Stress gives you strength


You may be eating well for your bones, but are you giving them the stress they need for optimal durability? Here’s a peek into the lives of some people who are, and aren’t.

starhealthfeedback@thestar.com.my

A LITTLE stress is manageable doses can make us, and our bones, stronger. For bones, that means getting regular weight-bearing exercise.

Weight-bearing exercises include – as the name implies – any exercise that makes your skeleton bear weight, so that rules out swimming (although swimming has other positive effects on health and fitness). Simple examples include perennial favourites like walking, running, hiking, dancing, tennis, and basketball. Then there are more exotic activities like gymnastics, skateboarding, pole dancing, and the high-action stunts Datuk Michelle Yeoh is so famous for.

Such exertions load, bend, and compress bones, creating differences in pressure along them. When administered regularly, this pressure (aka mechanical stress) is detected by bone-building cells (called osteoblasts) and bone-lining cells, triggering a chain of bone-building reactions.

Sleepy genes activate and hormones buzz around. Calcium comes rushing out of cells, which the osteoblasts deposit into new, growing bone tissue. After all that, what do you have? Tougher, stronger bones with higher bone mineral density (BMD). Stronger muscles, too, since muscles are what move your bones around in the first place. Science has proven as much, and now so have we.

It goes to show

To demonstrate how effective the twin guns of nutrition and physical activity are at shooting bone health through the roof, we chatted up some bone lovers and abusers (like me) while they got their BMD sussed out at the recent Science of Anlene Roadshow at One Utama, Petaling Jaya. (Which is where we caught up with Yeoh. Read more about that encounter on the next page.)

Later, we related their state of bone-being to nutrition expert and Fonterra Brands Ltd senior health platform manager, Joanna Todd, for her comments. Fonterra is the world’s largest exported of dairy products and New Zealand’s largest multi-national corporation. Fonterra Brands (Malaysia) produces a wide range of dairy products under consumer brands like Anlene.

Here’s what our interviewees, their numbers, and Todd had to say.

Dharshini Menon (26), female writer and dancer, scored off the chart with a massive +4.0.

She does: Classical Indian dance, one and a half to two hours a day, two to three times a week (a practice she’s kept up since her days of wearing navy blue pinafores). Before a big show, she ups the pace to daily sessions.

She eats: Milk, yoghurt, and cheese but does not consciously seek out calcium-rich foods.

Todd’s Take: This is an excellent result. From our database of Anlene Bone Health Check records, only 8% of women tested aged between 20 and 50 years have a score over +2.5, so she is well in the upper range.

This is most likely due to her healthy lifestyle with frequent exercise. It is good that she includes calcium-rich dairy foods in her diet, but she will need to ensure she makes more of an effort of this, as after the age of 30 bones can begin to deteriorate and she may start losing bone strength.

As we age and, often, as exercise becomes less frequent, it becomes particularly important to focus on our diet also and include calcium-rich foods such as fortified milk, yoghurt, certain types of fish (those that include the bones), green leafy vegetables, and nuts in it every day.

Lee Tse Ling (28), female Fit4Life writer, scored a sobering -1.3.

She does: Infrequent exercise (20-min run or 30-min yoga session two or three times a month) but tries to keep active in her daily life, eg by walking four storeys to her office daily, parking further away from mall entrances, and doing household chores.

She eats: Lots of dairy (cheese, home-made yoghurt, milk, cream) and dark greens. She also takes a multivitamin and calcium supplement when she remembers to.

Todd’s Take: Her score results put her into the Moderate Risk category of poor bone health. This is of concern, particularly given her young age.

There may be reasons such as family history or poor calcium intakes during childhood/adolescence that could be contributing to this. However she should take more action now while her bones may still be building up to reduce the risk of serious bone problems later in life.

Although she enjoys lots of dairy, she may not be including the sources that are richest in calcium. Regularly including a fortified milk can provide more benefit than irregular intake of supplements/tablets as the milks usually provide vitamin D, to help calcium absorption, and other beneficial nutrients for bones such as protein.

