I woke up feeling like an old lady this morning, but in a good way! My aching arms and stiff legs are evidence that the body pump class I endured yesterday did what it’s supposed to.
All those tedious front raises, silly squats, and boring bicep curls weren’t performed for purely aesthetic ends. No, vain as I am, I was planning ahead. Body pump is a weight-bearing exercise and as such, certifiably bone-building. That weekly hour of health club clock-watching is my way of protecting against osteoporosis when I’m older—my way of dealing with any damage I may have done.
Now that I’m forty (and absolutely not middle-aged!), I wonder if the decade of dedicated dieting I did in my teens and twenties did any long-term harm. I mean, how much goodness could there have been in the endless porridge-made-with-water suppers I made myself?
Osteoporosis means porous bones. It affects eight million women in the U.S.—the vast majority of whom are over fifty. But although osteoporosis is thought of as an older person’s disease, the latest thinking is that its roots lie much earlier in adolescence.
It makes sense. Our bones are living tissue consisting of a hard shell harboring a honeycomb structure. This honeycomb amasses to be dense and strongest in our twenties. But as we age, the holes inevitably become wider and weaker.
How much weaker depends on factors we cannot control—like our genes, and if we have another debilitating disease—and factors we can, such as diet and exercise.
Calcium is often called the skeleton’s building block and the amount we consume (or not) in our youth is a big determinate of future bone strength. Drinking and smoking to excess are detrimentally influential too. Osteoporosis can be a silent affliction that builds up for many years, and the evidence may hit without warning, when a bone is so frail it suddenly fractures.
Frail isn’t a word normally associated with young women, but in this age of epidemic childhood obesity, it’s a link that exists. Obsessions with dieting and competitive celebrity see-through sizes are pushing a generation of vulnerable dieters to eating disorders—the likely legacy will be premature osteoporosis. Maybe it’s always been this way?
Haley, thirty, was obese in her teens, until she started dieting in her early twenties. She shrank from 196 pounds to eighty-four pounds, initially spurred on by flattering comments, which ceased long before she settled at eighty-four pounds. She stayed stick thin for four years, subsisting on oranges, crisp bread, boiled eggs showered with salt, and diet fizzy drinks, undeterred by the fact she didn’t have periods any more.
Then, when she was twenty-five, Haley fell off a ladder while decorating and heard her spine crack. A bone-density scan diagnosed osteoporosis.
“The doctor was amazed because I was so young, but he could see I was severely malnourished,” Haley explains. “He said my lack of periods showed my body was seriously lacking estrogen. Now, I realize that’s a big risk factor.”
As Haley learned at her own cost, the female hormone, estrogen plays a large part in maintaining bone mass—which is why osteoporosis is so much more prevalent after menopause, when estrogen production has all but petered out.
Haley was immobile for more than three months. “It was terrifying, and it gave me plenty of time to think about how reckless I’d been. In an odd way, breaking my back was the jolt I needed to wake up to the fact I was anorexic. I decided to accept all the help I could get.”
The first thing Haley did was stop dieting. “I started to eat green leafy vegetables, shellfish, salmon, and a bit of cheese—not really fattening foods, just healthy ones rich in calcium that I was comfortable with.”
“My doctor prescribed the combined Pill, which contains estrogen, with calcium and vitamin D supplements to boost bone health.”
“One of the massive changes I made was to swap fizzy drinks for pints of milk,” she explains. “I developed a real taste for chocolate shakes.”
Perhaps Haley’s body naturally craved what it most needed. Recent research in Japan suggests proteins in milk improve bone strength in women of all ages. Conversely, it’s possible too much fizzy drink can impede the amount of calcium absorbed by bones. Interestingly, a high salt diet is also bad news because it increases the concentration of calcium lost in urine.
Luckily for Haley, her symptoms of osteoporosis were largely reversed. Her back healed, and although her bone density is still at the lower end of the scale, it’s within normal limits.
“I’m eight stone (112 pounds), and supple enough to do yoga, which is incredible considering I treated my body with contempt for so long,” she says.
She is fortunate, and fingers crossed, I am too. Not like the lady who lived next door when I was a girl.
I’ll never know if that tall, skinny lady in her seventies was anorexic when she was young, or even if she was an ex-dieter. But whatever—she was admitted to a senior citizen’s home soon after her husband knocked on our door to ask if I could help haul his wife off the floor.
“It’s this terrible osteoporosis,” he said. “She can’t get up.”
That lady broke her hip a week later. And she didn’t come home again.