September 13, 2024
Learn how to protect your hips as hip fractures account for 75,000 hospital admissions a year in the UK.
“The older you get the bigger the risk of a hip fracture, and in our paper, which simply looked at the consequence of an ageing of the population, we found a tripling of risk in the oldest age groups, but an increased risk of hip fracture across all adult ages,” says Samuel Hawley, a research fellow in musculoskeletal epidemiology at the University of Bristol. “But big drivers of fracture rates are diet and exercise and, while we have no control over our age, we do have control over these factors.”
Increasingly patients are forced to go private because of NHS waiting lists. Average waiting lists in England for a new hip were about 87 days before 2020, which roughly doubled to 180 that year, and have remained at about 128 days for the three years since the pandemic.
According to the Royal Osteoporosis Society (ROS), most hip fractures require surgery, with approximately two thirds of cases needing internal metalwork in the form of a sliding hip screw positioned at the neck of the femur to enable it to heal.
“It’s never too early or too late to take action for protecting your hip bones,” says Jill Griffin, the head of clinical engagement services at the ROS. “Prevention of fractures is the key and there are many things we can do throughout life to keep our hip bones as strong and healthy as possible.”
Here’s how to protect your hips:
Drink 1-4 cups of tea and coffee a day
Drinking 1-4 cups of tea or coffee a day can have mixed effects on bone health. While a high-caffeine intake may increase calcium loss through urine, potentially weakening bones, tea and coffee also contain beneficial polyphenols and phytoestrogens. These compounds appear to counteract caffeine’s negative effects, supporting overall bone strength.
Moderate consumption of tea and coffee—up to four cups daily—may positively influence bone health. Research indicates that each additional cup of these beverages is associated with a 4% reduction in hip fracture risk among middle-aged women. Adding milk to tea or coffee can further enhance calcium intake, supporting bone strength. While the exact mechanisms remain under investigation, it’s suggested that compounds in tea and coffee, such as polyphenols and phytoestrogens, may contribute to maintaining bone density.
Eat 1 gram of protein for every kilogram of your body weight daily
Increasing daily protein intake significantly reduces the risk of hip fractures, particularly in women. Research led by Professor Janet Cade found that a 25g daily increase in protein led to a 14% reduction in hip fracture risk on average, with underweight women benefiting even more—a 45% reduction.
“Proteins are essential for maintaining cells, tissues, and muscles, and they also support bone health,” explains nutritionist Rhiannon Lambert.
Protein Guidelines:
Incorporating protein-rich foods like lean meats, fish, beans, lentils, nuts, and seeds can help meet daily requirements and protect against fractures.
A study in BMC Medicine found that vegetarians have a 33% higher risk of hip fracture compared to meat eaters. To meet protein needs, foods such as three to four eggs, a steak, or a salmon fillet provide about 25g of protein, while 100g of tofu offers around 17g. Other excellent sources include yogurt, cheese, beans, nuts, and legumes.
However, very high protein intakes—double or triple the recommended amount—are not advised, as they may lead to health issues. A balanced approach to protein intake is key to supporting bone health and overall well-being.
Aim for 7-8 hours sleep a night
Both too little and too much sleep can negatively impact bone health, as our internal body clocks, controlled by specific genes, regulate bone turnover. These genes in bone cells release substances into the blood that act as markers for bone resorption (breaking down) and formation.
Bone turnover follows a daily rhythm, and disruptions to our circadian rhythm—caused by insufficient or excessive sleep—may impair this process, potentially weakening bone health over time. Maintaining a consistent and adequate sleep schedule is crucial for supporting healthy bone turnover.
Research highlights the impact of sleep on bone health. A study from the University of Colorado revealed that three weeks of sleep deprivation or disruption caused significant negative changes in bone turnover for both men and women.
Similarly, a study of 11,084 postmenopausal women published in the Journal of Bone and Mineral Research found that sleeping five hours or less per night was associated with 22% lower bone mass and a 63% higher risk of osteoporosis in the hip—a major fracture risk. Prioritizing quality sleep is essential for maintaining strong bones and reducing fracture risks.
Eat kale and prunes (Vitamin K)
Vitamin K, found in leafy greens and prunes, plays a vital role in bone health. The NHS recommends approximately 1 microgram of vitamin K per kilogram of body weight daily, so a 60kg person would need 60mcg.
An Australian study of 1,400 older women in Food and Function found that consuming 100mcg of vitamin K daily—from a large serving of dark leafy greens or 1-2 servings of other vegetables—reduced the risk of hospitalization due to hip fractures by 31% compared to those consuming less than 60mcg.
Prunes are another excellent source of vitamin K, along with phenolic compounds and dietary fiber, which also support bone health. A review in the American Journal of Clinical Nutrition found that eating 5-6 prunes daily for a year reduced inflammatory chemicals that contribute to bone breakdown, helping women maintain hip bone density.
Drink alcohol only 2-3 days per week
Excessive alcohol consumption is detrimental to hip bone health, says Antony Johansen, honorary professor and consultant orthogeriatrician. “In younger people, particularly men, high alcohol intake is one of the most common risk factors for hip fractures,” he explains. Over time, excessive drinking weakens bones and increases the likelihood of accidents and falls.
To protect bone health, limit alcohol intake to under 14 units per week and spread consumption across no more than 2-3 days a week. Studies show that staying within these limits does not adversely affect bone mineral density.
Consider a vitamin D supplement
A Mediterranean-style diet, known for its heart-health benefits, may also protect hip bones, according to a European study involving 1,294 participants in their sixties and seventies, including researchers from the University of East Anglia.
Over 12 months, one group increased their intake of nuts, olive oil, fish, and vegetables, while also taking a 10mcg vitamin D supplement, as recommended by UK health officials, to account for sunlight differences. A control group continued their regular diet with guidance from healthy eating leaflets.
In participants who already had osteoporosis—10% of the group—the Mediterranean diet increased hip bone density. “We used to think dairy and calcium were the main players in bone health,” says researcher Hawley. “But a holistic approach to a healthy diet is just as important.”
Load your hip bones with running, skipping and hopping
Strengthening exercises benefit both muscles and bones, according to Hawley, who explains that resistance and high-impact weight-bearing activities stimulate bone repair and maintenance. Exercises like weight training, jumping, skipping, hopping, and running provide the mechanical forces needed to strengthen the skeleton.
Dr. Nicky Keay of University College highlights that the femoral neck of the hip is particularly responsive to such loading, with activities like running offering significant benefits for strengthening it. Conversely, swimming and cycling, where the body is supported by water or a bike, are less effective for bone health.
For those who prefer swimming or cycling, Keay recommends supplementing with multi-directional hopping, skipping, or body-weight exercises for 15 minutes, three times a week, to build hip bone strength.
If you fracture a wrist, your hips are at risk
According to Antony Johansen, half of those who suffer a hip fracture have already experienced another fracture, marking a red flag for being at high risk of further fractures.
In England and Wales, about half of NHS trusts offer a Fracture Liaison Service (FLS) to identify, assess, and treat osteoporosis in people over 50 who have had a fracture. Johansen advises asking your GP or consultant if an FLS is available at your local hospital or surgery. If not, push for a referral.
Early intervention can prevent hip fractures. Treatments include:
Acting early on fracture risks can significantly reduce the likelihood of future hip fractures.
Read our post on Stretching to loosen limbs and joints
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