Bone health and falls

Keeping your bones healthy can make a big difference to the effect of a fall. If your bones are strong, the potential for a fall to cause serious damage – such as a broken hip or shoulder – is greatly reduced.

What can I do?

Calcium

Calcium is a mineral needed by your body to maintain healthy bones and teeth. As your body cannot produce calcium, you absorb it from the food you eat. The government recommended that adults over the age of 50 eat 700 mg of calcium a day to meet their daily requirement.

Dairy foods – such as milk, yoghurt and cheese – are good sources of calcium. Small amounts of calcium can also be found in:

• green leafy vegetables – such as broccoli, cabbage and okra but not spinach
• soya beans and tofu, or soya drinks with added calcium
• nuts, particularly almonds
• bread and anything made with fortified flour
• fish where you eat the bones – such as sardines and pilchards
• water

Try to avoid excessive amounts of caffeinated drinks – such as tea, coffee and fizzy drinks – as they can prevent the body absorbing calcium.

Dairy foods

Dairy foods are an excellent source of calcium but tend to be higher in saturated fats. To keep a healthy balance:

• choose lower fat options – such as semi-skimmed milk and low fat yoghurt
• try eating a smaller piece of a stronger flavour cheese rather than a large piece of a milder cheese
• grate rather than slice cheese for sandwiches as it encourages you to use less
• aim for 2 to 3 servings a day – a serving is a small matchbox size piece of cheese, one medium low-fat yogurt or a glass of milk

Vitamin D

You need vitamin D for healthy bones as it helps your body absorb calcium from the food you eat.

Your skin makes most of the vitamin D your bodies need from sunlight. Most people in the UK get enough vitamin D by exposing their hands and face to the sun for 10 minutes, one or twice a day (depending on skin type). This has to be without sunscreen and taking care not to burn. For most people, normal levels built up in the summer will be enough to last through the winter. If you struggle to get out and about, your GP might recommend vitamin D supplements.

You can also get a little vitamin D from fish like grilled herring and tinned pilchards in tomato sauce, but you’ll not be able to get all the vitamin D you need from food alone.

Learn more about vitamins

Keeping active

To maintain healthy bones you need to keep active and do plenty of weight-bearing and muscle-strengthening exercise. As well as being good for bones, regular exercise can also:

• benefit your heart and circulation
• improve mood and contribute to overall wellbeing

Swimming and cycling are good for overall health and fitness and can help keep joints flexible. Swimming and hydrotherapy can also be relaxing and help relieve pain in people with osteoporosis or fractures. These types of exercise aren’t weight bearing so won’t improve bone density so effectively.

If you’ve been diagnosed with osteoporosis, it’s a good idea to talk to a physiotherapist or exercise specialist before starting a new exercise programme, to make sure it’s right for you.

Weight-bearing exercises

Weight-bearing exercises are exercises where you support the weight of your body through your arms, legs and spine. These exercises can be either high or low impact:

• high impact – these place the greatest stress on your bones but may not be suitable if you have osteoporosis or aren’t used to exercising. Examples of high impact exercises include high-impact aerobics and jogging or running
• low impact – these place less stress on your bones but are still great ways to maintain bone strength. Examples of low impact exercises include tai chi, ‘low impact’ exercise classes and walking

Muscle-strengthening exercise

As well as weight-bearing exercises, you should also attempt muscle-strengthening exercises at least 2 times a week to keep your bones strong. These exercises are designed to work your muscles against resistance and can be done at home, or at your local gym.

Learn more about keeping active and exercise

Alcohol

Like caffeinated drinks, alcohol prevents the body absorbing calcium from the foods we eat. Drinking regularly to excess can weaken the bones, increasing the risk of a break (also called a fracture) after a fall. 

The Chief Medical Officers’ guidelines for both men and women are:

• To keep health risks from alcohol to a low level it is safest not to drink more than 14 units a week on a regular basis.
• If you regularly drink as much as 14 units per week, it is best to spread your drinking evenly over 3 or more days. If you have 1 or 2 heavy drinking episodes a week, you increase your risks of death from long term illness and from accidents and injuries.
• The risk of developing a range of health problems, including cancers of the mouth, throat and breast, increases the more you drink on a regular basis.
• If you want to cut down the amount you drink, a good way is to have several drink-free days each week.

Find out if you are drinking too much through Drinkaware

Smoking

Smoking affects how well the bone building cells in your body work. Recent studies have shown a direct relationship between tobacco use and decreased bone density, leading to an increased risk of developing osteoporosis.

In women, it can also cause an earlier menopause – increasing the risk of osteoporosis and breaking a bone.

Giving up smoking won’t just benefit your bones, it’ll also help your heart, lungs and overall fitness and wellbeing.

Osteoporosis

Osteoporosis is a common condition that affects bones, causing a reduction in bone density. Having osteoporosis doesn’t automatically mean that your bones will break (fracture), but it does mean that you’ve a higher chance of breaking a bone if you have a bump or fall.

There are usually no warnings you’ve developed osteoporosis and it’s often only diagnosed when a bone is fractured after even minor falls.

Wrist fractures, hip fractures and fractures of the vertebrae (bones in the spine) are the most common type of breaks that affect people with osteoporosis. However, they can also occur in other bones – such as in the arm, ribs or pelvis.

If you’ve had a broken bone following a simple slip or trip, speak to your GP or other health professional about your bone health.

Learn more about osteoporosis

Broken hips (hip fractures)

Hip fractures are cracks or breaks in the top of the thigh bone (femur) close to the hip joint and are normally the result of a fall. You’re more at risk of breaking your hip if your bones are weak due to osteoporosis.

A hip fracture is a serious injury and almost always requires treatment with surgery.

Hip protectors

If you’re at high risk of falling and breaking a bone, hip protectors can be worn to cushion the force of a fall.

They usually come in the form of hip protector pants, consisting of 2 protective shells or pads built into specially designed underwear. The shells should cover your hips and absorb or divert the impact of a fall to prevent a broken hip.

Guidance from NICE about hip protectors suggests that they may be effective when used by frailer older people living in care homes. It’s less clear how effective hip protectors are for people living in their own homes.

Where to start

Think about how you currently look after your bones:

• what positive things do you currently do to keep your bones healthy?
• what changes can you make that might help?
• how will you make these changes?
• who do you need to talk to?

Help and support

The Royal Osteoporosis Society works to improve the diagnosis, prevention and treatment of osteoporosis. To speak to a trained nurse about osteoporosis, phone their helpline on 0845 450 0230 (Monday to Friday 9.00 AM to 5.00 PM).