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October 20 marks World Osteoporosis Day – but despite being a relatively common condition, many people are unaware they’re at risk. According to Age UK, osteoporosis – which is associated with weakened bones and often referred to as a ‘silent disease’, as symptoms can creep up on people – affects approximately three million people in the UK. Yet, many only find out they have it when they break a bone. “[Osteoporosis] is a condition characterised by weakened bones, making them more prone to fractures,” explains Dr Zulqarnain Shah, a medical director at SSP Health. “It occurs when the body loses too much bone or makes too little bone, or both. Diagnosis of osteoporosis typically involves a combination of medical history, physical examination, and specialised tests, such as bone mineral density scans,” Shah adds. Could I be at risk of osteoporosis? According to Age UK, around half of women over 50, and around one in nine men in the same age group, will experience a fracture due to osteoporosis. However, several risk factors contribute to the development of the condition, meaning some people may be more likely to get it. “These include menopause, low calcium and vitamin D intake during younger years, family history, a sedentary lifestyle, smoking, excessive alcohol consumption, and certain medications,” explains Shah. “While it may not be possible to prevent all cases of osteoporosis, adopting a healthy lifestyle with regular weight-bearing exercise, a balanced diet rich in calcium and vitamin D, and avoiding smoking and excessive alcohol intake can help reduce the risk.” Being aware of osteoporosis can be particularly important if you have a family history. “A family history of osteoporosis or fragility fractures can indicate an increased risk,” explains Dr Elise Dallas, GP at The London General Practice. Other things that increase risk include having a history of “rheumatoid arthritis, low levels of oestrogen due to early menopause, anorexia nervosa or Turner’s syndrome, hyperthyroidism, parathyroid disease, Crohn’s and coeliac disease, and conditions that cause long periods of immobility”, adds Dallas. What are the symptoms of osteoporosis? When you have osteoporosis, you may suffer from “increased fracture risk, height loss, and chronic pain”, says Shah. “Fractures associated with osteoporosis are known as ‘fragility fractures’, which can occur with minimal impact. Fractures commonly occur in the spine, hip, and wrist, and can lead to significant pain, disability, and reduced quality of life,” he explains. Are there any early warning signs? Shah says: “Early signs of osteoporosis may not be apparent until a fracture occurs. However, a precursor condition called osteopenia may be detected through scans before the onset of full-blown osteoporosis.” Osteopenia is where the density of the bones decreases, but not thoroughly enough to be classed as osteoporosis. There are no real symptoms however, so it can only be detected with scans. The good news is, lifestyle measures and sometimes treatment can help prevent it getting worse. How is osteoporosis treated? Treatment for osteoporosis is mostly aimed at “strengthening bones and preventing fractures”, says Shah. “This typically involves a combination of lifestyle modifications, such as exercise and dietary changes, along with medication. “Medications may include calcium, vitamin D and bisphosphonates, hormone therapy for postmenopausal women, selective oestrogen receptor modulators (SERMs), and other options. “SERMS help manage the way oestrogen interacts with your body and has a similar impact on osteoporosis as hormone replacement therapy, to help mitigate the impacts of hormones on osteoporosis,” Shah explains. “Regular monitoring and adherence to treatment plans can help slow down or stop the progression of osteoporosis. A bone density scan – also known as a DEXA scan – can help monitor the progress of a condition and may be done at three to five-year intervals to assess progress. “Once a patient has been on bisphosphonates for five years, they may go on a ‘pill holiday’ for a couple of years, though the benefits of taking bisphosphonates continue long after the medication is stopped.” Getting support and advice to manage any pain and mobility challenges and reduce the risk of falls and injuries can also be very important for people living with osteoporosis, along with finding ways to stay active. If you are worried about your bones and osteoporosis risk you can reach out to charities like the Royal Osteoporosis Society and find out about your risk level. Read More How to support a child with a stammer From colourful gowns to drones, these wedding trends are set take over 2024 Call The Midwife ‘should come with a health warning’ Halloween: 10 wicked ways to kit out your haunted house Black magic: Go back to black this season with the catwalk-inspired trend How to prep your home for when the clocks go back

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When navigating the exciting (and let’s face it: downright stressful) undertaking that is planning a wedding, your bridesmaids are your support system. From organizing all of the pre-wedding festivities to standing beside you on the big day, this special circle of your nearest and dearest friends, family, and soon-to-be family plays an integral role in preparing for your upcoming nuptials…and keeping you calm and collected along the way. For this reason, it’s custom to show them a token of your appreciation and commemorate your forever bonds with a gift.

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Lewis Hamilton has called Red Bull chief Helmut Marko’s comments about Sergio Perez “completely unacceptable”. Marko, 80, referred to Mexican Perez’s background when discussing his driver’s inconsistent form this season. Speaking after the Italian Grand Prix earlier this month, Marko, Red Bull’s motorsport adviser and an ally of the team’s late co-owner Dietrich Mateschitz, said: “Let’s remember that he (Perez) is South American and so he is not as focused as Max Verstappen or Sebastian Vettel was.” Addressing Marko’s comments ahead of this weekend’s Singapore Grand Prix, Mercedes’ Hamilton, 38, said: “It is completely unacceptable. This is not something you just apologise for and it is all OK. “Whilst we say there is no room for any type of discrimination in this sport – and there should be no room for it – to have leaders and people in his position making comments like this is not good for us moving forward. “There are a lot of people in the background that really are combating these kind of things, but it is hard to manoeuvre if people at the top have mindsets which stop us from progressing. Let’s remember that he (Perez) is South American and so he is not as focused as Max Verstappen or Sebastian Vettel was Helmut Marko “But it is not my team and not how we move as a team. We still have a lot of work to do to make this a more inclusive environment.” Perez and team-mate Verstappen shared two victories from the opening four races, but the latter is unbeaten since the fifth round in Miami. Perez, 145 points behind Verstappen in the standings, said: “I had a private conversation with Helmut and he did apologise. To me, that was the main thing. Personally, I didn’t get offended Sergio Perez “Basically, we move on. I have a personal relationship with him. Knowing the person helps a lot, because I know he doesn’t mean it that way. “Personally, I didn’t get offended.” Read More Charity boss speaks out over ‘traumatic’ encounter with royal aide Ukraine war’s heaviest fight rages in east - follow live Max Verstappen tells Toto Wolff to focus on Mercedes after snipe at record win On this day in 2021: George Russell joins Lewis Hamilton at Mercedes Ferrari’s Carlos Sainz gets goosebumps after landing pole for Italian Grand Prix

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