Learn to lift heavy objects properly, bending your knees so that you use the strength of your legs and do not strain your back. A major reason for small fractures of the spine associated with osteoporosis is unnecessary bending from the waist.

Remember simple tools like long-handled shoe horns to minimize awkward bending.

All small rugs and carpet edges should be secured down to the floor.

Floors should not be highly polished.

Wipe up all spills from kitchen and bathroom floors immediately.

Make sure electrical wires are not trailing across rooms where they could be tripped over.

When buying slippers, choose those with soles that grip well for a firm footing.

If children are in the house, be careful of toys left on the floor.

Install grab bars on the side of the bath or beside the shower, to ease getting in and out.

Install non-slip strips in the bottom of the bath or shower.

Install non-slip strips on indoor or outdoor steps, on stepladders and walkways.

Plug in tiny night-lights in hallways or bathrooms to avoid stumbling in the dark.

Never stand on chairs or stacks of books to reach high shelves. Have a small stepladder handy, or buy pick-up tongs from a mail-order company, for hard-to-reach items.

Water high-up house plants with a water-wand; wash second-storey windows with a hose extension.

Install rails or banisters to all stairs.

Be sure spectacles are clean, so that dust specks don’t create distractions. If a new prescription for glasses causes problems, see your opthalmologist promptly. Take extra care when wearing bifocals.

In the garden, never leave hoses or tools on the ground where they could be tripped over; hang them up when not in use.

Have good lighting on paths and driveways, and keep ice and snow cleared. Be wary of uneven or slippery kerbs.

When shopping, use a trolley for support, even if you only buying a few items

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•    Certain drugs, such as cortisone for rheumatoid arthritis and

asthma; heparin (an anticoagulant) for heart disease and high blood pressure; diuretics for oedema; some antacids for acute indigestion; anticonvulsants for epileptic seizures.

Disorders such as hyperthyroidism and kidney disease.

Destruction of bone cells by radiation treatment or chemo-

therapy.

•    Inability to absorb calcium from the intestine (severe ulcers

or through the removal of part of your stomach).

•    Excessive excretion of calcium in the urine (idiopathic

hypercalciuria).

•    Scoliosis (spinal curvature).

Discuss drugs with your doctor to see if dosage could be reduced, or if alternative medicine is available that would be less conducive to bone loss. For instance, if you take heparin, ask your doctor if you could change to a warfarin-type anticoagulant. If you take steroids for arthritis, would one of the new nonsteroid drugs be as effective for you? At the same time, ask your physician about calcium supplementation or other bone-promoting therapy that would be appropriate for your condition.

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Vitamin A must by law be added to margarines and lowfat spreads in the amount of 255 micrograms per ounce. Vitamin A may also be in skimmed milks, dried milk powder and yogurts to offset the loss of the vitamin when milkfat is removed.

Vitamin A is also found in liver (beef, chicken and lamb) and liver sausage, yellow fruits (such as apricots, cantaloupe melons, mangoes, nectarines, papayas and peaches) and yellow vegetables (such as carrots, pumpkin, sweet potatoes, winter squashes and yellow varieties of sweet corn).

Because it is fat-soluble and stored in the liver and fat cells of

your body, it is important not to overdose on this vitamin.

Prolonged excessive intake may trigger bone loss, as well as cause

diarrhoea, liver damage, drowsiness, headaches, loss of hair and

nausea. Avoid eating large quantities of liver, yellow fruits and

yellow vegetables – especially during summer when produce is

plentiful.    

Liver is particularly high in vitamin A. An example of that is the story of some starving Arctic explorers who ate the livers of dogs which had been fed whale meat, and were poisoned by the concentration of vitamin A stored in the dogs’ livers. Such an incident is unlikely to recur, however, as foods in the UK do not contain such toxic amounts of vitamin A. Nevertheless, large amounts of vitamin A are particularly dangerous, and to be avoided for good bone health.

The vitamin A content in foods is not reduced by normal cooking; quickly steamed vegetables will have the maximum, but frying in oil will cause some loss. Canning and freezing have little effect on vitamin A content, but sunshine causes destruction, with sun-dried foods having a much reduced amount of the vitamin compared with commercially dried fruits.

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The sniffing of glues and aerosols (aeroplane glue, plastic cements, paints, lacquers, thinners, cleaning fluids, petrol, lighter fuel) can damage the liver and kidneys. Amphetamines (‘uppers’) and methamphetamines (‘speed’) create loss of appetite down to starvation levels, leading to malnutrition. Barbiturates can cause an impairment of liver function, change metabolism, producing deficiencies of hormones and vitamins, and reducing calcium levels.

Doctors report that girls and young women are now smoking crack as a cheap and quick, but misguided, way to diet and lose weight. The drug reduces weight because it is an amphetamine and therefore an appetite suppressant, linked to eating disorders such as anorexia and bulimia. Young girls are being misled by drug dealers, who suggest crack to help lose pounds and get thin.

The Home Office reported that the number of registered drug addicts in Britain rose to 14,800 in 1989. Police claim that this figure should be multiplied by at least five to give a true indication of the number of addicts.

Not all drugs are illegally obtained; many women acquire them legally with doctors’ prescriptions, perhaps without realizing they are becoming increasingly dependent on them.

Drug dependence will eventually cost you something in health, although not every drug abuser pays the same price for the same excess. Among heavy drug users, malnutrition is often the result of erratic and irregular meals, producing mineral and vitamin deficiencies. When the function of the liver is impaired, it may affect your ability to activate vitamin D, leading to a decreased absorption of calcium in your intestines.

