Health Management

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Healthy Bone For Preventing Osteoporosis

Software Engineer Karen Liew's mother suffered from osteoporosis three years ago and she is worried that, with her current sedentary lifestyle, she might be at risk of contracting the disease as well.

Karen's mother, Mdm Yam was diagnosed with osteoporosis and scoliosis in 2006 and is currently taking medication and regular private Tai Chi lessons on a weekly basis. Prior to taking up Tai Chi lessons, Mdm Yam had been taking calcium tablets for 2 years as prescribed by the doctor. Instead of showing signs of improvements, her bone mass density has shown to decline over the years. Her doctor feedback that the body does not absorb the calcium as intended and thus recommended that she should engage with regular exercise in conjunction with the medication.


Yip See Kit, senior coach from NewAgeTaichi which is also the personal trainer for Mdm Yam comments “Tai Chi exercise is considered as a safe and alternate complementary therapy for prevention of osteoporosis because of its weight bearing nature. Together with the focus on balance and fall prevention in the Tai Chi training program, it has greatly improved her condition.”

Coach Yip also conducted regular record of Mdm Yam's body composition measurement using Tanita InnerScan Body Composition Monitor before and after each Tai Chi lessons to monitor her bone mass and muscle mass. It was observed that she has been able to maintain her bone mass and that her BMR – basal metabolic rate also shows an increase after each Tai Chi lesson, which is one of the psychological benefits of exercise.

Jane Tan, senior coach of NewAgeTaichi with a Dip in sports & exercise science, stressed that the body need both exercise and vitamin D (readily obtained from sunlight) to effectively absorb the calcium into the body, otherwise the excess calcium will just pass out from the body as waste.

Since osteoporosis usually strikes women after menopause, a common belief is that it's an older women's disease. However, a recent study conducted in Britain by the University of Surrey and the Royal Cornwall Hospital in Truro in 2008 showed that 20 per cent of women aged 20 to 29 had low bone mass, which could lead to early onset of osteoporosis.

It would be a good idea for women to start engaging in weight bearing exercises (rebounding, running, jumping, jogging, Tai Chi, resistance training) as bone mass loss begins at around age 30, which will potentially lead to the disease and causing painful fragility fractures. Dr Lau Tang Ching, president of the Osteoporosis Society (Singapore), said that a person's bone mass usually starts declining by about 1 per cent a year after that age, and that a sedentary lifestyle together with poor dietary habits, which is often the result of living in a busy, modern world like Singapore, can multiple the risk of osteoporosis. In such cases, bone mass deterioration can occur at a rate of 2 or 3 per cent a year, he added. That, combined with unhealthy lifestyle choices, such as smoking means young people are at higher risk of developing this disease in the near future.

Dr Bernard Thong, head and senior consultant of the Rheumatology, Allergy and Immunology Department at Tan Tock Seng Hospital stressed that prevention is easier than cure when it comes to osteoporosis. And that specifically means reducing alcohol intake and smoking, increasing aerobic exercise and improving dietary calcium and vitamin D intake, said Dr Thong.

According to Ministry of Health clinical-practice guidelines released in January 2009, the incidence of hip fracture in Singapore has increased 1.5times in men and five times in women since 1960s. One in five dies within a year after sustaining a hip fracture. About 800 to 900 hip fractures occur every year in Singapore because of osteoporosis.

“Fragility fractures of the hip and spine can lead to significant pain and immobility, and affect daily activities, especially among able-bodied working adults,” said Dr Thong.

“We are currently conducting Tai Chi for Osteoporosis classes, which is a special program catered for osteoporosis patients to educate and guide how to exercise safely and effectively. We have been getting very well responses from the participants and the class does not only restrict to people with osteoporosis and is also suitable to people with all ages,” added Coach Jane.

References

Cambell, A. et al. (1997) Randomised controlled trial of general practice programme of home based exercise to prevent falls in elderly women. British Medical Journal 315 1065-1069

Dianne Daniels, M.A., (2008) Exercise for Osteoporosis (3rd Edition Ed) Hatherleigh Press New York, London

Kerri Winters-Stone, P., (2005) Action Plan For Osteoporosis - Your guide to stronger, healthier bones Human Kinetics USA

Kontulainen, S. et al. (2001) Good maintenance of exercise-induced bone gain with decreased training of female tennis and squash players: a prospective 5-year follow-up study of young and old starters and controls. J Bone Miner Res 16:202

Loomer, P. (2001) The impact of microgravity on bone metabolism in vitro and in vivo. Crit Rev Oral Bio Med 12:252

Mau-Roung, L. et al. (2006) Community-Based Tai Chi and Its Effect on Injurious Falls, Balance, Gait, and Fear of Falling in Older People. PHYS THER 86 (9): 1181-1201

Mosekilde, L. (2000) Age-related changes in bone mass, and strength - effects of loading, Z Rheumatol 59 Suppl 1:1

Risser, W. (1990) Bone density in eumenorrheic female college athletes. Med Sci Sports Exerc 22:570

Snow-Harter, C. and Marcus (1991) Exercise, bone mineral density, and osteoporosis. Exerc Sport Sci Rev 19:351

Tanno, M. et al. (2001) Age-related changes in cortical and trabecular bone mineral status. A quantitative CT study in lumbar vetebrae Acta Radiol 42:15

Voukelatos Alexander, M.P. et al. (2007) A Randomized, Controlled Trial of tai chi for the Prevention of Falls: The Central Sydney tai chi Trial. Journal of the American Geriatrics Society 55 (8): 1185-1191

Wolf, S. et al. (1993) The Atlanta FICSIT study: two exercise interventions to reduce frailty in elders. Journal of the American Geriatrics 41 329-332
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