irish
osteoporosis
news
Issue No.1 Summer 2009 Price: €4
Men and osteoporosis
It’s not just a woman’s disease
Eating disorders
How they can affect your bones
Starting young
Investing in your bones from childhood
Bone health
Takes centre stage
Contents
Summer ‘09
News 6
Craig Doyle launches three-dairy-a-day campaign...Vitamin D linked
to muscle power... Pancakes ideal all year round... Mild anorexia harms
bone structure
Men 8
men
8
With one in five men now developing osteoporosis, it can no longer be
thought of as a disease only affecting women. Bricklayer, Philip Byrne
recounts his experience of a shock osteoporosis diagnosis
Eating Disorders 10
At only 23 years old, Dr Ann Manley discovered that she had the bones
of a 70 year old woman. She talks to Olivia Fens about how teenage
anorexia caused some unexpected health problems
Starting Young 13
13
starting
young
Looking after your bones in your childhood and teenage years is the best
way of ensuring good bone health later in life
Nutrition 15
Eating a healthy and varied diet rich in calcium and vitamin D is one of
the most important ways of keeping your bones healthy
18
What is weight-bearing exercise and what is not? Olivia Fens reports
Q&As 21
IOS president, Prof Moira O’Brien answers your questions about
osteoporosis and bone health
Join us 23
The Irish Osteoporosis Society is a charity dedicated to supporting
people with osteoporosis and their families. See how you can become a
member
15
nutrition
irishosteoporosisnews
Exercise 3
irish
osteoporosis
news
Issue no.1 Summer 2009
Website: www.irishosteoporosis.ie
Email: [email protected]
Ph: Lo-call 1890 252 751
Fax: +353 (0)1 6351698
Irish Osteoporosis Society Editorial Board
Prof Moira O’Brien
Michele O’Brien
Niall McLoughliin
Produced by:
Medmedia Publications
25 Adelaide St
Dun Laoghaire
Co.Dublin
Tel: 01- 280 3967
Email: [email protected]
www.medmedia.ie
Welcome to the first
Osteoporosis News
We are delighted to present you with
the first issue of Osteoporosis News.
Our cover in this issue shows
broadcaster Craig Doyle, who has
been working with us on a major
promotional campaign which has
featured on prime time radio.
This was undertaken in conjunction
with the National Dairy Council to
promote the consumption of threedairy-a-day to maintain bone health.
Here, at the Irish Osteoporosis Society,
we are dedicated to promoting bone
health and reducing the prevalence of
osteoporosis in Ireland.
Osteoporosis is a silent disease that
affects one in five men over 50, one in
two women over 50, and also affects
children. However, it is usually both
preventable and treatable.
In our first issue of Osteoporosis
News, we examine the best ways to
maintain good bone health.
The Irish Osteoporosis Society thanks the
following for supporting this issue:
Ireland (Human Health) Limited
Regular weight-bearing exercise
and eating a diet rich in calcium and
vitamin D are essential to keeping
your bones strong and healthy.
We highlight the growing incidence of
osteoporosis in men and hear from a
young bricklayer who, like many, was
shocked to learn he had osteoporosis
but is now well on the road to living a
fulfilled and healthy life.
This issue also focuses on the strong
link between osteoporosis and eating
disorders.
Dr Ann Manley tells us how anorexia
in her teenage years led to her
discovery that she had osteoporosis
at the age of 23.
One of the best ways to prevent
osteoporosis is to focus on bone
health from a very early age.
Healthy eating and regular exercise
during childhood, especially
the teenage years, cannot be
underestimated, as it is then that the
majority of our bone is laid down.
President of the IOS, Prof Moira
O’Brien, answers your most frequently
asked questions and dispels some of
the myths associated with osteoporosis.
The Osteoporosis Society is a
charitable organisation which was
set up to support people with
osteoporosis and their families.
Our aim is to reduce the prevalence of
this disease and to increase awareness
generally about the importance of
bone health. As a charity, we rely
on donations to continue our many
activities. For more information or to
become a member, see page 23.
We hope you enjoy our new magazine
and find it helpful and informative.
irishosteoporosisnews
Osteoporosis Society of Ireland
12 Burlington Road (garden level)
Ballsbridge
Dublin 4
5
news
Craig Doyle
launches national
campaign
A major new campaign was recently
launched to raise awareness that three
portions of dairy a day, combined with
good nutrition, can help to prevent
and treat osteoporosis and ensure
the development and maintenance of
healthy bones, whatever your age.
Sports presenter and international
triathlete, Craig Doyle, has fronted
the recent national radio advertising
campaign to promote osteoporosis
awareness and the importance of dairy
products in developing and maintaining
bone health.
“Our goal, and that of the National
Binge drinking
bad for the bones
It has already been shown that binge
drinking can decrease bone mass
and strength, increasing the risk of
osteoporosis. Now researchers
claim to have found a possible cause
for this. According to a US study,
alcohol disturbs the genes necessary
for maintaining healthy bones.
irishosteoporosisnews
This finding could help in the
development of new drugs to
minimise bone loss in alcohol
abusers. Such drugs may also help
people who do not abuse alcohol
but who are at risk of developing
osteoporosis.
6
“Of course, the best way to
prevent alcohol-induced bone loss
is to not drink or drink moderately.
But when prevention doesn’t
work, we need other strategies to
limit the damage,” explained one
of the authors. The findings were
published in Alcoholism Clinical and
Experimental Research.
Dairy Council is to
encourage as many people
as possible to adopt a
bone-healthy lifestyle.
“This can be achieved through
eating a healthy diet, taking regular
weight-bearing exercise, and being
aware of the many risk factors for
osteoporosis,” said Prof Moira O’Brien,
president of the IOS.
“We are hoping to prevent people
from developing the disease which – if
left untreated – can cause severe pain
due to multiple fractures and loss of
independence,” Prof O’Brien added.
The Irish Osteoporosis Society and the
National Dairy Council’s joint campaign
highlights the importance of including
three servings of milk, cheese or yogurt
per day, as part of a balanced diet.
For further details and booklets, see
www.3aday.ie.
Mild anorexia harms
bone structure
Children and teenagers with even mild
cases of anorexia display abnormal
bone structure, a new study has
revealed.
A team of US researchers set out to
determine if changes in bone structure
occur in the early stages of anorexia,
before significant decreases in bone
density become apparent. Bone loss
is among the many health problems
associated with anorexia.
bone structure begin to occur
in patients with anorexia well before
decreases in bone density.
“Adolescence is the most critical
period for growth of bone mass, and
the onset of anorexia interferes with
that process. Impairment of bone
development may permanently alter
bone structure and increase the risk
of fractures and osteoporosis in adult
life,” explained Prof Miriam Bredella of
Harvard Medical School.
The researchers studied 10 girls aged
13 to 18 who had mild anorexia, and 10
girls of a similar age who did not have
the disorder.
She said that in patients with anorexia,
bone structure should be analysed to
detect abnormal bone health.
