Healthy bones can sustain us
throughout life without ever breaking.
But brittle bones can develop fragility
The American Academy of Orthopaedic
Surgeons defines fragility fractures as
“fractures resulting from a fall from a
standing height or less, or presenting in
the absence of obvious trauma. Fragility
fractures affect up to one-half of women
and one-third of men over age 50, and
are often associated with low bone
As we grow, our bones are shaped
continuously by the destruction of
old bones and the regeneration of
new bones. Ninety per cent of peak
bone mass is formed by about age 18
in females and by about age 20 in males.
It is very important to develop this bone
mass by the teen years and maintain it.
So, fragility fracture prevention starts
in our childhood and teens.
Prevention begins with:
Exercise. Recent studies show that
exercise induces stem cells to make bone
rather than fat. Resistance and balance
exercises are also recommended.
Eat healthy. Build strong bones for life
with healthy diet that contains calcium-rich foods (such as milk, cheese, yogurt,
nuts, etc.), vitamin D (present in milk,
fortified soy, rice or almond drinks) and
fish such as char, herring, mackerel,
salmon, sardines or trout. Vitamin K2
(present in kefir, a yogurt drink, and
dried plums) also helps. Dried plums
have been shown to help reduce bone
Maintain optimal weight. Maintaining
optimum weight is important as obesity
increases risk of fragile fractures. If you’re
calorie-conscious about drinking milk,
1% or skim milk will deliver the calcium
you need without extra fat.
Avoid smoking. Smoking accelerates
the thinning of bones.
Drink alcohol in moderation.
Chronic alcohol abuse is associated
If you are 50 or older
As we age, our bones begin to lose
density and are more prone to a fragility
fracture. If you’re more than 50 years old,
these tips can help you prevent falls and
If you have a tendency to fall, ask your
doctor if you have:
• Orthostatic hypotension (abnormal
drop in blood pressure on standing up)
• Irregular heart beat
• Parkinson’s disease.
Maintain good visual health. Have your
eyes examined regularly for eye diseases
such as cataracts, glaucoma or macular
degeneration. Wear glasses or contact
lens as prescribed.
At home, remove loose carpets and
clutter that you could trip over. Wear
sensible footwear with suitable grips.
Improve your gait and balance with
exercises such as Tai Chi or fall-preven-tion training; 80 per cent of fragility
fractures are associated with falls.
Ask your doctor or health-care
provider if you are at risk of or need
to be treated for osteoporosis if you:
• Have been taking glucocorticoids
(cortisone) continuously for three
months or more
• Have fractured your hip, back,
upper arm or wrist. For women
over 40, the risk of a second fracture
is five times higher
• Have rheumatoid arthritis, celiac
disease or Crohn’s disease
• Are a long-term care resident
• Have had early menopause (before
the age of 45), a hysterectomy and
your ovaries removed.
You can also ask your doctor or
health-care provider if you need
calcium or vitamin D supplements.
By taking personal responsibility,
you can reduce your risk of a fragility
fracture. It is your choice whether you
act on this advice or not. Choose well.
— Kamalesh Gangopadhyay
Kamalesh Gangopadhyay is a retired doctor.
Preventing bone breaks
begins early in life
Diet, exercise and weight affect your bone health