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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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Joe Biden’s sartorial choices have been called into question after the president was seen wearing sneakers seemingly without socks as he boarded Air Force One. On Sunday, the president boarded Air Force One at Dover Air Force Base as he headed to London. For the trip, Biden was dressed in blue slacks, a pale blue button-down shirt, and a blue blazer. He completed the look with a pair of navy and grey Skechers slip-in shoes. However, according to New York Times reporter Doug Mills, one thing the president was missing was his socks. Mills sparked a debate about the apparent fashion faux pas when he tweeted on Sunday that the 80 year old had allegedly gone sans socks for the flight. “@Potus boards Air Force One at Dover Air Force Base as he departs for London, England. Biden was not [wearing] socks with his sneakers,” Mills tweeted, along with a photo of Biden’s full outfit, as well as a close-up shot of the president’s sneakers and bare ankle. The tweet, which has been viewed more than 4.2m times, has prompted a conversation about the president’s fashion choice, with some questioning whether Biden’s apparent decision not to wear socks with sneakers was newsworthy, while others argued that Biden was actually wearing the footwear correctly. According to others, the president was likely wearing no-show socks. “How do you know he doesn’t have very low-rise socks? Anyway, what’s the problem with not wearing socks with sneakers?” one person asked, while another said: “Probably the invisible or low-rise socks. Everyone I know wears them.” Someone else claimed that “it’s pretty normal for beach locals to go without socks” while noting that Biden and his wife Dr Jill Biden had just returned from a trip to their Delaware beach home. “It’s pretty normal for beach locals to go without socks and he had just spent a day at his beach home. If he’s more comfortable this way on his flight, why does it matter?” they asked. According to others, Biden was actually wearing the shoes, which happened to be a $90 pair of Men’s Skechers Slip-Ins Ultra Flex 3.0, correctly. “Slip-on Skechers are designed to be worn without socks. The fabric is lightweight and breathable, allowing feet to stay cool and dry,” one person claimed in response. “Plus, the sole of the shoe is designed to provide maximum cushion and comfort without the need for socks.” On Skechers’ website, it notes that the “easy-wearing style” is designed with “air-cooled memory foam” that cushions the insole, and a “Stretch-Fit design for sock-like comfort”. However, on the shoe company’s website, it also includes a video of various individuals stepping into the shoes, with each wearing a pair of no-show socks. Although it is unclear whether the president was indeed wearing no-show socks, or whether he had actually chosen to wear the shoes without socks, many defended Biden on the basis that his fashion choices aren’t important. “Oh thank god, here’s the news finally - we were on the edge of our seats waiting to hear if he had socks on. This was riveting, thank you,” one person tweeted sarcastically, while another added: “Impeach!!” “So? Sneakers with socks isn’t in the Constitution. Find something else to complain about,” someone else wrote in response to Mills’ tweet. The reporter’s tweet also prompted some to compare the situation to the uproar after former President Barack Obama wore a tan suit, which his critics deemed unacceptable, in 2014. “Omg, tan suit again yawn,” one person tweeted. As of now, the president, who is currently in the UK meeting with King Charles III and British Prime Minister Rishi Sunak ahead of a NATO meeting in Lithuania, has not addressed the fashion choice. The Independent has contacted Skechers for comment. Read More Biden relaxes on Delaware beach with wife Jill The Rolling Stones and Skechers launch shoe collaboration with iconic tongue logo Watch as Joe Biden meets King Charles at Windsor Castle Joe Biden to meet with the King at Windsor Castle What is sleep apnea and how is Joe Biden treating his using a CPAP machine? Margot Robbie hits Barbie red carpet in 1960s Mattel-inspired gown

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