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Osteoporosis: Nature, Nurture and Navigating Risk

Osteoporosis is a condition that weakens bones, making them fragile and far more likely to break. It is more common than you might expect. The NHS cites over 3 million people in the UK are affected and states half of women over 50 years and one third of men over 60 years of age will have a low trauma fracture due to osteoporosis. Despite this, it is often not picked up until someone suffers a fracture. For this reason, it is known as the ‘silent disease’ as it usually does not make itself known until it is well established in the bones.

What causes osteoporosis – nature or nurture?

It’s true to say that both our genetic make-up and our lifestyle choices can play a big part in someone developing osteoporosis.  It’s important to explore the interplay of nature and nurture in the development of the disease: hereditary risk factors along with common diet and exercise misconceptions can all contribute to this condition. Here we look at the risks you’re born with (nature/hereditary) alongside the risks you can control (nurture) to reduce your chance of developing osteoporosis.

Nature: The Role of Genetics

There is no getting away from the fact your genetic makeup plays a significant role in determining your level of risk of developing osteoporosis. If you have a family history of the condition your risk increases. Certain genetic factors can influence your bone density, bone structure and the ability of your body to absorb and use the mineral calcium and vitamin D.  And if your body is struggling to absorb either or both of these, that’s problematic as they work together, with collagen, to play a key role in keeping your bones healthy. Furthermore, if you’re petite and have a slight frame, your bones are smaller and more prone to being fragile.

It’s not pre-ordained

While you can’t change your genetic makeup, having a good understanding of your family history can help you be proactive. You can take steps to manage and reduce your risk and stay alert to any signs or symptoms.

Nurture: Lifestyle Choices and Osteoporosis

  1. Dietary Mistakes

Insufficient Calcium and Vitamin D

The mineral Calcium is essential for building and maintaining strong bones and vitamin D helps your body absorb the calcium. As such, a diet low in these nutrients runs an increased risk of leading to bone weakness.

Eat calcium-rich foods, such as:

  • dairy products
  • leafy green vegetables
  • fortified foods (products which have extra fortification will say so on the labels)

For increased vitamin D levels:

  • safe exposure to sunlight – 20 minutes a day in the summer is recommended but as too much exposure is very harmful to the skin and protective suncream blocks the vitamin D from getting through, it’s best to consume vitamin D through food and supplementation

Eat foods to boost vitamin D, such as:

  • fatty fish
  • egg yolks
  • fortified products – again, the labels state this


These are readily available but should be approached with care in respect of calcium as you can have too much of a good thing! Excess calcium in the body can be stored in your arteries – which is far from healthy!

If you follow a healthy diet your calcium levels may well be good enough. Your vitamin D levels are more likely to need topping up (and carry less risk if you have too much!)

Supplements to boost your level can be beneficial – but don’t exceed the RDA (Recommended Daily Amount).  If in any doubt, consult with your GP or nutritionist.

Avoid Too Much Alcohol and Caffeine

The old adage, ‘a little of what you fancy does you good’ is particularly pertinent in this case.  You should limit your alcohol intake to no more than one drink a day for women and two for men.  Keep your caffeine intake to two or three cups a day.

Reason being, high consumption of alcohol and caffeine can interfere with calcium absorption, which will contribute to bone loss.

  1. Exercise Errors

Lack of Weight-Bearing Exercise

Regular physical activity is very important.  You should look to stimulate bone growth and strength by engaging in activities where you’re putting your body weight through your bones such as: walking, running, dancing, body weight exercises (squats, plank, lunges). Also lifting weights such as dumbbells and kettlebells make the muscle pull on the bones to stimulate a strengthening response.

Important note! Cycling and swimming, while great forms of exercise for your heart, mind and weight management, are NOT beneficial to bones as your body weight is supported by the bicycle or water respectively so it’s not going through your bones!

As in any scenario where you undertake a change of lifestyle, you should always check with your GP before starting a new exercise regime.

Avoid Overdoing It or Adopting Incorrect Techniques

Getting the balance right is essential.  The case for moderation is also important with exercise regimes.  This is especially important if you are new to such activities, as excessive exercise or improper techniques will increase the risk of fractures and bone damage – the very thing you are trying to avoid.

Ensure you’re following a balanced exercise regime and seek guidance from a fitness professional if you have any uncertainty about what you are aiming to do.  Group fitness classes are a great way to get started!

Hereditary Risk Factors and Prevention

As already said, your genes play a role but there are several things you can do, in addition to those outlined above, to further reduce your risk:

  1. Know Your Family History

If osteoporosis runs in your family, you do need to discuss this with your doctor. It is possible that they will recommend earlier, or more frequent, bone density tests.

  1. Bone Density Testing

Regular bone density tests (which are non-invasive) can help detect osteoporosis before a fracture occurs, especially if you have a family history or other risk factors.

In conclusion, while the nature aspect – your genetic makeup and family history – could set the stage for your risk of osteoporosis, the way you nurture yourself though good lifestyle choices can play a critical role in managing and, potentially, reducing that risk.

Stay alert to how you’re feeling, make healthy diet and lifestyle choices and consult with healthcare and exercise professionals to ensure you’re doing everything you can to protect your bones.