Ladies of a certain age face the prospect of ever-weakening bones. Each year after age 50, fracture risk grows. A bone density scan has revealed one of my 52-year-old well-exercised hips as being on the cusp of below normal. What to do?
Last year, I wrote about University of Auckland research showing extra calcium is unlikely to help. So my ears pricked up when I heard of the Osteo-Gains app by Tracey Clissold, a sports lecturer specialising in bone health at Toi Ohomai Institute of Technology in Tauranga, and her team.
The app takes subscribers through a 3-5 minute programme a few times a week. It teaches basic moves like star and stride jumps. The secret lies in repetition, a distinct stiff-legged landing and specific rests in between.
The landing stimulates bone to slowly remodel, says Clissold. “If we land the way we’ve always been taught, we protect our joints, but we also attenuate the force on our bones.” People should land stiffly only when doing the programme, she says.
The rests are crucial. “This is the optimal number of loading cycles bone can respond to before it switches off again. It takes another 24 hours to regenerate and be ready to receive the forces.”
Clissold led a study showing that after a year, premenopausal women aged 30-51 doing the jumps improved the bone density and bone mineral content of their hips and lumbar spines. Average increases ranged from about 0.5% to nearly 4%, depending on the site. The femur neck, which tends to snap when older people fall, grew in girth and wall thickness by 3-4%. The control group’s measures declined slightly.
“If you want to age well, you need strong bones and muscles,” says Clissold, who cautions against comfort-zoning your life. An endurance runner herself, she says walking and even running aren’t enough to strengthen bones. She’s post-menopausal – a time when bone responds less to force – yet her bones responded similarly to the programme.
But it doesn’t help the upper body. That matters because from age 50, women tend to accumulate vertebral fractures that they rarely notice but that gradually collapse spines into dowager’s humps. A new approach arrests that with an old drug. It’s an infusion called zoledronate that, like Fosamax, slows down whole-body bone degradation while bone-building cells keep working.
It’s the timing that’s new. An infusion just once every few years, starting soon after menopause, seems to maintain bone density at the early post-menopausal level. (Hormone replacement therapy has a similar level of effect.)
Mark Bolland, an endocrinologist at the University of Auckland and clinician, co-authored a paper in the New England Journal of Medicine showing that women aged 50-60 receiving an infusion every 5-10 years had 41-45% fewer vertebral fractures and 23-30% fewer fractures overall. Their bone mineral density increased by about 2% over 10 years. That’s huge post-menopausally; the untreated women declined by more than 6% on average.
Bolland says you can wait until you’re high-risk for fractures – meaning you might have already had one or you have low bone density and are having falls – and then take treatment. But most people who have fractures aren’t yet in that high-risk group. “A lot of people say, ‘I don’t want any fractures. Why would I wait?’ The best way to prevent fractures that we know about is these medicines.”
GP practices give the infusion. Very high doses can cause jaw osteonecrosis, where bone cells in the jaw die, but for osteoporosis it’s so rare that Bolland’s never seen it. One in four or five women have a short, flu-like illness afterwards, which anti-inflammatories can help with.
Bolland’s not familiar with Osteo-Gains, and nobody knows if the two approaches together are better than either alone. I’ll crack on with both.