CT scans showed significant differences
in bone structure between the two
groups. There was no difference,
however, in bone density between
the groups, indicating that changes in
The results of this study appeared in
the December issue of Radiology and
were recently presented at the annual
meeting of the Radiological Society of
North America (RSNA).
news
Pancakes ideal all year round
Pancakes are a delicious way to fulfil
some of your daily dairy needs, and
most of us see them as a welcome treat.
According to the Irish Osteoporosis
Society (IOS), pancakes are ideal all
year round and are a perfect example
of the many versatile ways to include
milk and dairy in a balanced diet in
order to achieve the recommended
three portions of dairy a day.
Kerrie Patten (age 10), from Clontarf, Evie McLoughlin (age 3) from Donnybrook, Jamie McLoughlin (age 5) from
Donnybrook, Charlotte Patten (age 6), from Clontarf, with Ryan Tubridy
jam and dairy cream, or ice cream.
Experimenting with savoury ideas, such
as roast vegetables or ham with grated
cheese, are also delicious.
Vitamin D linked to muscle power
Muscle power and force in teenage
girls is strongly associated with levels
of vitamin D, according to a new UK
study. Although vitamin D is naturally
produced in the body through exposure
to direct sunlight, vitamin D deficiency
has become widely common in the US.
Vitamin D deficiency has been shown
to have a significant negative impact on
muscle and bone health, and can lead
to conditions such as osteoporosis and
rickets.
“We know vitamin D deficiency can
weaken the muscular and skeletal
systems, but until now, little was known
about the relationship of vitamin D
with muscle power and force. Our
study found that vitamin D is positively
related to muscle power, force, velocity
and jump height in adolescent girls,”
said Dr Kate Ward of the University of
Manchester, who was the lead author
of the study.
For this study, researchers examined
99 girls between the ages of 12 and 14.
Blood samples were taken to measure
the girls’ levels of vitamin D. Many were
found to have low levels of vitamin
D despite not presenting with any
symptoms.
Researchers used a new method called
jumping mechanography to measure
muscle power and force. This calculates
power and force measurements from
a subject’s performance in a series of
jumping activities. According to Dr
Ward, this method of testing is ideal
as the muscles required to jump are
those most often affected in subjects
with vitamin D deficiency. Girls without
vitamin D deficiency performed
significantly better in these tests.
“Vitamin D affects the various ways
muscles work and we’ve seen from
this study that there may be no visible
symptoms of vitamin D deficiency,”
said Dr Ward, adding that further
studies are needed.
The results of the study
will be published in
the Journal of Clinical
Endocrinology and
Metabolism.
Pancakes are nicest served straight from
the pan. The IOS recommends using
fortified milk with added calcium and
vitamin D to make your pancakes.
Irish not getting
enough dairy
Nearly one-third of Irish adults
do not consume the basic three
servings of dairy products a day
for appropriate calcium intake as
recommended by the Department
of Health, according to the National
Dairy Council (NDC).
New research commissioned by
the NDC, 29% of adults has shown
that adults are not meeting their
recommended calcium intake and are
missing out on essential nutrients.
The Council warned that a lack
of dietary calcium could lead to
serious long-term health risks like
osteoporosis. The daily guidelines
from the Department of Health
recommend ‘three dairy a day’ for
adults, such as a piece of cheese
(about the size of a matchbox), a
carton of yoghurt and one-third of a
pint of milk.
Higher levels of calcium are needed
in women who are breastfeeding
or are pregnant. Children and
adolescents also need higher levels
as 90% of adult bone mass is
created in teen years.
irishosteoporosisnews
Serving pancakes with delicious fresh
fruit and berries is a great way of also
increasing your fruit intake. Try adding
blueberries, raspberries or fresh fruit
with a sprinkling of sugar or sugar
substitute. As a treat, fill them with
butter, lemon juice and castor sugar,
7
men
Make no bones
about it…
Osteoporosis in men
is increasing steadily,
but most are not
tested and treated
until much later
than women, writes
Joanne McCarthy
As many as 20% of all people with
osteoporosis are men, although
osteoporosis is often thought of as a
woman’s disease.
More men than ever before are now
developing the disease as a result of
reduced sex hormone levels caused by
increasingly high stress levels, smoking,
excessive alcohol consumption,
steroids and physical inactivity.
Osteoporosis in men continues to be
under-diagnosed and under-treated.
Because weak bones are usually
associated with older women, men
who suffer fractures are at a huge
disadvantage when it comes to being
screened for osteoporosis.
irishosteoporosisnews
A recent report by the International
Osteoporosis Foundation found that
the lack of awareness of osteoporosis
in men is similar to the lack of
awareness in women 50 years ago.
8
Osteoporosis occurs when the density
of bones is reduced, meaning that
bones become fragile and liable to
break easily.
Men lose the same amount of bone
mass as women, with both losing
almost half of the bone mass achieved
during growth over the course of a
lifetime. However, men compensate
better for the loss of bone
mass by naturally laying down more
bone on the outer surface of the bone.
They have larger skeletons so it takes
longer for them to develop fractures,
and they have no period of rapid
hormonal change as women do, which
occurs at the menopause.
The new bone on the outer surface
does not entirely compensate for
the loss of bone, however, and so
about one in every five men suffer
osteoporotic fractures.
This number is on the rise, with some
estimating that by 2025, the number of
fractures in men will be similar to the
number in women.
Key risk factors for men are the
same as those for women except
that men are affected by low levels of
testosterone. Testosterone deficiency
(hypogonadism) is the most common
cause of osteoporosis in men.
Symptoms include loss of sex drive,
loss of erections, depression and/or
fatigue. All other risk factors affecting
women also apply to men.
Stress
Smoking, excess alcohol consumption
and lack of exercise also increase
the risk. High levels of stress
are increasingly being linked to
osteoporosis in men.
Like many men, Philip Byrne, a
48-year-old bricklayer from Carlow,
was shocked to discover that he had
osteoporosis when he was diagnosed
at the age of 45. “I injured my back, I
thought maybe I had pulled a muscle
or something. It went on for a long
period of time and it got worse rather
than better. It wouldn’t be uncommon
for me to injure myself at work and
still continue working through the pain.
But this injury never went away, it got
worse.
“I eventually went for an x-ray. I
didn’t have any broken bones, but it
was suggested that I should go for a
DXA scan, as my bone looked thin.
That’s how they discovered I have
osteoporosis,” he said.
Like many men his age, Philip knew very
little about osteoporosis. At first, it was
a relief to get a diagnosis, but that relief
quickly turned to shock when he was
told that he would never work again.
“It was a huge shock to me when I sat
in front of the doctor and he gave me
the bad news, which was that I would
never work again.
“In five minutes everything had
changed, from me thinking I was just
going to go into the chemist and get
this sorted, to basically being told I was
never going to work again. My whole
world was upside down,” he said.
