Bone Health

Why does bone health matter? 

Bones play many roles in the body. They provide the body with structure, protect your organs, and help to store calcium. As you get older, a large decrease in your calcium levels and bone mass can put you at a higher risk of bone fractures if you fall.  

What are the symptoms of osteoporosis? 

There are no obvious symptoms of osteoporosis. However, becoming shorter slowly over time as you age might be a sign that the bones in your spine may have become weaker. If you have had a recent fracture, it could also mean that your bones are weaker.  

Am I at risk of having osteoporosis? 

You will be at risk of osteoporosis if your bone mineral density (BMD) levels are low. The bone mineral density is a measurement of the amount of minerals, such as calcium, in your bones.  

The common risk factors of low BMD and osteoporosis include  

  • Gender Women have a higher risk of osteoporosis than men. During menopause, the drop in oestrogen levels, a female hormone, can cause a decrease in your BMD.  
  • Age: As you age, your BMD decreases, putting you at a higher risk of osteoporosis.  
  • Body size: If you have a body mass index (BMI) less than 18.5, you might have low BMD. 
  • Alcohol intake and smoking: Smoking and drinking too much alcohol can cause you to lose bone mass, putting you at a higher risk of osteoporosis.  
  • Family history: You are at a higher risk of osteoporosis if you have a family history of this condition. However, you can prevent this by exercising and having a healthy diet.    

What can I do to reduce the risk of osteoporosis? 

Having enough calcium and vitamin D are important in building up healthy and strong bones and reducing your risk of osteoporosis.    

Dairy products, such as milk and cheese, and food that contain additional calcium are the best sources of calcium. Some fruit juices, cereals and breads have added calcium in their products. The amount of calcium required in normal healthy adults is 800mg to 1000mg a day and you can get this through your diet or through taking supplements.  

Vitamin D helps to increase the absorption of calcium. You can get this from your diet or through exposing your skin to sunlight two times a week for 5 to 30 minutes each time. Most normal healthy adults would need about 2.5mcg of vitamin D a day.   



Food containing Calcium 

Yogurt, Milk, Cheese, Sardines, Eggs, Fortified cereals, Spinach 

Food containing Vitamin D 

Salmon, Tuna, Liver, Eggs 


What do I have to pay attention to if I’m taking calcium supplements? 
Some medicines should not be taken at the same time as calcium supplements. This includes 

    • Antibiotics such as doxycycline or ciprofloxacin 
    • Thyroxine, a medicine use to replace low thyroid levels 
    • Medicines for osteoporosis such as Alendronate or Risedronate  

Check with your doctor or pharmacist before taking these medicines together with calcium. Taking high amounts of calcium, more than 4000mg a day, can cause constipation, nausea or kidney stones to form. You should follow the dose recommended by your doctor or pharmacist.  

How can I prevent falls? 

By not falling, you decrease your chance of causing a bone fracture. Refer to the following table on some tips on preventing falls.  

Make sure your house is well lit  

  • Provide extra lighting along the path from your bedroom to the bathroom.  

Do not block the walkways 

  • Arrange your furniture in a manner that makes it easy and safe for you to move around 
  • Remove or shift away objects that can cause you to trip, such as wires 
  • If your floor at home is uneven, you can consider using carpets to make it smoother to move around and avoid tripping 

Keep your bathroom safe 

  • Use raised toilet seats to make it easier for you to sit down and stand up 
  • Install grab bars in your bath tubs or have a toilet safety frame to provide support when you are in the bathroom 
  • Place anti-slip mats on the bathroom floor or on the bath tub floor to prevent slipping 

Make sure you can reach your items easily 

  • Keep items that you always use at waist level so it is easy for you to reach them 
  • Install shelves and cupboards at a correct height so you can reach items easily 

Take care of yourself 

  • Check your eyesight every year  
  • Exercise regularly to improve your balance, strength and coordination 
  • Wear shoes with rubber soles at home to prevent slipping 
  • Use walking sticks or walking frames to help you if necessary 
  • Find out if the medicines you are taking can cause drowsiness and dizziness and take extra care when you are on them 
  • If there are any spills, clean up immediately to prevent slipping 

Source: American Bone Health, Singapore SilverPages, NHG Polyclinic Fall Prevention brochure, Health hub recommended dietary allowances 

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