BRITTLE BONES AFFECT MEN, TOO

IN my practice last week, I saw a man who was staggered to have been diagnosed with osteoporosis. He, like many people, thought that the brittle-bone disease was confined to women. Many doctors and other healthcare workers haven't cottoned on to the fact that men can suffer from this disease too, so it is often not until a man is wheeled into Casualty with a fracture that osteoporosis is diagnosed.

It appears that although men don't generally experience the same rapid bone loss as women during their 50s, they are losing bone mass at the same rate by the time that they reach 65 or 70. And men, it seems, have a higher risk of fracture due to secondary causes, such as coeliac disease (in which intolerance to the protein found in wheat and other grains interferes with calcium absorption), or medicines that can affect bone mass (such as steroids used to treat asthma and rheumatoid arthritis).

My patient had been prescribed the bone-building drug Fosamax, but wanted to discover what he could do nutritionally to try to preserve what bone he had left, and this is what I told him.

Calcium is the key to warding off osteoporosis in both men and women. In the UK, the reference nutrient intake (RNI) for adults aged between 19 and 50 is 700mg a day, but many nutritionists, myself included, believe that the USA's recommended daily amount of 1,000mg is more like it.

The best way of giving your bones calcium is to eat plenty of dairy products, such as cheese, yoghurt and milk, leafy green vegetables, small-boned fish, such as sardines, fortified soya milk, orange juice, cereals, seeds, nuts and dried fruits.

If you have a high cholesterol level, you may feel that you should avoid full-fat dairy products, in which case remember that skimmed milk contains lots of calcium, as do naturally lower-fat cheeses such as edam, gouda and cottage cheese. And one of the reasons why it is advisable to stick to naturally lower-fat dairy products is that you will be limiting your intake of saturated animal fats, which reduce your body's ability to make the bone-protecting hormone progesterone.

Also, steer clear of salt and cola as both increase calcium excretion, and boost your magnesium intake by eating plenty of beans, tofu, almonds, cashews, lentils, potatoes and oatmeal.

My non-nutritional advice includes spending 15 minutes in the sunshine every day to ensure that your body manufactures vitamin D. If you can't do this, scientists currently recommend taking 200 to 400 international units (IU) of vitamin D a day if you are under 70, 600 if you are over.

It's also important to take regular weight-bearing exercise, such as walking, jogging, stair-climbing, tennis, weight-training or dancing. Not only will they strengthen your bones, these exercises may improve your balance, thereby reducing your risk of falling and breaking a bone.

Finally, smoking suppresses the body's bone-building cells, so if you're a smoker, quit!

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