Thankfully, Philip was able to prove that
verdict entirely wrong. After seeing an
osteoporosis specialist, he received
the treatment he needed and made a
number of lifestyle changes.
“I was out of work for a full eight
months. I’m back working now, but
the way the industry is at the moment
I’m in and out of work and to a degree
that suits me, because I’m not up to full
men
“If I wasn’t involved in the construction
industry, I believe things would be fine,
but my job is very physical. I have to lift
a lot of weight every day and my job
involves a lot of bending. That’s where
I’m having the most problems, with
pain,” he explained.
When he was diagnosed, Philip says
he was ‘unfit to walk, let along work’.
However, after responding well to
his medication, changing his diet and
starting regular weight-bearing exercise,
he saw major changes.
“I’m very cautious about what I do
now. I watch what I’m eating and I
make sure that I look after myself a lot
better than I did a couple of years ago.
“I thought I was looking after myself,
but it’s a lot higher up on the list now.
It’s number one on the list really, just
to eat properly and be more active as
far as exercise is concerned.
“Before, I never used to eat in the
mornings, I’d be up and out the
door, always last minute. Now I eat
a lot better. If I’m late, I’m late, and
it doesn’t bother me too much any
more,” he said.
Optimistic
Philip is now very optimistic about the
future, and plans to stay working for a
long time.
He is currently completing a course
in Carlow IT on Building and Energy
Rating, and is hoping to get into that
field, where he can use his building
expertise but not have a physically
demanding job.
Philip attributes his disease to stress,
and says he has had to make “quite a
few changes” to the stressful lifestyle
he was living before his diagnosis. He
now recognises that he was taking on
too much.
“There was many a year that I would
feel that I was doing too much, but
then again I was over the top.You
wouldn’t want to work with me, let’s
put it that way! I’ve calmed down a lot.
“I’m mindful that there are more
important things than upsetting
yourself over something you really
might have no control over,” he said.
Professor Moira O’Brien, president
of the Irish Osteoporosis Society
(IOS), believes that one of the major
reasons for the increased incidence
of osteoporosis in men is stress. Ten
years ago, just one in 20 men had
osteoporosis; now, one in five men get
the silent disease.
“Stress means that men have
decreased sex hormones. If you have
less sex hormones, you don’t absorb
calcium and vitamin D.You lose calcium
from your bones, and then you run
into trouble. This applies to both men
and women, but because men are not
considered liable to get it, they’re often
not investigated,” she explained.
Prof O’Brien recommends that men
who have low levels of sex hormones
or who have had chemotherapy or
radiation should have a DXA scan.
In fact, every man should fill out a
risk factor questionnaire and if they
have one or more of the risk factors
associated with osteoporosis, they
should have a DXA scan, no matter
how old they are.
Increased awareness of the disease
in men will amount to a rise in the
number of men getting tested, and
a rise in the number getting tested
earlier.
Osteoporosis is treatable in the
majority of people, and the earlier it
is detected, the higher the chance of
success.
irishosteoporosisnews
speed yet. I have to take something for
pain on occasion when I am working.
9
eatingdisorders
Extreme
thinness
jeopardises
bone health
One woman in her 20s discovered that
her eating disorder had aged her bones
to that of a 70-year-old.
Olivia Fens reports
At every stage of life a nutritious,
balanced diet promotes strong, healthy
bones. A good diet includes sufficient
calories and adequate protein, fat and
carbohydrates, as well as vitamins and
minerals – particularly vitamin D and
calcium. In younger adults, a good diet
helps to build bone mass and strength.
However, for people with anorexia
nervosa (an eating disorder that affects
both men and women) restrictive
eating leads to malnourishment.
irishosteoporosisnews
People who are malnourished have
significantly lower than average bone
density (quantity of bone that indicates
bone strength) and are at an increased
risk of developing osteoporosis at an
early age.
10
For Dublin doctor, Ann Manley, her
teenage anorexia caused osteoporosis
at the age of 23. But it was a diagnosis
of osteoporosis that helped her on
the road to recovery from her eating
disorder, while at the same time
addressing her bone health before it
was too late.
“My mother had been diagnosed a
couple of years before me and I knew a
lot about osteoporosis being a medical
student at the time,” Dr Manley said.
“Actually, being diagnosed with
osteoporosis made me realise that it
wasn’t just my external appearance that
was being affected by anorexia, it was
my insides as well. And if my bones
were affected who knows what else
was going on inside my body.”
Dr Manley’s GP suggested a DXA scan,
which proved that her eating disorder
had done a great deal of damage.
“My bones were worse than my 70year-old mother’s bones at the time.
She had moderate osteoporosis and my
bones were worse than that, I wasn’t
expecting that. I thought my bone
mass might have been a bit low but I
didn’t expect full-blown osteoporosis.
So I think that gave me the shock and
incentive to actually turn things around
and to start eating again,” she said.
Dr Manley is currently working as
a hospital doctor in Waterford and
hopes to become a specialist in old age
medicine in the future.
Family history and genetics
Bone health is also largely dependent
on genetics. Therefore, if a parent has
osteoporosis their children are more
susceptible to developing osteoporosis
and fragile bones.
Dr Manley’s whole family had
been diagnosed with osteoporosis,
dramatically increasing her
osteoporosis risk.
“I would have eventually developed
osteoporosis more than likely because
my sister has it, mother, aunts and
granny have it,” she said. Her sister
was diagnosed in her late 30s but her
mother wasn’t diagnosed until the age
of 68.
She would not have expected to be
diagnosed at the age of 23, but her
eating disorder had brought it on
prematurely.
Osteoporosis in your 20s
People with anorexia have a low bone
density, so many will go on to have
fractures at a young age.
“Having osteoporosis in your 20s and
30s means a complete life change. I
have broken ribs coughing, and I broke
two bones in my foot while running for
a bus,” Dr Manley said.
“You can’t play contact sport and you
can’t go skiing. A lot of my friends
at the time were playing tag rugby
and there was a great social scene
connected to that and if you are in
eatingdisorders
“Now I do at least 30
minutes of walking a day, for
both my bone health as well as
my relaxation time – walking is
a great de-stressor.”
Recovery
At 29 years old, Dr Manley’s bones
are almost back to normal density. But
it has only been through recognising
her eating disorder that has led to her
bone recovery.
“My bones are almost back to normal
now and recovering from anorexia has
been the main step to improving my
bone density,” she said.
“Eating properly, getting my periods
back and taking calcium and vitamin D
supplements – all of those things helped
my bones.
“Obviously it was tough at the start,
but with time I stopped over-exercising
and started eating more. It took me
a couple of years to really make the
necessary changes.”
Dr Manley was also on the combined
oral contraceptive pill for a number of
years to raise oestrogen and to help get
her hormones back on track.
Anorexia and bones
Anorexia has a
number of
consequences
on the body
that can lead to
severe bone loss,
including:
Low hormones
Most women with anorexia
have low levels of oestrogen.
