Professor Robin Daly The Break Debate Interview
New research revealing one in five (20%) older Australians is not partaking in any form of regular exercise has prompted leading experts to warn about the impact of little to no physical activity on bone health.
Coinciding with World Osteoporosis Day (October 20), key findings from the Ostelin Movement Index showed Australians had limited concern for bone health with one in five (20%) claiming there were other more pressing health issues to worry about. This is despite muscoskeletal conditions such as Osteoporosis impacting double the number of Australians than cardiovascular-related conditions.
The research comes hot on the heels of a study undertaken at Deakin University which revealed that moderate impact weight bearing activities such as step-ups, jumping side-to-side or skipping, coupled with strength and power training, effectively improved bone health and muscle strength in older adults who were at increased risk of falls and fractures.
The outcomes of the research indicate that more targeted and personalised exercise guidelines are needed for bone health, raising questions around the benefits of traditional recommendations to engage solely in lower-impact weight bearing activities like walking and swimming. This is critical information for the 1.2 million Australians estimated to have Osteoporosis and 6.3 million affected by low bone density.
However, this new position on exercise has caused some confusion for consumers and sufferers alike with few aware of what they should be doing in order to promote stronger bones. Despite a massive 75% of Australians saying they are now aware of the link between vitamin D and bone health, less than one in five (17%) knows what type of exercises they should be doing to maintain strong bones.
Professor Robin Daly, who led the Deakin University research team, said both pieces of research highlighted the need for further education around the important link between exercise and bone health.
'While any form of physical activity is better than none for improving overall health, not all exercise is equal when it comes to stronger bones," he said.
'Contrary to popular belief, walking alone offers little osteogenic benefits and promoting an increase in muscle power - or the ability to produce force rapidly – has emerged as a more crucial variable than simply trying to gain muscle strength or mass as we age.
'Essentially, this means that exercise programs incorporating a diverse range of weight bearing activities in combination with higher speed strength training are likely to be more effective in slowing bone deterioration and improving functional performance like speed and mobility."
Professor Daly added that while Osteoporosis is a significant health problem, in some cases it can be prevented by simple lifestyle changes including exercise and exposure to sunlight.
'It's imperative that we act now to raise greater awareness of the seriousness of the condition which impacts millions of Australians and reinforce the simple steps we all can take encourage proactive bone health management," he concluded.
Professor Daly's Six Steps to Better Bone Health Management
Vitamin D: Vitamin D and calcium are essential for strong bones and there is a proven link between Vitamin D and safe sun exposure. Getting outdoors for a few minutes each day will help to maintain your vitamin D levels.
Test Yourself: There are a number of online tools available to assess your risk of lowered vitamin D levels. Ask your GP or pharmacist to recommend the best tool for you.
Engage in a diverse range of weight-bearing exercises: Step-ups, jumping from side-to-side, skipping and hopping are all good examples of moderate impact, weight bearing activities that can help assist in maintaining stronger bones.
Engage in higher intensity strength and power training: Paired with weight bearing impact activity, progressive strength training and higher speed power training are considered the best way to promote strong bones and improve muscle function.
Calcium and K2: Calcium forms the major building block for healthy bones. High calcium foods include dark leafy greens, cheese, low fat milk and yogurt. Furthermore, Vitamin K2 (a nutrient that can be low in the typical western diet) may help decrease bone loss in postmenopausal women.
Interview with Professor Robin Daly
Question: Can you tell us about the findings of your clinical research at Deakin University?
Professor Robin Daly: The findings revealed that a combination of moderate weight bearing exercises and higher speed strength training can effectively improve bone health – a very important piece of information for the 1.2 million Australians who suffer from osteoporosis – as well as muscle strength and function (e.g. balance and mobility) which is important to reduce the risk of falling – a key factor contributing to osteoporotic fractures.
Question: Can you talk about how a significant number of Australians are risking their long-term bone health through inactivity?
Professor Robin Daly: It is important to understand that bones like stress, and so when they are inactive and not loaded their strength can be reduced. The Ostelin Movement Index found that one in five older Australians are not partaking in any form of regular exercise at all, which is particularly concerning given exercise is essential for maintaining healthy bones. Furthermore, the research revealed that Australians have limited concern for bone health with one in five (20%) claiming there were other more pressing health issues to worry about.
Question: How are inactivity and long-term bone health related?
Professor Robin Daly: Movement and exercise have been shown to offer a number of benefits when it comes to maintaining strong, healthy bones. While any form of exercise is better than none for overall health benefits, fewer than one in five Australians are aware of the specific types of exercise that are best for maintaining strong bones – and it's clear we need to increase awareness around this important link.
Question: What are you daily exercise recommendations?
Professor Robin Daly: To maintain better bone density as you age, include 30 minutes of the following osteogenic exercises four to six times a week:
Weight-bearing exercise involves activities where your feet and legs support your body weight, placing stress on the bones forcing them to work harder e.g. tennis, netball, dancing, impact aerobics and jumping rope. As little as 50 to 100 jumps at least 3 times per week in different directions can help to stop or slow bone loss.
Resistance training includes exercises that use targeted muscle groups around the hip, spine and wrist to lift and lower moderate to heavy weights. They can be machine-based e.g. leg press, seated rower or pull-down, or using free weights such as dumbbells. The impact of weight bearing and resistance exercise on bone health and strength is improved when:
It gets progressively harder over time
There is variety in the exercise routine;
It is performed in short, high intensity bursts
Question: What exercises are particularly beneficial to long-term bone health?
Professor Robin Daly: Exercise programs incorporating diverse movements such as skipping, jumping side to side and hopping, are likely to be more effective in slowing bone deterioration and improving physical health amongst older Australians. This new position on exercise challenges the benefits of traditional recommendations to engage solely in lower-impact weight bearing activities like walking and swimming, which offer little osteogenic benefits.
Question: What is Osteoporosis?
Professor Robin Daly: Osteoporosis is a condition in which bones lose their strength and thickness (density), leading to a higher risk of fractures than normal. Osteoporosis occurs when bones lose minerals such as calcium more quickly than the body can replace them. Any bone can be affected by osteoporosis, but bones of the hip, spine and wrist are the most commonly affected sites.
There are many factors that predispose an individual to osteoporosis. Although women are at a greater risk of developing the condition, most of the main risk factors apply to men as well. Risk factors include: menopause, family history of osteoporosis, inadequate calcium intake, low vitamin D levels, cigarette smoking, high alcohol / caffeine intake, or a sedentary lifestyle.
Question: What are the symptoms associated with Osteoporosis?
Professor Robin Daly: Osteoporosis is referred to as a silent disease, as the process of bone loss is gradual and painless. As we age, bone formation slows down and bone loss increases. Our bones lose calcium, phosphorous, boron and other minerals become lighter, less dense and more porous. This can progress to Osteoporosis, with a broken bone often being the first obvious sign of the disease.
Question: How can we prevent Osteoporosis?
Professor Robin Daly: While Osteoporosis is a significant health condition, in some cases it can be prevented by simple lifestyle changes including exercise and exposure to Vitamin D and maintaining an adequate calcium intake. Jumping from side-to-side, skipping and hopping are all good examples of moderate impact weight bearing exercises that can help promote strong bones and improve muscle function to reduce falls and fracture risk.
Question: What is your main message to Australia's on World Osteoporosis Day?
Professor Robin Daly: As today is World Osteoporosis Day, we're encouraging all Australians to be more proactive about managing their bone health by making simple lifestyle changes including exercise and exposure to Vitamin D.
Interview by Brooke Hunter