Findings from a recent survey found that one in five (22%) adults have broken or fractured a bone since they turned 40 years of age. Over a third (35%) of these patients reported to have had a fragility fracture. Osteoporosis is a condition that causes bones to become weakened which can lead to fragility fractures. A fragility fracture is a broken bone that occurs due to minimal trauma, such as from a fall from standing height or less. Surprisingly, the rate of fragility fractures was high amongst 40-54 year olds with almost one in five (18%) surveyed having sustained a fragility fracture. This level of fractures would generally be expected amongst older age groups.
The research commissioned by Athena Pharmaceuticals surveyed 600 Irish men and women aged 40-90 to understand the occurrence of fragility fractures and awareness of appropriate nutritional supplementation for optimal bone health as people advance in age. The findings revealed a significant lack of awareness and confusion regarding the recommended daily allowances (RDA) of both Calcium and Vitamin D. 85% of adults are unaware of the correct amount of Calcium they require daily and 90% are unclear on the correct amount of Vitamin D required for optimal bone health.
The recommended allowances, as defined by the Institute of Medicine, are outlined in the table below:
Diet is a major contributor to optimal bone health. The recommended daily allowance of calcium and Vitamin D as defined by the Institute of Medicine and Food Safety Authority of Ireland is outlined in Table 1 above. Calcium intake may be achieved by consuming three portions of any of the following: 1 glass (200ml) of milk, 1 carton (125g) yoghurt, 1 bottle (200ml) yoghurt drink, 2 thumbs (25g) of hard or semi‑hard cheese such as cheddar or edam or 2 thumbs (25g) soft cheese such as brie or camembert. Of those surveyed, over three-quarters (76%) of men and women above 40 years old are not getting the appropriate amounts of calcium in their diet, only consuming <50% of the RDA. Worryingly, 80% of adults who have a history of a fragility fracture are not consuming adequate calcium and alarmingly, 7% report they are consuming none. Vitamin D5 is available from two sources, sunlight exposure during the summer months and diet. Sources include natural foods such as egg yolks and oily fish, and fortified foods such as cheese and milk drinks. Supplements are usually necessary to get the recommended amount. But this survey found that 90% of people are unsure of the daily vitamin D requirements.
Dr Miriam Delaney, Specialist in Osteoporosis, Metabolic Bone Disorders and Calcium Metabolism at the Galway Clinic and Athena Pharmaceuticals Spokesperson, said:
“It is important that people build and maintain their ‘bone bank’ throughout their lives. Anyone who has had a fragility fracture over the age of 40, is considered at high risk of osteoporosis and should discuss evaluation and treatment with their doctor. Achieving bone health may include behavioural changes, such as improving diet, engaging in weight-bearing exercise and taking oral supplements of calcium and vitamin D, if required.
“Eating behaviours have changed drastically over the past three decades with our families and children eating very differently to how we, or our parents, would have eaten in the past. We develop our bone bank during our early decades of life and after achieving peak bone mass, we naturally lose bone mass with ageing. Hence it is essential that our diet provides us with sufficient calcium and vitamin D, to minimise bone loss as we age. People with little or no calcium in their diet are at elevated risk of osteoporosis and fractures in later years. Falling and fracturing the hip or spine, is a major cause of long-term pain, decreased mobility, loss of independence, hospitalisation and death in the elderly.
Individuals at a higher risk of Osteoporosis include those with many underlying illnesses, or taking certain medications such as oral steroids (for asthma or COPD), patients being treated for cancer, those with limited mobility, those in care homes or hospitals, etc and should be recognised as being at risk of weakened bones as a result of their underlying illness and treatment.
When supplementation is deemed necessary, it is important that people get expert advice from their pharmacist or healthcare provider.”
The survey revealed a need for education surrounding calcium and vitamin D intake in those over 40. Consultation with their pharmacist or GP regarding appropriate Vitamins and Mineral supplementation, especially Vitamin D and Calcium. 62% of adults over 40 surveyed buy over-the-counter vitamin supplements, but 45% of them don't seek expert advice, and since 85% are unsure of the correct amount, this often results in incorrect dosing.
For more information about the risk factors, assessment and treatment of osteoporosis click here.
