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Calcium, vitamin D, exercise and bone health

February 4, 2013

New guidelines published in the Medical Journal of Australia's open access journal (MJA OPEN) reveal calcium, vitamin D and exercise are the key to Australia's bone health.

'Building Healthy Bones Throughout Life: an evidence informed strategy to prevent osteoporosis in Australia' presents key recommendations for different stages of life.

This 18 month body of work has culminated in today's publication of key guidelines that are essential to the bone health of all Australians. Instigated by Osteoporosis Australia, and commenced with a national summit, over 100 leading experts, from a range of disciplines, had the opportunity to analyse and critique evidence specific to bone health and prevention strategies.

The nation's bone health needs addressing as 1.2 million Australians have osteoporosis and 6.3 million have osteopenia (low bone density)*. Over 80,000 Australians suffer minimal trauma fractures each year.**

Professor Peter Ebeling, Medical Director of Osteoporosis Australia and lead author on the paper said "When we look at optimising bone health, we must look at the whole life cycle and extensive research gives us clear directions on what is required at different ages."

"This paper clearly identifies the central role a combination of adequate calcium, vitamin D and exercise provides at all life stages, to improve our nation's bone health," said Prof Ebeling. 

"The clear message today is we have an opportunity to make a difference to bone health for all Australians. We have the tools, but we now have to use them all. Our call is to both the public and general practitioners to focus more attention on bone health."

“Childhood plays an important role in determining our future bone health. It is estimated that osteoporosis can be delayed by 13 years if a 10% increase in peak bone mass (bone bank) can be achieved in childhood and adolescence. It is also estimated that a 50% reduction in the risk of fracture later in life can be achieved if this gain is maintained,” said Professor Ebeling.

“Yet we know many people do not get adequate calcium, have low vitamin D levels and are not exercising properly.”

The review of evidence, as part of the guidelines, identified studies showing up to a third of adults have low vitamin D, and many pregnant women have low vitamin D. Almost half of all adults do not reach their recommended levels of calcium intake. Teenagers were the other group most at risk of not meeting daily calcium requirements, likely due to the decline in milk intake and its replacement with carbonated beverages, high in caffeine and phosphorus.

Associate Prof Deborah Kerr, School of Public Health, Curtin University and co-author said “While people generally understand calcium is important for their bones they are often not getting enough calcium on a daily basis, and this is something we aim to change.” Prof Robin Daly, Chair in Exercise & Ageing Deakin University and co-author said “Prolonged periods of sedentary behavior should be avoided due to its detrimental effect on bone. Our bones respond to a level of stress placed upon them during exercise. We now know that specific types of exercises have a positive effect on bones. We are encouraging Australians to help their bones through exercise and of course the benefits of exercise apply from childhood right through to older age.”

Professor Michael Kimlin, Faculty of Health, Queensland University of Technology and co-author said “When it comes to vitamin D and the sun we must balance our vitamin D needs and ensure we avoid any skin damage” “The role of vitamin D is critical in maintaining healthy bones from childhood and throughout life, yet how much Vitamin D you get from sun will depend on where you live in Australia, the season and your skin type.” “Generally with fair skin 5 or so minutes in summer sun at mid-morning or mid-afternoon is enough, and in winter slightly longer, 7 – 30 minutes, depending on where you live. The timing is slightly longer with darker skin.”

Professor Peter Ebeling said “The recommendations published today stress a combination of adequate calcium, vitamin D and exercise is best for your bones. Osteoporosis Australia is committed to implementing these recommendations to ensure Australians build healthy bones.”

Content updated 8 February 2013

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