Oestrogen protects bone density,
and low levels can lead to a loss of
menstrual periods.
Oestrogen deficiency in younger
women contributes to bone loss in
much the same way that oestrogen
deficiency after menopause does.
Men with anorexia have very low
testosterone levels, which also affects
bone density.
Lack of nourishment
Because people with anorexia restrict
their food intake, their bodies lack
calories and protein. This leads to
malnourishment, causing the body
to produce high levels of the steroid
cortisol, which affects bone density and
scaffolding.
Lack of calcium
Calcium is the building block of bone.
Most people with anorexia limit or
exclude dairy products, resulting in
calcium deficiency.
Lack of vitamin D
Low levels of vitamin D affects calcium
absorption. It can also affect nerve and
muscle function. Therefore, low vitamin
D levels can indirectly increase bone
loss.
The future
The best time in life to ensure bone
health for the future is to start from
childhood.
Exercise and good nutrition, with plenty
of calcium-rich foods and enough
regular sunshine to maintain vitamin D
production, makes for
strong bones.
However, most people think that
osteoporosis only affects older
people. Besides genetics and diseases,
osteoporosis can affect people of all
ages for different reasons.
“I think raising awareness is essential
because if people know what
osteoporosis is, then they know that
it is preventable and treatable in most
cases. I think this type of awareness
may take the stigma away from
osteoporosis,” she said.
One way Ireland is raising awareness,
Dr Manley adds, is the introduction of
osteoporosis education to the school
curriculum.
Osteoporosis has been included in the
home economics and biology syllabus
for 2009.
Over-exercising
A lot of people with anorexia also
over-exercise which can lead to the
body switching off female/male
hormones.
irishosteoporosisnews
your early 20s
you want to
be a part of
it. But with
osteoporosis I
couldn’t go near
a tag rugby pitch.
11
childhood
Starting young
It has been said that osteoporosis is a
childhood disease that manifests itself in
adulthood. Joanne McCarthy reports
The more bone that gets laid down
in childhood, the less risk there is of
developing fractures later on.
According to Prof Moira O’Brien,
president of the Irish Osteoporosis
Society, the growth period between
the age of eight to 20 is extremely
important when it comes to
laying down bone and preventing
osteoporosis.
“All years are important when it comes
to osteoporosis, but of particular
importance are the growth years. The
age varies from child to child, but it’s
generally when they get the growth
spurt, in puberty and pre-puberty,” she
explained.
In those years, children need more
calcium, vitamin D and weight-bearing
exercise than at any other time. They
also need normal hormone levels and
adequate calories.
Calcium and vitamin D
Calcium is the most abundant mineral
found in our bones, helping to give
them strength and rigidity. The
recommended amount of calcium is
1,200 mg per day for boys and girls
aged 11-18, according to the Food
Safety Authority of Ireland.
This amounts to about one litre of milk
per day, but there are plenty of other
sources of calcium that can be enjoyed
if you don’t want to rely solely on milk.
The good news is that cheese and
yogurt are also great sources of
calcium, and even broccoli,
spinach, beans, oranges,
tofu, salmon,
whitebait, brazil
nuts and dried
apricots also all
contain calcium.
The really good
news is that ice cream and
even milk chocolate also count towards
a child’s calcium intake.
Vitamin D is needed to help the body
absorb calcium. The major source of
this is from sunlight on the skin, and
about 15 to 20 minutes of sunlight a
day during the summer months, before
putting on sunblock or makeup, is
adequate to enable the body to store
enough vitamin D.
much of
the wrong foods,
and then there are
those that don’t eat enough
for what they’re doing,” said
Prof O’Brien.
“Anorexia is becoming increasingly
common in that age group, and it’s
very worrying. Often, it means that
girls don’t get their periods when
they should, they don’t have normal
hormones, and they don’t lay down the
bone that they should. The trouble is,
you’re really paying for it for the rest of
your life,” she added.
Prof O’Brien believes that the media
may be playing an unhelpful role when
it comes to provoking eating disorders.
Teenagers constantly receive messages
that they are too fat, and that there’s
nothing wrong with being very thin.
Staying out in the sun for too long
can be dangerous, so it’s important to
maintain a healthy balance. Foods such
as fortified dairy products, margarine
and fish oils also contain vitamin D.
“The ‘size zero’ phenomenon is a
disaster. People don’t realise the effect
this weight loss has on their health.
People don’t realise how it can shape
their lives in later years,” she said.
Adequate calories
Taking adequate calories during this
growth period is essential to healthy
bones. Eating disorders, which
often develop in adolescence, can
have a detrimental impact on bone
development.
“It’s very hard for them to realise that
just before you get your period you
may put on a bit of weight. And it’s
helpful if you do.Your hormones need
a certain amount of weight. We’re
not talking about a lot of weight, but
the thing is if they are very thin their
periods will be delayed,” Prof O’Brien
added.
“Adequate calories depend on how
much exercise they do. There are two
extremes. There are those that eat too
Dairy products are often thought of as
irishosteoporosisnews
Investing in your bones at a young age
is the best way to prevent osteoporosis
later in life. With 60% of the bone a
person will develop being laid down
in childhood, there is never a more
important time to get active and look
after your calcium and vitamin D intake.
13
childhood
fattening, but Prof O’Brien is quick to
stress that they are not. Skimmed milk
has even more calcium in it than whole
milk, and super milk, which contains
added calcium and vitamin D, is low in
fat.
Children can develop it as a result of
being on steroids for treatment of
asthma or skin diseases, or from having
chemotherapy or radiation. However,
these are just a few of the many causes
of osteoporosis in children.
“You don’t get fat from drinking milk.
You’re far more likely to get fat from
eating excess junk food, like crisps,
burgers, and fries. Alcohol is also very
fattening,” she pointed out.
Prof O’Brien stresses that people with
coeliac disease and cystic fibrosis are
also at risk of developing it, and Ireland
has some of the highest rates of both
these conditions in the world.
“Bones also need protein, meaning that
people who are vegetarian during their
teenage years are also at increased
risk of developing osteoporosis,” Prof
O’Brien added.
However, osteoporosis is often not
detected in childhood, because there
are few warning signs.
Exercise
Weight bearing exercise describes any
activity you do on your feet that works
your bones and muscles against gravity,
stimulating growth and therefore
strength. Good bone-building exercises
include running, brisk walking, aerobics,
tennis, skipping, or even running up
stairs.
Weight bearing exercise is essential for
children to build healthy bones during
that important growth period.
irishosteoporosisnews
Prof O’Brien recommends that they get
at least 30 to 60 minutes of exercise
a day, but stresses that the exercise
doesn’t have to be done all at once.
14
“In Canada, they found that doing
jumps for five minutes in between
classes during the school year improved
children’s bone density by 5%.You
don’t need any equipment for that,
it’s a very simple idea. It’s not rocket
science, it’s very simple basic common
sense,” she said.