It is good that she is trying to be more active. A continued focus on this with more weight-bearing exercise such as walking on a daily basis will help to protect her bones.

Samantha Chong (33), female photographer, scored a modest -0.5.

She does: An hour of yoga at home or a class, three times a week. Her job keeps her on the go, with heavy equipment to lug around.

She eats: A typical Malaysian diet, and does not seek out calcium-rich foods.

Todd’s Take: A score of -0.5 for a 33-year-old female is reasonably typical in Malaysia. It does place her into the Low Risk category of poor bone health, but it is close to being in the Moderate Risk category.

As she ages, she should focus more on choosing more calcium-rich foods in her diet to ensure that her risk doesn’t increase. While yoga is a good form of exercise, it is also useful to engage in regular exercise that places more weight on the bones, such walking, running, tennis, dancing etc.

Chan Lai Mun (45), female office worker, scored -0.4. Given her age, this might become problematic.

She does: By her own admission, not very much to support her bone health; she is rather sedentary, “on the Internet all day”, and not much of an exerciser. (However, she looks rather trim for her age and was up and about at 10am for the free bone check, which might mean she’s reasonably active and interested in her health.)

She eats: A typical Malaysian diet, and does not seek out calcium-rich foods.

Todd’s Take: A score of -0.4 puts her into the Low Risk category of poor bone health. However, it is getting close to that of being in Moderate Risk. It is possible that unless she takes action now she may soon fall into this category.

Her age means her bones are now more likely to be breaking down with less rebuilding, a process which rapidly increases with menopause, so she is approaching the age where she really needs to start focusing more on her bone health.

Regular exercise, such as walking, and looking for calcium-rich foods (see above) to include in her daily diet will help reduce this risk.

Azman Mahmoud (33), male journalist, scored a neat +0.2.

He does: Cardio sessions at the gym at least twice a week. He also swims at least once a week.

He eats: “I’m not a big eater,” he says, and while he does not consciously seek out calcium-rich foods, he happens to like cheese.

Todd’s Take: A score of +0.2 is a good result for a man of this age and puts him into the Low Risk category.

The amount of exercise he does will be contributing to this result, although generally swimming doesn’t provide such strong benefits as it doesn’t place weight on the bones. As he ages he’ll need to ensure he continues the other forms of weight-bearing exercise.

Although he eats cheese, there are other, more calcium-rich foods that would also provide benefit (see above). Starting to incorporate these more regularly in his diet will help ensure he maintains his bone strength as he ages.

Ignatius Lau (21), male student, also scored off the chart with a whopping +4.3. Group champion!

He does: Taekwondo religiously, training two to three hours a day, three days a week. He also hits the treadmill at his gym at least once a week.

He eats: Or rather, drinks, lots of full cream milk. When studying in Australia, used to down a couple of glasses a day. Back here, he has at least one a day. Besides that, he eats what he thinks is quite a healthy diet.

Todd’s Take: This is another excellent score, and falls into the top 4% of Anlene Bone Health Check scores recorded of men aged 20 and 50 years. This clearly reflects his active lifestyle and love for calcium-rich milk.

As he is still in the phase of building up his bone strength, it will be important to maintain his habits. He is consuming less milk now than he has in the past, so it would be useful to switch to a fortified milk product that provides more calcium in only one serve. However it is excellent to see such great results and lifestyle habits!

Note: Todd did not speak directly to the persons above. Her comments are based solely on the information that appears here. All names apart from mine and Lau’s have been changed at the request of those interviewed.

All readings were taken from the right heel of interviewees by way of quantitative ultrasound (QUS) using machines calibrated for age and gender and operated by technicians, not medical professionals. While (QUS) can be a convenient method of screening those at risk of osteoporosis, it is not meant to be used to diagnose the condition. A dual energy X-ray absorbtiometry (DXA or DEXA) scan (eg as a follow up investigation of a low QUS T-score) remains the gold standard for the diagnosis of osteoporosis and fracture risk assessment.

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