also needed. There are different tests that can be carried out to determine if a person faces the risk of falling.
“Only when we have both (bone measurements and falls assessment), can we calculate an individual’s real risk of hip fracture,” he added.
“Just measuring the bone-mineral density is not enough. It has been shown in the last few years, from big studies, that more than 50% of hip fracture patients didn’t have osteoporosis. Why did they have hip fractures? Because not only the bone mass, but also the bone structure and quality are negatively changed.”
The tests to assess a person’s risk of falling include the lower extremity test where a person is asked to stand with feet close together for 10 seconds, then stand with the heel of one foot in line and touching the toe of the other foot. Those who cannot stand in this way for more than 10 seconds have a risk of falling.
Another is the timed up-and-go test. A person sits in a chair of normal height, gets up and walks 3m, and then walks back and sits down again. If she or he takes more than 12 seconds to do it, then there is a risk of falling.
Then there is the gait velocity test, where a person is required to walk normally for 4m, and if the she or he walks less than one metre per second, it shows a high risk of functional decline, which is related to falls and fractures.
But Dr Schacht said it is not all just about the bones, as bones and muscles are a unit. If you don’t use your muscles, you also lose your bones.
“You see it in hospitals with bed-ridden patients, or in space where astronauts lose muscle mass and then bone mass,” he explained.
Correction of vision and minimising the dosage of drugs combined with muscle, gait and balance training such as tai chi, can help to prevent falls.
“So the muscle is responsible for the bone’s growth. Therefore a drug that affects both muscle and bone can positively influence bone strength and reduce falls.”
Such a drug is already being introduced. Called alfacalcidol, the drug has been shown in tests to greatly reduce falls in a community of men and women with a total calcium intake of more than 500mg a day and normal vitamin D serum levels.
Alfacalcidol is a D-hormone analog that works simultaneously in the parathyroid hormone, immune system, intestine, bone muscle and nerves.
“Muscle growth, and muscle differentiation and maturation can be controlled by this drug,” said Dr Schacht.
He said alfacalcidol has been shown to influence the fall-risk assessment tests.
“Studies have shown that if you cannot do these tests within the stipulated time, in 10 years, you will have a 60% risk of getting a hip fracture,” said Dr Schacht. “But if a patient uses alfacalcidol, there is a reduction of two seconds in the performance of these tests.

Ultimately it is the loss of mobility, which increases with age, that is a major threat to growing old successfully. Mobility impairment is what leads to gait and balance problems, and coupled with vision and cognitive impairment, increases the risk of falls.
Correction of vision and minimising the dosage of drugs combined with muscle, gait and balance training such as tai chi, can help to prevent falls.
“The elderly don’t do sports like young people,” said Dr Schacht. “There is no specific rehabilitation programmes for muscles and bones. But the only thing I can recommend, which has been validated, is tai chi. And it’s not only working in Asia, it’s working for American housewives as well.”

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