A trip over the edge of the rug. You used to be back on your feet in no time. But in later life that same fall can mean a broken wrist or hip. The difference often lies in the strength of your bones, and that is exactly what bone loss quietly erodes: you notice nothing, until something breaks.
My view: most people only think about their bones after a fracture. That is a shame, because there is much to be gained beforehand. A fall with strong bones often turns out far better than a fall with brittle ones.
What is bone loss (osteoporosis)?
In bone loss, also called osteoporosis, the density of the bone tissue decreases. The bones become more porous and therefore break more easily, for example in a fall or sometimes even spontaneously. The process usually causes no pain or symptoms until the moment a fracture occurs. That is why osteoporosis is sometimes called a silent condition.
The Dutch College of General Practitioners (NHG) points out in its Fracture Prevention guideline that a fracture after the age of 50 is itself an important signal. If you have already broken something after 50 in a minor fall, discuss this with your GP.
Why do bones become weaker with age?
Bone is living tissue that is constantly broken down and rebuilt. Over the years that balance tips, and breakdown wins over build-up. In women this speeds up after the menopause, when the protection of the hormone oestrogen falls away. The table below lists the main factors.
| Factor with age | Effect on the bones | What you can do about it |
|---|---|---|
| Slower bone repair | Breakdown wins over build-up | Keep moving, with attention to strength |
| Less oestrogen after menopause | Speeds up bone loss in women | Discuss your risk with your GP |
| Less time outside and less sun | Less of your own vitamin D production | Outside daily, consider vitamin D |
| Less movement | Bones are stimulated less | Walking, stairs, balance exercises |
| One-sided diet | Less calcium intake | Dairy, green vegetables, nuts |
So bone loss is partly part of ageing, but you can certainly influence the pace.
What role do calcium and vitamin D play?
Calcium is the building block of bone. Vitamin D helps your body absorb that calcium from food. Without enough vitamin D you use calcium less well, however healthily you eat. In later life the skin also makes less vitamin D from sunlight, and many older people spend less time outdoors.
That is why the Netherlands Nutrition Centre (Voedingscentrum) advises everyone from age 70 to take 20 micrograms of vitamin D daily, and women aged 50 to 69 to take 10 micrograms a day. This advice is based on the recommendations of the Health Council of the Netherlands (Gezondheidsraad). When assessing the bones, a doctor often looks at your vitamin D and calcium in the blood, and sometimes at your alkaline phosphatase, a value that can say something about bone metabolism.
Do supplements help against fractures?
Honesty is in order here. The evidence that calcium and vitamin D supplements prevent fractures in healthy, independently living older adults is mixed and not clear-cut. Supplements are therefore not a guarantee. With a proven deficiency or a raised risk they can be worthwhile, but that is a matter of tailoring.
My advice: do not take supplements on the off chance. Vitamin D in line with the Nutrition Centre's advice is sensible for many older people, but for higher doses or for calcium the rule is: discuss with your GP what suits you. Too much calcium from pills is not automatically better.
How do you keep your bones strong?
Alongside diet, movement and fall prevention count heavily. Walking, climbing stairs and strength or balance exercises stimulate the bone and keep you steady on your feet. A safe home helps prevent falls. Concretely:
- Move daily, with attention to strength and balance
- Go outside regularly for daylight
- Eat calcium-rich: dairy, green vegetables, nuts
- Make your home fall-safe: good lighting, few loose rugs
- If in doubt, have your vitamin D and calcium measured
You can have your vitamin D and calcium measured with the Vitamin and Iron Panel from Levenswijs, without a referral. If you want the bigger picture, read about energy and vitality after 60 or about what changes in your blood values with age. Always discuss an abnormal result with your GP.
Frequently asked questions
Can I feel bone loss?
Usually not. Bone loss itself causes no pain or symptoms until a fracture occurs. That is why it is wise to discuss your risk with your GP if you have already broken something after 50.
How much vitamin D do I need after 70?
The Nutrition Centre advises 20 micrograms of vitamin D daily from age 70. Whether a higher dose is needed for you depends on your blood value and should be discussed with your GP.
Is milk enough for strong bones?
Dairy provides calcium, but strong bones need more than calcium alone: vitamin D, movement and fall prevention all count. A combination works best.
Często zadawane pytania
How much vitamin D do I need at my age?
The Nutrition Centre advises everyone from age 70 to take 20 micrograms of vitamin D per day, and women aged 50 to 69 to take 10 micrograms. The right amount depends on your situation. If in doubt, discuss it with your GP.
Do calcium and vitamin D prevent fractures?
The evidence for this in healthy community-dwelling older adults is mixed and not clear-cut. Supplements are therefore no guarantee. With a proven deficiency or high risk they can be worthwhile, in consultation with your doctor.
Will I notice myself that my bones are growing weaker?
Usually not. Bone loss runs quietly and only causes complaints at a fracture. That is why movement, fall prevention and timely vitamin D measuring help. A blood test does not provide a diagnosis.
Can I have my vitamin D measured without a referral?
Yes. At Levenswijs the Vitamin and Iron Panel measures your vitamin D and calcium, without a referral. The result is reviewed by a doctor registered in the Dutch BIG register. For treatment, your GP remains your point of contact.
Autor
Levenswijs
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