Q: I’m approaching the menopause and am extremely worried about the risk of osteoporosis associated with it because my mother and grandmother both suffered from it. What can I do to prevent it?

A: A greater cause of immobility than strokes or heart attacks, osteoporosis (also known as brittle bone disease, when your bones become weak and fracture easily) results in disability, pain, loss of independence and even death. The risk of osteoporosis increases with age, especially after the menopause when oestrogen levels decline. Other risk factors are a slight build, family history of the disease, early menopause and chronic bowel problems like irritable bowel syndrome and diverticulitis. Some of these risks, like your family history, can’t be changed – but there are plenty of ways you can defend yourself against the onset of this disease. It’s never too late to start because diet and lifestyle changes can slow and reverse the symptoms at any age. In addition to eating a healthy diet, rich in phytoestrogens (naturally occurring forms of oestrogen) found in soybeans, wholegrains, flaxseeds and legumes, the recommendations that follow can help reduce your risk of osteoporosis:

Change your lifestyle: Women who sit for more than nine hours a day are twice as likely to have hip fractures as those who sit for less than six hours a day. So if you have a sedentary job or lifestyle you should build more exercise into your life. Activity is crucial because it helps build strong bones and muscles, so make sure you follow the menopause diet exercise guidelines. Don’t become a gym junkie though. Excessive exercising, as well as dieting and overeating, can increase the likelihood of developing the condition.

 

Avoid faddy diets: Without enough vitamin D, calcium and other valuable nutrients your body cannot defend itself against osteoporosis. So don’t follow faddy diets or crash diet as it deprives your body of the nutrients it needs to keep your bones healthy.

 

Stop smoking and drink in moderation: Women smokers generally have lower bone density and after the age of 40 they lose bone faster than non smokers. Excessive alcohol consumption interferes with the way your body handles calcium, increasing the amount you get rid of and decreasing the amount you absorb.

 

Eat for strong bones: Calcium is your vital mineral for the formation and continuing strength of your bones and teeth and a diet rich in it is your first step in protecting yourself against osteoporosis. Some women increase their intake of dairy foods to boost calcium intake, but this can be counter productive. Although these foods do provide us with calcium, the acidic nature of some dairy foods, particularly cheese, can in fact encourage our bones to release calcium rather than conserve it. Therefore, it’s important to look at other food sources. Calcium-rich foods include tinned sardines and salmon (with bones), seaweed, eggs, sesame seeds (tahini), figs, almonds, hazelnuts, walnuts, amaranth, spring greens, cabbage, broccoli, parsley, watercress, sunflower seeds, soya, chickpeas, black beans, pinto beans, buckwheat, brown rice and quinoa.

 

In addition to calcium you also need to get plenty of vitamin D, as without it your body can’t put calcium into your bones. Your body manufactures its own vitamin D when your skin is exposed to ultraviolet light from the sun, and 10 to 15 minutes daily exposure without sunscreen is perfectly safe in the early morning or late afternoon. The best dietary source of vitamin D is oily fish, although there are small amounts in egg yolks. If you don’t go out into the sunlight at all you should take vitamin D supplements. A strong skeleton also needs omega-3 fatty acids from flaxseeds and fish oil and vitamin K from green vegetables, which is vital for hardening calcium in your bones. Magnesium, found in nuts, seeds and peanut butter, is another vital mineral because it helps your body absorb calcium and vitamin D. And don’t forget to get enough vitamin B. A new study in the Journal of Clinical Endocrinology has found that elderly people with low levels of B vitamins are more likely to have hip fractures. Cereals, beans, fish and pulses are all good sources of the B vitamins.

 

Lose excess weight: But don’t get too thin or exercise too much. Your body needs some fat to produce oestrogen, which is produced in fat cells; thin women, especially those who diet and over exercise, are more likely to suffer from osteoporosis.

 

Watch your stress levels: When you are anxious your adrenal glands pump out a number of hormones including cortisol, which can increase the risk of fractures, so find ways to manage stress. I recommend yoga, breathing exercises and meditation – but find what works best for you.

Your risk of osteoporosis will be higher because of your family history, but it is not inevitable that you will have it too, so put into place preventative measures to protect yourself. For more detailed information on what to eat and what supplements to take, see my book ‘Osteoporosis – the silent epidemic’.

