Staying healthy as we age – avoiding osteoporosis, sarcopenia and hip fractures…

I’m crossing the boundary into nutritional therapy (the other hat that I wear – see www.marieperezwellness.com) with this post, which was prompted by a family incident. My elderly father fell recently and has since been experiencing some neck and upper back pain. He was MRI’d at the hospital; the outcome was that he had some stenosis (narrowing of the “passageway” through the vertebrae where the spinal cord runs), and some very minor damage to a cervical vertebrae. He got off lightly; falls I the elderly do not always work out this way.

The statistics around older people who fall and fracture a hip are truly awful:

• About 70–75,000 hip fractures (proximal femoral fractures) occur annually in the UK

• Hip fracture is the commonest reason for admission to an orthopaedic ward, and is usually a ‘fragility’ fracture caused by a fall affecting an older person with osteoporosis or osteopenia

• Mortality is high – about 10% of people with a hip fracture die within 1 month, and about one third within 12 months

(Source: www.data.gov.uk)

Everyone over, say, their mid-40s should take a moment to think about that and to consider what you can start doing today to make sure you don’t get to a place where a fall = a hip fracture = a steep incline in your potential to shuffle off this mortal coil more quickly.

So what can you do? I can immediately think of 3 things:

• Keep up your muscle mass (don’t let sarcopenia get the better of you)

• Keep up your bone density (don’t let osteopenia and osteoporosis get the better of you – especially the ladies)

• Keep your balance! (don’t get to a place where balance is an issue and you fall more easily).

Muscle Mass

So first off, muscle mass. It is a sad fact that after the age of about 30 (yes really) our muscle mass starts to decline. This is called sarcopenia. The message? Use it or you’ll lose it, it’s that simple. Don’t become sedentary, keep moving, find forms of movement that you enjoy. Get out for a walk every single day – get a dog! You don’t have to become a gym bro, but do consider some forms of resistance exercise – yoga where you’re supporting your own body weight, or some kind of work with weights or resistance bands, for example. Get an exercise buddy to do this work with you – you are much likely to keep doing the exercise if you do it together.

Muscle mass at 40 and again in old age. Source; The Physiological Society

Don’t go hell for leather. Build up slowly and make sure you are using good form - make sure you are using yourself well when you are doing the work. I find personally that any form of exercise helps bring focus to the use of myself – is my gait skew-whiff when I’m walking? Mmm look that yoga lunge is much easier on that leg than on the other… why could that be? How does that tie in to what I know about my use of myself?

The other key thing to consider here is nutrition – in order to keep up muscle mass you need protein. Possibly more protein than you realised. Remember that protein is key not only for the repair and maintenance of the body but that amino acids (the building blocks of protein) are essential “ingredients” in the synthesis of neurotransmitters, of enzymes, and of the globulins that carry hormones and other goodies round in your blood. In my other role as a nutritional therapist `I have had a couple of cases recently where the client felt much better emotionally simply by upping their protein intake – the body will divert resources to where it thinks it needs them most in the case of shortages, and this may be repair and maintenance of muscles to the detriment of neurotransmitters, for example. You can visit my sister website www.marieperezwellness.com for more information on this and other nutrition topics.

Don’t forget that some sources of protein are richer than others – the animal sources are a lot richer than the plant sources, although it is perfectly possible to get enough protein as a vegetarian, you will just have to use a lot of tempeh and tofu!

Bone Density

The answer to the second action point, about maintaining bone density, is very similar to the first point, with a slight change in emphasis. It is an unfortunate but very true fact that bone mineral density decreases faster for women than for men post-menopausally (though bone density goes down for men too, just the drop isn’t so steep). This is to do with declining oestrogen levels – oestrogen facilitates bone formation by acting upon cells called osteoblasts – bone-forming cells.

Source: Rejuvenage.com

So ladies, you have to do something to keep up that bone density – you have to do some kind of resistance work, and you have to do it regularly. It is not just about eating or (god forbid) supplementing with calcium (please don’t ever supplement with calcium on its own, that’s a bit perilous). You can’t just say ah but I drink my milk, eat my yogurt and sardines including the bones, I’ll be ok….nope, you have to use that muscle and bone to keep up the density. By the way, if you are interested in monitoring your bone density wheat you want is a DEXA scan – you can get these on the NHS but will need a referral. You can also pay for them to be done privately.

One final point on this – exposure to heavy metals can play havoc with bone density. Why? Because the heavy metals (especially cadmium and lead) can displace minerals like calcium and magnesium. You can do a hair tissue mineral analysis to assess your exposure to heavy metals. They play havoc with many other systems of the body, by the way, not just bone density.

Balance and Posture

Human startle pattern. Source: Alexander-technique.london

The final point here is keep your balance. Don’t let postural imbalances (literally) get you down. Sorry to state the obvious but you are much more likely to fall over if your balance is not good, or if you have one side of your body which is weaker than the other, or if you go round permanently is a version of human startle pattern - see pic. There is quite a bit of research on “Improved postural control” with the Alexander Technique - see for example this piece (https://pmc.ncbi.nlm.nih.gov/articles/PMC6185086). The Alexander Technique really does help keep you upright and balanced for longer, and therefore more able to do the exercise and resistance work I set out above.

Resist!!! And keep resisting!!! And stay balanced!!!

Marie