Osteoporosis in children
Osteoporosis can develop at any age,
including childhood. Bones are laid
down as early as when a child is in
utero, and there are even children that
are born with osteoporosis, according
to Prof O’Brien.
Prof O’Brien advises that if there is a
strong family history, or if they have
received treatment that may give rise
to osteoporosis, they should have a
DXA scan to see what their bone
mineral density (BMD) is, and assess
their risk of fracture.
“Explaining the DXA results to them
helps them to understand.You can
explain it to them, tell them what
the risk factors are, give them the
information, but they have to decide
what to do about it,” she said.
“We had one case where two parents
had osteoporosis and we tested
their three sons. The son that did no
exercise and didn’t drink any milk was
worse than his parents, and he was
only 17. It was only when we did the
DXA scan that we found this out.
“At that stage, he hadn’t broken
anything. But you don’t want
them to break anything.
Prevention is so
important,”
Prof O’Brien
explained.
Prof O’Brien
believes that
there is now an
osteoporosis
epidemic in this
country,
largely due to the lack of exercise
undertaken in schools and increased
amounts of physical inactivity, as
computer games and television shows
replace activities.
“Some schools have even used the
excuse that they could be sued, and
were using it as an excuse not to let
the children run in the playground.
Sometimes it’s easier to let kids sit
down and do nothing, but they pay for
it later on,” she explained.
“The essential thing is, if somebody
wants a good happy life, they need
to lay down healthy habits when
they’re young. That means regular
weight-bearing exercise – exercise
for everybody, it doesn’t have to be a
competition – and adequate nutrition.
“And if people have any problems, they
should seek help straight away, and find
out how they can correct them,” she
concluded.
Exercise, proper nutrition, calcium
and vitamin D not only prevent
osteoporosis, they also prevent
diabetes, coronary heart disease,
hypertension, and depression,.
The formula for healthy bones is so
simple and so cheap, yet its importance
cannot be underestimated.
Diet and
osteoporosis
Healthy eating is essential for healthy
bones. Bones are living tissue and
therefore need certain foods to stay
strong and healthy
• 50-55% carbohydrates: bread,
cereal, pasta, rice, potatoes, fruit and
vegetables
• 30% fat, which should be poly and
monounsaturated: low fat milk,
yogurt, low fat cheese
• 10-15% protein: fish, poultry and
some red meat
• 30 grams of fibre, from sources
such as wholegrain cereals, fruit and
vegetables
• At least two litres of fluid (preferably
water) a day.
A simple way to adhere to the above is
to follow the Department of Health’s
food pyramid. Even if you are trying to
lose weight, it is essential to have a diet
containing sufficient calories, protein,
fat and carbohydrates as well as calcium
and vitamin D.
Calcium and vitamin D are essential
nutrients in the prevention and
treatment of osteoporosis. Both help to
prevent as well as treat osteoporosis,
in tandem with appropriate weightbearing/strengthening exercises and a
suitable osteoporosis medication.
Substantial clinical evidence
demonstrates that low calcium and
vitamin D intake or poor absorption
are linked to an increased risk of hip
fractures in the elderly. It is therefore
essential that older people get their
daily amount of calcium and vitamin D,
preferably in their food. If this is not
possible, supplements are available.
tinned fish also contain calcium, as do
some dark green vegetables. Some
brands of orange juice and most
breakfast cereals have added calcium.
Mineral water can often contain
calcium, but check the details on the
label as the amounts can vary.
Calcium
Calcium is the most abundant mineral
found in our bones and helps to give
bones strength and rigidity. Every cell
in our body, including those in the
heart, nerves and muscles, rely on
calcium.
Calcium alone is not enough to treat
bone loss, and is not a substitute for
osteoporosis medications that treat
bone loss.
It has been said that osteoporosis is
a childhood disease that manifests
itself in adult years. As children, it is
necessary to grow a strong healthy
skeleton that will last a lifetime.
Typically we reach our peak bone mass
by age 25 to 30, and the density of our
bones will depend in part upon the
calcium and vitamin D in childhood
and teen years.
Calcium is also particularly important
at the time of menopause, because
calcium absorption slows down, due to
low levels of oestrogen.
Studies in older adults shows that
adequate calcium intake and vitamin D
can lower the risk of fracture.
You need to ensure that the food you
eat is rich in calcium. Calcium is best
absorbed from dairy products. The best
sources of calcium are milk, cheese
and yoghurt. Bread, almonds and
Teenagers and pregnant women
require 1,200mg/day of calcium and
will need at least five servings per day
to get the recommended daily intake.
The servings below each contain
between 250 and 300 mg of calcium.
• A glass of milk. ‘Fortified milk’ is
fortified with added calcium and
vitamin D and is low fat
• A matchbox-sized piece of low fat
cheese
• A carton of low fat yoghurt
Calcium supplements
To avoid constipation problems while
taking calcium supplements, make sure
to take plenty of fluids throughout
the day (two litres is recommended,
preferably water). Always consult
your doctor before taking any new
medication or supplement.
Vitamin D
Vitamin D is often referred to as the
‘sunshine vitamin’. It is critical for
irishosteoporosisnews
A well-balanced diet should contain
a variety of foods which provide
adequate calories. These should be
made up of:
15
irishosteoporosisnews
nutrition
16
calcium absorption as it increases the
body’s ability to absorb calcium by 30
to 80%.
Remember also to take plenty of fresh
fruit and vegetables that contain other
vitamins and minerals.
thumb when eating high fibre foods
is to include extra calcium, that will
balance the inhibiting activity.
The most important source of vitamin
D is from the action of sunlight on
the skin. About 15 to 20 minutes of
sunlight on the face and arms every
day during the summer months will
enable the body to store vitamin D.
However, it is very important to avoid
over-exposure resulting in sunburn,
due to the damaging effects of the
sun, especially in terms of skin cancer.
Wearing sun block continuously will
stop vitamin D absorption.
Caffeine
Excessive intake of caffeine can
contribute to calcium loss through the
kidneys. Caffeine is contained in coffee,
tea, chocolate, stimulant drinks and
cola-based soft drinks. Decaffeinated
beverages are recommended as a
substitute or alternatively, adding extra
calcium to counteract the effect of the
caffeine. Choosing lattes, cappuccinos
or hot chocolate made with milk will
also help boost calcium intake.
Vegetarians/vegans
Vegetarians with a low intake of
calcium, as well as vegans, need to
calculate their average daily intake of
calcium from food sources and may
have to maximise their intake by taking
a calcium supplement.Vegans should
use milk substitutes that are fortified
with calcium like soya and rice milk. A
vitamin D supplement should also be
taken if intake is low.
Vitamin D can also be found in some
foods. Fish oils and species of fish such
as salmon, tuna, sardines, mackerel,
halibut and herring are all excellent
sources of vitamin D. Eating oily fish
once a week should meet your vitamin
D requirements.
