Bone Loss with Ageing

Low Bone Mass and Osteopenia
Bone Health and Bone Density

Bone Loss and Fragility

Our skeletal bones are a major structural component of the body. Bones are composed of living tissue.  As we enter midlife we must pay close attention to the status of our bone health. It is at this time that many of us begin to lose bone mass. By understanding the science of bone loss and fragility, we may be able to make educated choices regarding our bone health and take preventative action.

Bone Remodeling

Bone remodeling is the process that takes place whereby bone tissue is renewed. This two part process involves resorption and formation. When bones are going through resorption, specialised cells referred to as Osteoclasts break down to remove old bone tissue. During the bone formation process this old bone is replaced by new bone tissue. So long as an individual does not have any underlying medical conditions, this process is fairly balanced throughout our youth. As we age however, an imbalance often begins to occur regarding how quickly the bone tissue breaks down in comparison to the formation of new bone tissue.

Bone Loss During Menopause and Andropause

Menopause signifies a time in a woman’s life where the bones in the body become less dense and fragile. This not only occurs in females, but in males who are entering andropause. Andropause in males is similar to menopause in women. Many of the menopausal symptoms experienced in women have been linked to oestrogen and testosterone decline which is a hormonal deficit apparent in the aged. Likewise in men, the decline of circulating testosterone have been linked to several known symptoms of andropause.
Both oestrogen and testosterone are hormones that play a role in the bone renewal process. When they decline, the process of bone remodeling becomes unbalanced. Bone resorption takes place at a much quicker rate than the bone formation process which replaces the old bone with the new. Due to this imbalance, bones become fragile.

Bone Fragility

Bone fragility is a big concern in the aged. The consequences lead to a heightened risk of falls, injury and bone fracture. The fact that one’s bone tissue is declining as only one part of the heightened risk. Another contributor to the aged and falls is the coinciding loss of muscle mass and strength. Muscles and tendons support the skeletal frame. Where both are weak and frail, the control one has over their body is diminished dramatically.

How to prevent falls and bone injury in the aged

To prevent injury and falls as we age it is important to upkeep the health of our bones.
WEIGHTS AND RESISTANCE TRAINING- Though it is quite common to feel listless and tired as we approach midlife it is of the utmost importance to continue getting adequate exercise. Since muscle loss is also a symptom of ageing, we must approach our workouts intelligently and ensure weight lifting is included in our training. Weight training supports bone health and numerous studies indicate its effectiveness for increasing bone density, improving balance and connective tissue strength.
BONE HEALTHY DIET AND NUTRITION – Vitamin D and Calcium are important for bone health. Both work as a team to protect bones. Calcium is crucial for building and maintaining bone tissue. Vitamin D helps the body absorb calcium which is then supplied to the bone tissue.
BONE DENSITY TESTING – As we age, we must have our bone density tested, to ensure our levels are healthy and not actively depleting. This should be done with regularity, particularly if we are among those of high risk. Individuals with a genetic predisposition, alongside smokers and those with an affinity toward alcoholic beverages should get their bone density tested.
HORMONE TESTING AND SUPPLEMENTATION – As we age, our hormonal secretion tends to slow down. Since hormones regulate a number of vital functions within the body including those that affect bone tissue, getting tested for a hormonal deficiency is a smart move to ensure bone health is optimised. GH levels are shown to reduce roughly around the age of 30 years old. GH deficiency has been shown to contribute to the development of low bone mass. Peptide supplementation has been shown useful in addressing symptoms of Growth Hormone Deficiency. 
 

References
  • Capozzi, A., Casa, S. D., Altieri, B., & Pontecorvi, A. (2014). Low bone mineral density in a growth hormone deficient (GHD) adolescent. Clinical cases in mineral and bone metabolism : the official journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal Diseases, 10(3), 203-5.
  • D Kearbey, Jeffrey & Gao, Wenqing & J Fisher, Scott & Wu, Di & Miller, Duane & Dalton, James. (2009). Effects of Selective Androgen Receptor Modulator (SARM) Treatment in Osteopenic Female Rats. Pharmaceutical research. 26. 2471-7. 10.1007/s11095-009-9962-7.
  • (2011). Treatment of osteopenia. Reviews in endocrine & metabolic disorders, 13(3), 209-23.
  • Oztürk Tonguç, M., Büyükkaplan, U. S., Fentoglu, O., Gümüs, B. A., Çerçi, S. S., & Kirzioglu, F. Y. (2012). Comparison of bone mineral density in the jaws of patients with and without chronic periodontitis. Dento maxillo facial radiology, 41(6), 509-14.
  • Ibeneme, S. C., Ekanem, C., Ezuma, A., Iloanusi, N., Lasebikan, N. N., Lasebikan, O. A., & Oboh, O. E. (2018). Walking balance is mediated by muscle strength and bone mineral density in postmenopausal women: an observational study. BMC musculoskeletal disorders, 19(1), 84. doi:10.1186/s12891-018-2000-3
    Laird, E., Ward, M., McSorley, E., Strain, J. J., & Wallace, J. (2010). Vitamin D and bone health: potential mechanisms. Nutrients, 2(7), 693-724.
  • Steffl, M., Bohannon, R. W., Sontakova, L., Tufano, J. J., Shiells, K., & Holmerova, I. (2017). Relationship between sarcopenia and physical activity in older people: a systematic review and meta-analysis. Clinical interventions in aging, 12, 835-845. doi:10.2147/CIA.S132940
    Choi, M., & Kim, M. (2016). The Association between Coffee Consumption and Bone Status in Young Adult Males according to Calcium Intake Level. Clinical Nutrition Research, 5(3), 180. doi:10.7762/cnr.2016.5.3.180
  • Jang, H., Hong, J., Han, K., Lee, J., Shin, B., & Choi, S. et al. (2017). Relationship between bone mineral density and alcohol intake: A nationwide health survey analysis of postmenopausal women. PLOS ONE, 12(6), e0180132. doi:10.1371/journal.pone.0180132
  • Santos, L., Elliott-Sale, K. J., & Sale, C. (2017). Exercise and bone health across the lifespan. Biogerontology, 18(6), 931-946.
  • Shanb, A. A., & Youssef, E. F. (2014). The impact of adding weight-bearing exercise versus nonweight bearing programs to the medical treatment of elderly patients with osteoporosis. Journal of family & community medicine, 21(3), 176-81.
  • Smoking and Bone Health | NIH Osteoporosis and Related Bone Diseases National Resource Center. (2016). Bones.nih.gov. Retrieved 15 November 2018, from https://www.bones.nih.gov/health-info/bone/osteoporosis/conditions-behaviors/bone-smoking
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