Preventing bone loss key to reducing fracture risk

Women face more than double the risk of getting fractures compared with men, largely due to osteoporosis, or major loss of bone mass.

It is one reason they spend 10.7 per cent of their lives in poor health, compared with 9.4 per cent for men.

The Women's Health Committee headed by Senior Minister of State for Health Amy Khor hopes to change this.

Although half the fractures occur in the spine, doctors use hip fractures - which account for one-sixth of all fractures but are better recorded - as a proxy.

Between 2007 and 2009, 1,477 women and 634 men fractured their hips each year. These fractures often result in long periods of immobility, loss of muscle strength and bed sores.

But the bigger problem for women are fractures to their spine, said Dr Chionh Siok Bee, president of the Osteoporosis Society of Singapore.

In fact, half the fractures women suffer occur in the spine, resulting in backache and hunched backs caused by thinning bones that collapse the vertebrae.

Madam Tan See Moy, 67, who has been on medication for osteoporosis for the past three years, fell when getting off her bed last July and broke two of her vertebrae. She needed three months of rehabilitation. She suffered weeks of pain and now takes calcium and exercises regularly to try to preserve her bone mass.

Women start to lose bone mass from age 35, against 45 for men. They also do so at a faster rate - 0.75 per cent to 1 per cent a year compared with 0.5 per cent a year for men. To make matters worse, bone loss for women accelerates to 2 per cent to 3 per cent a year in the year prior to and the two years following menopause.

Dr Chionh, who is also a senior endocrinologist at the National University Hospital specialising in osteoporosis, said the biggest loss in bone mass during that menopausal period is in the spine.

Women also lose bone mass during pregnancy and breastfeeding. Dr Chionh said: "It didn't matter so much in the past when most women did not live past the age of menopause, but it is quite unfair now."

But the news is not all bleak.

Women, and men too, can prevent bone loss by ensuring they consume at least 1g of calcium, 400 IU of vitamin D, which helps the body absorb calcium, and do 30 minutes of weight-bearing exercise a day.

They should also avoid smoking and take no more than one standard alcoholic drink for women and two for men.

Salma Khalik

A version of this article appeared in the print edition of The Straits Times on January 14, 2017, with the headline 'Preventing bone loss key to reducing fracture risk'. Print Edition | Subscribe