Magnesium
Magnesium is often combined
with calcium in supplements, even
though it is not necessary for calcium
absorption. It can however counteract
the constipating effect some calcium
supplements can have.
Other dietary sources include dairy
products, margarine, eggs and chicken
livers. A lot of milk products and
margarines are fortified with vitamin
D, but check labels for specific nutrient
information. Breakfast cereals, soya
milk and rice milk may also be fortified
with vitamin D. Individual brand labels
show detailed nutritional information.
Protein
Protein is necessary for building and
repairing all body tissue. Protein foods
(meat, fish, poultry, eggs, diary and
some legumes such as peas, beans,
and lentils) contain amino acids that
are building blocks for repair and
maintenance. Note that the amino-acid
profile of vegetarian sources of protein
are not as good, and many vegetarians
therefore do not consume enough
protein. A lot of women and seniors
also do not consume enough protein
daily.
Vitamin D supplements
People who may become deficient in
vitamin D, such as senior citizens living
in nursing homes who rarely spend
time outside, require supplements of
vitamin D and calcium. If you do not
like eating oily fish a supplement may
be recommended. Always consult
your doctor before taking any new
supplements.
How much do I need?
About 10ug or 800 international units
(iul) is the recommended dose of
vitamin D for adults and children. The
upper limit of vitamin D is not well
established, but medical supervision is
recommended at doses greater than
30ug per day.
High fibre foods
High fibre foods such as cereals
and legumes contain phytates and/
or oxalates that hinder absorption
by binding with calcium. Although
vegetables such as spinach, rhubarb and
beet greens are nutritious foods, they
are not considered a good source of
calcium.
Wheat bran can also inhibit
absorption. Oat bran does
not have the same inhibiting
effect. A good rule of
Coeliac
People with coeliac disease
have problems with calcium
absorption. If you have
symptoms such as
diarrhoea with foul odour,
stomach pain and
bloating, constipation,
chronic tiredness,
anaemia, chronic
mouth ulcers,
indigestion,
bone pain,
moodiness or
depression
you may
need
nutrition
DXA scanning
If you have one or more risk factors
for osteoporosis, we recommend that
you speak to your doctor about your
risk of breaking a bone. A DXA scan of
your spine and hips is the gold standard
for diagnosing osteoporosis and is
highly recommended if you are at risk.
Otherwise you will not know whether
or not you have osteoporosis as it is a
silent disease. Based on your results,
you can then help prevent its onset or if
you have osteopenia/osteoporosis, you
can prevent further deterioration and
increase your bone strength.
For further information
please contact the Irish
Osteoporosis Society at
Lo-call 1890 252751 or
www.irishosteoporosis.ie
More details on nutrition
are available at
www.indi.ie
How much calcium do I need?
Adults (men) 800 mg per day
Adults (women) 800 mg per day
Pregnant women (second half)* 1,200 mg per day
Breastfeeding women (first 6 months)* 1,500 mg per day
Children (1-10 years) 800 mg per day
Teenagers (11-18 years)* 1,200 mg per day
* Teenagers and pregnant/breastfeeding mothers may need to increase to
1,500 mg calcium per day if they have osteopenia or osteoporosis
An indication of the calcium content in everyday
foods. Choosing calcium rich foods will help maintain
a healthy skeleton
Food
Whole milk
Semi-skimmed milk
Skimmed milk
Soya milk
Goat’s milk
Low-fat yoghurt
Cheddar cheese
Cottage cheese
Boiled broccoli
Baked beans
Large orange
Dried apricots
Brazil nuts
Whitebait(fried)
Salmon(tinned)
Tofu
Milk chocolate
Ice cream
Weight
Calcium (mg)
190ml
190ml
190ml
190ml
190ml
150g
28g
112g
112g
112g
1g
100g
100g
56g
56g
100g
56g
112g
224
231
235
25
190
225
202
82
45
59
58
170
170
482
52
480
123
134
irishosteoporosisnews
to be checked for coeliac disease. Seek
medical advice.
17
exercise
Exercise keeps heart
and bones strong
Exercise is not only important in the
prevention of a number of diseases
including heart disease, diabetes and stroke,
it is also an essential part of keeping bones
healthy and strong. Olivia Fens reports
The importance of exercise for
maintaining strong, healthy bones
cannot be underestimated.
Exercise can help to build bones in
youth – and it can also help to maintain
them in adulthood.
Bones need regular weight-bearing
exercise. Exercise stimulates bone,
creating bone turnover, growth and
strength.
Weight-bearing exercise includes any
physical activity where you have to
support the weight of your own body.
These weight-bearing exercises include:
irishosteoporosisnews
• Dancing
• Running
• Walking
• Jogging
• Aerobics
• Tennis
• Squash
• Football.
18
While cycling and swimming are
excellent activities for overall
fitness they do not benefit
bone strength as they are
not weight-bearing.
President of the Irish
Osteoporosis Society, Prof Moira
O’Brien, recommends 30 minutes of
daily weight-bearing exercise for all age
groups, including senior citizens.
This type of daily exercise is incredibly
important for children as most peak
bone mass building is done during
adolescence, Prof O’Brien said.
“The most important age for people to
exercise is during the growth period,
from eight to 20 years. Sixty per cent
of the bone you are going to have
throughout your life is laid down at that
time,” Prof O’Brien said.
“Unfortunately, computers and handheld games are very popular for people
in that age group, and they often
choose them over playing outside.
“A study in Canada found that
students who did jumping jacks for 10
minutes every day improved their bone
density significantly,” Prof O’Brien
added.
But it’s not just children who need to
do daily weight-bearing exercises.
Prof O’Brien said even older people
need at least 30 minutes of weightbearing exercise each day.You can even
break this exercise up into three to five
minute intervals over the course of the
day.
“Walking is a weight-bearing exercise,
but you need to alter speeds (eg. brisk
two minutes, moderate one minute,
brisk two minutes, etc). However, you
need good balance to do this,” Prof
O’Brien said.
“Dancing is a great weight-bearing
exercise for all age groups. There are
also certain exercises that can be done
sitting or lying down.
“Walking waist-deep in a swimming
pool is good for people with arthritis.
Gravity is reduced and the resistance
from the water is great for muscles
and bones. It can improve strength and
endurance and it means there’s a lot
less stress on the bones. It is modified
weight-bearing and it is a great form of
exercise which can be combined with
weight-bearing exercise.”
Exercise awareness
Last year, the UK’s National
Osteoporosis Society surveyed
more than 2,600 people, and
found that only 44% of the
people questioned could
identify walking as being
beneficial for bone strength.
Less than a quarter of
exercise
The survey added that knowledge of
how to reduce the risk of osteoporosis
through exercise was lowest among
18 to 24 year olds. More than half of
young people in this age group did not
think that exercise played a role in
reducing the risk of osteoporosis.
International studies
The IOF reports that a Finnish study
of teenage girls found that those who
were the most physically active gained
40% more bone mass than the least
active girls.