Q: I have re-subscribed to your magazine and have just received my copy, which I have found very, very interesting as usual. When I came to your Ask Marilyn section I thought that I’d contact you to see if you could answer this question, which has been concerning me for a while.

I am 63 and have been getting many, many moles appearing on my skin, but I am most concerned about the many red spots that are also appearing all over my body. Some are not very big, just like pin head size, and others are about a quarter of an inch wide; some are flat to the skin, but most are slightly raised and hard. All of them are bright red. I have been monitoring them and they do not go away. I am most conscious about the ones on my neck and chest, although I can disguise these a little with make up. Is there anything that I can do to get rid of them? My diet is very good and I always buy organic foods where possible and only use natural soaps and body lotions that do not contain any nasties, and I drink mainly green tea. 

 

Obviously the moles are an age related problem, but what are these hard red spots and can I cure them?

 

 

A: With any moles or unusual spots appearing on the skin it is always important to have them seen by your doctor who may refer you to a dermatologist for a check up.

 

It is likely, however, that the red spots are something called cherry angiomas, which are broken blood capillaries that are visible on the skin. They are more common as we get older because the skin isn’t as strong because it has lost collagen and the capillaries can become more fragile. These cherry angiomas can bleed if injured because the blood vessels are so close to the surface.

 

Medically there is no known cause for cherry angiomas and no real research into the problem because they are usually harmless. They can be treated by using Intense Pulsed Light or lasers. 

 

Nutritionally my approach would be to work on strengthening the capillaries and improving the manufacture of collagen. There’s a class of antioxidants (called flavonoids, of which more than 4,000 have been characterized) and two of them are especially important for you. These are the bioflavonoids and the proanthocyanidins.

 

The bioflavonoids are closely associated with vitamin C and are found in citrus fruits.  They are excellent at strengthening capillaries and also help to preserve collagen, which can so easily be damaged by free radicals. Proanthocyanidins are the flavonoids which give the deep colour to many berries such as blackberries, blueberries, raspberries etc.  They are excellent ‘free radical scavengers’ so, like bioflavonoids, they help to slow down the ageing process and also help to preserve the integrity of capillaries. They also strengthen the collagen matrix and stop the destruction of collagen, which is not only important for our skin but also for our bone health and the prevention of osteoporosis. 

 

So make sure you eat a good amount of fruits, especially berries, and take a supplement of vitamin C containing bioflavonoids (500mg twice a day). You can also get the proanthocyanidins as freeze dried berries in a concentrated form (see the Resources Page). But do make sure you see your doctor to get the all clear on both the moles and the cherry angiomas.

A British Nutrition Foundation Healthy Ageing Report, compiled by experts from universities including Oxford, Surrey and Newcastle and released earlier this year, has confirmed that simply eating a healthy diet, quitting smoking and getting enough exercise are the keys to a long and healthy life.

The report explains how the bones, eyes, brains and heart can all be protected in later life by eating the right things. Quitting smoking is the major lifestyle change, but modest differences in diet and lifestyle can also have big effects on blood pressure and blood cholesterol. Foods rich in vitamin B12 (such as fish and eggs) and omega 3 (such as oily fish, nuts and seeds) are all good for the brain. Calcium rich foods, such as yogurt and green leafy vegetables, keep bones strong and healthy and cut the risk of osteoporosis. And vitamin D, found in sunlight and oily fish, is also good for bones and muscles.

 

Nutrients for a healthy heart include omega 3, fibre, folic acid, vitamin B12 and potassium. Eating oily fish, leafy vegetables, beans, fruit and nuts will boost the chances of getting enough of these vital nutrients. Even eyes can be kept healthier for longer by eating the right food: kiwi fruit, grapes, broccoli and red peppers are sources of nutrients which protect the eyes. Activities such as walking, dancing and even gardening reduce the risk of heart disease, diabetes, obesity and even some types of cancer.

 

The report’s message is simple and clear: the key to staying fit and healthy in later life is to eat well, quit smoking and exercise regularly. For a better quality of life it is never too late to start eating a balanced and nutritious diet.