With the right help, drug habits can be broken, although withdrawal can be painful and difficult, and it may take months. Getting off drugs can be done with outpatient or residential treatment, chemically-assisted or drug-free, depending on what programmes are available to you locally. Your family doctor may not be the ideal professional to talk to about turning off, and he may refer you to a specialist on drug dependency. Your health and local authorities have information about nearby help for drug-abuse.

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Women are starting to smoke at a younger age, frequently to stay on diets. Smokers are more likely to be underweight. Pregnant mothers who smoke have babies that are on average 200 grams smaller than babies whose mothers do not. Oestrogen levels are lower in smokers, and they have menopause at an earlier age, hastening it by as much as five years, exposing them to greater risk. Studies of groups of osteoporotic women revealed that over 75 per cent were smokers, and more than 66 per cent smoked more than a pack of cigarettes a day. It has been speculated that there may be a relationship between smoking and the effective functioning of the liver where vitamin D is activated. If smoking impedes the system of the activation of vitamin D, less calcium is absorbed, creating a calcium deficit and subsequent bone loss.

According to a report from the Office of Population Censuses and Surveys (General Household Survey 1988), 32 per cent of people in Britain are smokers, and of this number, 52 per cent are women. Furthermore, women were smoking more cigarettes per week in 1984 than in 1972.25 per cent of girls were smoking by the age of sixteen, compared with 16 per cent of boys. Medical authorities consider the age at which you start to smoke is crucial, because the earlier you begin, the longer is your exposure to tobacco and the risk of smoking-related illnesses, such as lung cancer, heart disease, chronic bronchitis and emphysema. Smoking is deadly!

The British Medical Association is now urging the phasing out of all advertising and promotion of tobacco products, and stressing the printing of sterner health warnings on cigarette packets. In the United States, most states have laws banning smoking in public buildings, restrictions in factories and shops, and many restaurants have ‘No smoking’ sections. Unfortunately, cigarette manufacturers try to equate smoking with Women’s Liberation or project cigarettes as part of a glamorous style young people should copy.

According to a study completed recently by the US Environmental Protection Agency, chronic exposure to tobacco smoke can also affect now-smokers to the same extent as smoking one to ten cigarettes a day.

Some young people are turning to ‘alternative’ choices of clove cigarettes (kreteks) or chewing tobacco, as the newest fads. Clove cigarettes, imported from Indonesia, are often labelled as a herbal low-tobacco substitute, but laboratory analysis shows their composition to be 60 per cent tobacco and 40 per cent cloves. Studies indicate that they are in no way a safe substitute for conventional cigarettes. Because clove cigarettes are unfiltered, they produce almost twice as much tar, nicotine and carbon monoxide as ordinary moderate-tar cigarettes, and have associated risks of nosebleeds, lung infections and asthma. 30 per cent of clove cigarette smokers cough up blood. Eugenol is a major component of cloves and, while it is recognized as safe when eaten as a spice in foods, evidence has shown eugenol to be unsafe for inhaling. This has prompted the American Lung Association and the American Health Foundation to issue stern warnings about the danger of clove cigarette use.

Chewing tobacco and snuff have a direct relationship with the development of cancer of the gums and mouth. According to an Ohio journal Preventive Medicine Monthly (November 1984), smokeless tobacco can cause ‘discolored teeth and fillings, destruction of periodontal bond and soft tissue, slow-healing cuts and sores in the mouth and increased tooth sensitivity . . . The habit may also cause gums to recede, teeth to become vulnerable, drift from position and fall out . . .’.

The time to quit is now Many smokers can stop easily, but most have difficulty even though well-motivated. Some smokers find it beneficial to join groups in cigarette-withdrawal clinics. Others can fight nicotine addiction with various products available at the chemist.

For instance, some smokers find nicotine chewing gum is effective. ‘Nicorette’ is a prescription drug in chewing gum form, used as a temporary crutch for smokers trying to stop, especially in programmes supervised by doctors or in stop-smoking groups or clinics. The patented formulation is made in Denmark by A. B. Leo, a Swedish company, and at the moment it is the only brand on the world market, available in the UK, USA, Europe, Canada and Australia. The nicotine in this gum is absorbed through the lining of the mouth directly into the bloodstream. Overall blood levels of nicotine are similar to those obtained from cigarettes, the rate of release of nicotine being controlled by the rate of chewing. The object is to relieve withdrawal symptoms of a smoker; the smoker still has to adjust to living without cigarettes. Check with your dentist before using ‘Nicorette’ as up to 2 per cent of users report dislodged dental fillings, loosened inlays and gummed-up dentures.

Another smoking-deterrent chewing gum containing silver acetate is available at chemists without a «prescription, under the brand name ‘Tabmint’. This product works differently, producing an unpleasant metallic taste in your mouth if you attempt to smoke while chewing the gum. This nasty effect can last for up to four hours, making smoking less desirable. Study results vary, but the product does appear to reduce or stop the use of cigarettes over a few weeks’ time. The US Food and Drug Administration has established the safety of silver acetate gum when used for no longer than three weeks. If used excessively, it may cause permanent bluish-grey discoloration in your mouth. You should not use it when pregnant, and it should be kept away from children.

Among other products to help stop smoking are ‘Test 60′ tablets by Ashe Laboratories and ‘Nicobrevin’ capsules made in West Germany. A variety of filters can be attached to a cigarette, reducing tar and nicotine inhaled, but they have not been effective in assisting smokers to stop.

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