International research also showed
that older people benefited from
weight-bearing exercise and could
actually reduce the risk of a fracture
(breaking a bone).
A study in the US and Japan, found that
older, postmenopausal women, who
used small weights to strengthen their
back muscles over a period of two
years, were less likely to get vertebral
fractures. In fact the back strengthening
exercises reduced the chance of
getting a fracture by almost threefold.
In the women aged 58 to 75 years,
only one in 10 of those who exercised
were found to have a vertebral
fracture, while almost one-third of the
women in the group that had not used
the exercise regimen had suffered a
fracture.
Women who had not taken part in
the back exercise programme were
also about twice as likely to have a
compression fracture in the spine. This
can lead to a hump developing on a
person’s upper back, a very painful
condition which increases the risk of
falling.
Don’t overdo it
While exercising is important, it is also
possible to exercise too much, which
can affect hormone levels and worsen
bone mass:
• Women and teenage girls who
exercise to an extreme degree
with inadequate calories can
develop amenorrhea (cessation of
menstruation) due to oestrogen
deficiency
healthy bones, it was only one of four
essential steps to good bone density:
• The bones need regular weightbearing exercise – consider brisk
walking, jogging or weight training
• The bones need adequate calories – a
healthy diet rich in calcium and vitamin
D is essential for healthy bones
• Bones need normal hormones levels
– excessive exercising and stress can
affect sex hormone levels, which
can lead to an increased risk of
osteoporosis
• Protein – bones need protein (from
meat and dairy products). Also
excessive fibre (vegetarian and vegan
diets) can affect hormone levels.
• Preoccupation with exercise can be
a sign of an eating disorder, such as
anorexia or bulimia
Additionally, too much alcohol, smoking
and too much caffeine can all have
detrimental effects on bone density.
• Both male and female athletes who
exercise excessively without adequate
caloric intake are at a heightened risk
of osteoporosis. Athletes who train
hard while trying to keep their weight
below a certain level for competitive
reasons are at particularly high risk
Prof O’Brien added that if you have
already been diagnosed with low bone
density, it is essential to determine and
treat the cause/causes.
• Too much exercise can result in stress
fractures or joint damage.
Key things to remember
Exercise is not only essential for
building bone strength in young
people, it can also play a crucial role
in rehabilitation. Exercise can help to
rebuild bone in those who have already
developed osteoporosis, and it can also
provide relief from osteoporosis pain.
Prof O’Brien said that while exercise
was crucial to maintaining
Prof O’Brien concluded: “You have to
commit, making exercise part of your
daily routine. The most important thing
is that doing exercise is just as effective
inside the house as it is outside.”
The advice of the Osteoporosis Society
is to pick an exercise you enjoy doing,
and you’re more likely to continue with
it. Doing a mix of different exercises is
ideal.
irishosteoporosisnews
people thought that dancing could
be beneficial to bones, and only 18%
recognised that running could help
to reduce the risk of osteoporosis.
However, in the survey, 46% of
participants believed that swimming was
beneficial in preventing osteoporosis.
19
queries
Questions and
answers
Your queries addressed by
Prof Moira O’Brien
What is osteoporosis?
Osteoporosis is a silent disease that
affects the strength/thickness of bones.
It makes the bones more fragile and
is often not diagnosed until a fracture
(broken bone) or multiple fractures
have occurred.
What is osteopenia?
Osteopenia is the early stage of
osteoporosis. Having osteopenia
places a person at risk of developing
osteoporosis. A diagnosis of osteopenia
is a warning that you must start taking
care of your bones and that prevention
methods need to be put in place. The
risk factors for developing osteopenia
are the same as for osteoporosis.
How can a person know if they
have osteoporosis?
irishosteoporosisnews
A person will never know if they have
osteoporosis unless they have a DXA
scan of their spine and hips. Signs and
symptoms include breaking a bone from
a trip and fall from a standing position
or less, losing more than 2cm of height,
developing a hump on the upper back,
or experiencing sudden severe back
pain.
20
I think I may have osteoporosis –
how is it diagnosed?
The first thing to do if you suspect
that you have osteoporosis, or if
you feel you may have a chance of
developing it, is to fill out a risk factor
questionnaire, available on the Irish
Osteoporosis Society’s website at
www.irishosteoporosis.ie, and bring it
to your doctor. Speak to your doctor
about your risk of fracture and discuss
whether you need a DXA scan. This is
a particular type of bone scan which
can be carried out to measure the
density of the bones. It is a simple,
painless procedure.
I have asthma and eczema, could
my medication increase my risk
of osteoporosis?
Some asthma and eczema treatments
contain glucocorticoids, which while
helpful in treating your condition, could
also cause bone loss and increase the
risk of developing osteoporosis.
The risk of osteoporosis depends
on the dose of glucocorticoids and
the length of treatment. However,
the exact dose needed to cause
osteoporosis is not yet clear.
Glucocorticoids taken in an inhaler for
asthma, or in a cream applied to the
skin for conditions such as eczema,
rather than as tablets, means that
much smaller doses can be used, and
this reduces the risk of osteoporosis.
The larger the area treated for eczema
patients, the larger the steroid dose
required.
What is hyperthyroidism and
does it cause osteoporosis?
The thyroid gland in the neck produces
hormones that regulate the speed
at which our body cells work. If
the thyroid gland is overactive and
thyroid hormone levels are high,
hyperthyroidism occurs.
Hyperthyroidism can cause problems
including weight loss, anxiety,
palpitations and
eye problems.
It may develop
due to enlarged
thyroid nodules or an
autoimmune disease, where the
body’s immune system attacks its own
tissues.
Excess thyroid hormone hastens the
rate of bone turnover. If this process
is happening too rapidly the bonebuilding cells may not be able to
replace bone fast enough, thus the
overall rate of bone loss is increased.
If the thyroid hormone level stays too
high for too long, there may be an
increased risk of developing
osteoporosis.
How does
coeliac
disease affect
the risk of
osteoporosis?
One of the most
common long-term
problems associated with coeliac
disease is osteoporosis. One recent
study showed that half of people with
the coeliac disease had low bone
density. A UK osteoporosis clinic found
that 6% of men with osteoporosis had
an undiagnosed absorption disease.
The reasons why those with coeliac
disease have a lower than average bone
density include the poor absorption of
calcium, especially in early life.
This may mean that bones fail to reach
peak strength. Calcium malabsorption
queries
A strict gluten-free diet can
significantly improve bone strength,
especially in the very young and for
those who had the lowest bone
density results to start with.
Early diagnosis and treatment of coeliac
disease gives a person the best chance
of reducing their risk of osteoporosis.
Some studies have shown that those
with coeliac disease still have lower
than average bone density despite a
strict gluten-free diet.
There are, however, few studies of
children and one showed near normal
bone density for those on a strict
gluten-free diet.
Adequate calcium in the diet is
important to maintain healthy bones.
Current guidance for adults with coeliac
disease is 1,000mg of calcium per day.
For post-menopausal women and
elderly men a higher intake of 1,2001,500mg daily has been recommended.
I am taking the contraceptive
Depo Provera, should I be
concerned about osteoporosis?
Depo Provera lowers oestrogen levels,
so in theory, bone loss may occur.
However, there has been no conclusive
research to show that having low
oestrogen whilst on Depo Provera
causes a reduction in bone density.
The World Health Organisation
(WHO) has suggested that Depo
Provera should be used with caution by
women who are under 18 (when bone
density is being built up rapidly) and in
women over 45 (who are approaching
menopause). However, even in these
age groups, the advantages of using
Depo Provera will generally outweigh
the disadvantages, according to the
WHO.
If you are concerned about this topic,
speak to your GP.
I was diagnosed with
osteoporosis a year ago and it
was recommended that I take
an osteoporosis medication. I did
not take the medicine, as I don’t
like to take pills. I have increased
my calcium and vitamin D intake
and I do weight-bearing exercise
every day.
Is this enough to prevent it from
getting worse?
No. It is very important that you take
your osteoporosis medication, along
with calcium, vitamin D and weightbearing exercise and that you get rescanned every two years.
It is the combination of all three that
can help prevent your osteoporosis
from declining.You were put on the
medication because you needed to
protect your bones.
Undiagnosed osteoporosis or not
taking your recommended medication
can lead to multiple fractures, becoming
wheelchair bound and possibly dying
prematurely, which can happen due to
the secondary effects of osteoporosis.
My local chemist is advertising
that they do ‘bone density’
testing. My friend got one done,
they only tested her heel and told
her that their machine was just as
accurate as the DXA test for the
spine and hips, is this true?
We do not recommend it for the
diagnosis of osteoporosis. Most of these
machines are ultrasound machines
which can not measure bone density.
Heel scan testing uses an ultrasound
machine which measures the speed
at which the sound waves travel. If a
person has flat feet, as many women
over 40 do, they are usually told they
have good bone density.
The IOS does not recommend any
type of heel scan testing for the
diagnosing of osteoporosis.
I was diagnosed with osteoporosis
from an x-ray, do I need a DXA
scan?
Yes, unless you are
bed bound or
unable to lie still for
approximately eight
to 10 minutes. If you
do not know the exact
state of your bones,
you will not know if your
bones are improving or your
response to the treatment. People
usually are scanned every two years,
if access is available and preferably on
the same machine. In the majority of
cases, a change will not be seen in one
year.
I have been told that I have
osteoporosis, but I am only
twenty-five years of age. I have
always eaten healthily and
exercised and do not know how
I got it. I thought it was an old
woman’s disease?
Osteoporosis can affect men, women
and children of all ages and due to the
increase in osteoporosis awareness,
more people from all age groups are
being diagnosed.
If you fill out our risk assessment form
and bring it to your doctor, they should
be able to help figure out why you
developed it, as it is essential that the
cause or causes be found and addressed.
I had a DXA scan three years and
was told that I did not have to
get re-scanned. How do I know I
am improving if I do not get rescanned?
When possible you should be rescanned every two years, to monitor
your response to treatment and
your results should not decline. If
your results do not improve you
should speak to an
osteoporosis
specialist, so they
can figure out
why you have
not improved.
irishosteoporosisnews
can speed up the process of bone
renewal or bone ‘turnover’ and lead
to osteoporosis.Vitamin D absorption,
which is needed to absorb calcium into
bones, may also be affected by coeliac
disease.
21
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The Irish Osteoporosis Society is a
charitable organisation and relies on
donations to continue our activities.
These activities include:
About the Irish Osteoporosis Society
The Osteoporosis Society (IOS) was founded
by Professor Moira O’Brien in 1996 as a patient
support organisation for those suffering with
Osteoporosis and their families.
caption
From the outset, the IOS has beenPhoto
dedicated
to reducing the incidence of osteoporosis, a
preventable bone disease in most cases, and
promoting bone health.
The IOS provides information to the public and
health professionals on all aspects of the disease
and offers support to those with osteoporosis or
at risk.
Aims
• Increase the awareness of the problem of
osteoporosis in Ireland
• Significantly decrease the number of people
affected by osteoporosis
1. Helpline – The IOS operates a Patient Support
Helpline which is open from 9am to 5pm Monday
to Friday.
2. Press and advertising for promotion campaigns.
3. Literature and promotional materials. The IOS
distributes osteoporosis information (leaflets,
books, posters etc.) to IOS members, members
of the public, GPs, nurses, physiotherapists, other
health professionals, HSE staff, clinics etc.
4. Website – the IOS website is a comprehensive
source of information for both the public and
health professionals.
5. Bi-annual magazine.
6. Public Lectures – Our Health Promotion
Officer delivers osteoporosis information seminars
in locations around the country throughout the
year.
7. Schools Information DVD / Workbook /
Powerpoint presentation – We have produced
an osteoporosis / bone health information DVD
targeted at secondary school pupils along with an
accompanying workbook for schools.
• Provide support, advice and information for
people suffering from osteoporosis
8. Awareness Groups – The IOS has begun the
process of establishing a national network of
osteoporosis awareness groups.
• Establish a network of osteoporosis
awareness groups
9. Annual Medical Conference – The IOS hosts an
international medical conference on osteoporosis
(for health professionals) each year in October.
• Distribute up-to-date information to doctors
and healthcare workers on current methods of
prevention and treatment
• Encourage research into this area in Ireland
10. Patient advocacy. The IOS regularly meets
with government bodies and TDs to discuss policy
relating to osteoporosis and to brief them on
issues and requirements in the prevention and
treatment of the disease
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osteoporosisnews
osteoporosisnews
To find out more or to make a donation, visit our
website at www.irishosteoporosis.ie or phone
us at 1890 252751
sample literature
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IOS membership Form
Headline
Personal Details
There
is only a slight
Name:
Organisation (iffor
relevant):
modification
this,
Address
1:
writes
Joanne
McCarthy
Address 2:
Town:
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County:
Telephone:
Mobile:
Email:
How did you hear about the IOS?:
Membership Details
(Please tick
)
Type of membership: Charity membership: Health care professional: New
Renewal
€25
Photo caption
€40
In addition, I would like to make a donation to the Irish Osteoporosis Society in the amount of:
€5,000
€1,000
€500
€100
€50
€25
€10
Other €_______
Payment Details
Cheque
Postal order
Visa
Mastercard Laser
Card Number
Expiry Date
Total Amount (membership plus donation, if any): €________
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Please send completed form to:
Irish Osteoporosis Society,
12 Burlington Road (garden level),
Ballsbridge,
Dublin 4
or alternatively call at 1890 252751
or fax us at 01- 6351698
with your credit/debit card details.
osteoporosisnews
osteoporosisnews
Your details will not be passed on to anyone else without your permission
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The Irish Osteoporosis Society thanks the following
for supporting this issue:
Ireland (Human Health) Limited