Steve Georganas (Hindmarsh, Australian Labor Party) Share this | Link to this | Hansard source

Thursday, 20 October 2011 was World Osteoporosis Day, and I am very delighted to assist in helping raise the awareness of this disease and the impact it has on millions of Australians in this place. I am also proud to highlight the work of Osteoporosis Australia and some of the simple steps that they recommend to prevent the disease from developing.

Osteoporosis is a disease where bones become fragile and brittle, as we all know. As a result, they fracture more easily than normal bones and even a minor bump or very small tap or fall can cause a serious fracture. Osteoporosis occurs when bones lose minerals, such as calcium, more quickly than the body can replace the minerals, including calcium, in them, leading to a loss of bone thickness or bone mass or density. Any bone can be affected by osteoporosis but the most common sites are bones in the hip, spine, wrist, ribs, pelvis and upper arm. Osteoporosis usually shows no signs or symptoms until a fracture happens, and this is why osteoporosis is often called the ‘silent disease’. In Australia, there are over 1.2 million people with osteoporosis. Half of all women and one-third of men over 60 years of age in Australia will have a fracture due to osteoporosis at some stage. Every five to six minutes, someone in Australia will be admitted to hospital with an osteoporotic fracture. This is expected to rise to every three to four minutes by 2021 as the population ages and the number of osteoporotic fractures increases. Fractures due to osteoporosis can lead to changes in posture—for example, developing a stoop, commonly known as a dowager's hump, in the back—muscle weakness, loss of height and bone deformity of the spine. Fractures can lead to chronic pain, disability, loss of independence and even premature death.

Figures published in 2007 suggested that approximately 25 per cent of those who sustain a hip fracture die within 12 months of sustaining that fracture. Of those who do not die following their hip fracture, 50 per cent require long-term help with routine activities and cannot walk unaided and 25 per cent require full-time nursing home care. The costs associated are substantial and many are met by the taxpayer through our healthcare system. An osteoporotic fracture places a significant burden not only on those living with the disease through the constant pain they must bear every single day but also on their families, friends and communities.

Prevention is really important because, whilst there are treatments for osteoporosis, there is no cure. For that reason alone it is very important that all governments of all persuasions work harder to bring about more awareness of this disease. A recent study revealed that, while the Australian public has a reasonable understanding of calcium's role in promoting good bone health, 49 per cent, only one in three people surveyed, recognised the need for regular exercise and seven per cent cited vitamin D, sunshine, as being important. So these are some of the messages that we can get out there. Worryingly, one in five respondents could not nominate a single risk factor for osteoporosis.

Low bone density is an osteoporosis risk factor and a clear sign that preventive action needs to be taken. This refers to when bone mineral density, known as BMD, is lower than the normal BMD level but still not low enough to be classed as osteoporosis. As with osteoporosis, women have a higher chance of having a lower BMD than men. It affects a staggering 5.4 million Australians. In the over-50s population 14.8 per cent have osteoporosis, while 51.8 per cent have osteopenia. Fragility fractures are not confined to people with osteoporosis. They commonly occur in people with osteopenia. Intervening at the right time and taking preventive measures may stop many Australians with this disease from developing the next stage, which is osteoporosis.

Osteoporosis is a degenerative disease that affects men and women. Women are more susceptible than men due to the rapid depletion in oestrogen levels during the menopause. Men also lose bone mass as they age, but this generally happens later in life. The risk factors for osteoporosis include having a family history of osteoporosis and repetitive fractures; certain medications, such as corticosteroids, which are commonly used for asthma; some conditions like rheumatoid arthritis, an overactive thyroid and a whole range of other things. There are also lifestyle factors such as smoking or excessive alcohol consumption, diets lacking in calcium, lack of exposure to sunlight, lack of exercise and, for women, early menopause. For men, impotence, lack of libido and other symptoms of low testosterone levels are risk factors. There are risk factors that you can change. For example, physical activity is something we can all do and should do more of. Other things we can change are smoking, high alcohol intake, low calcium intake, low vitamin D levels, and low or high body weight. There are risk factors that you cannot change. Being female, for example, means you are at higher risk because women develop thin bones sooner than men. Genes, menopause, age, certain medical conditions and a range of other things cannot be changed.

It is clear that Australians need more information about risk factors and about the prevention of this disease. A recent study found that 49 per cent of Australians understood the need for calcium but only one-third understood the need for exercise and only seven per cent knew that lack of vitamin D, which is sunshine, is a risk factor. Around 20 per cent of Australians believe that osteoporosis is part of ageing and cannot be changed. In fact, there are three ways you can maintain your bone health: a diet rich in calcium, safe levels of vitamin D exposure through sunlight, and doing regular weight-bearing exercise. Calcium combines with other minerals to give bones their strength. Our bodies cannot make calcium so it has to come from our diet. It is easiest to get calcium from dairy, tinned salmon, sardines and calcium-enriched foods, but smaller amounts can also be found in nuts, bread, cereals and some fruits and vegetables, which I hope all members of this House are consuming on a regular basis.

Vitamin D is essential to strengthen the skeleton. Without it calcium is unable to be fully absorbed into the body. As Australia has such a high level of sun exposure, Australians are often overcautious about the effects of exposure, and so we should be. This overcaution could lead us to not receiving adequate levels of this very important vitamin D. So it is important for people to understand that, while overexposure to the sun can be detrimental to our health, so can underexposure. A study of women living in south-east Queensland, Victoria and Tasmania found that respectively 40 per cent, 37 per cent and 67 per cent of respondents experienced vitamin D insufficiencies during the winter and spring. In Australia the best source of vitamin D is from a safe level of direct sunlight. Vitamin D can also be found in small amounts in a few foods like salmon and eggs. Exercise is important in building and maintaining healthy bones. Weight-bearing exercise such as jogging, tennis and skipping increases the bone mass and also improves balance, which can lead to a reduced fracture rate.

If we were able to reduce the burden of fractures caused by osteoporosis by around 20 per cent, it would significantly reduce both the direct costs of health care and the indirect health costs to families and the economy. Even if just calcium intake and vitamin D levels were addressed, the direct cost of osteoporosis in Australia could be lowered by up to $432 million per year. I congratulate Osteoporosis Australia on all the work they do to help educate the public and to raise awareness about this disease so that rates of osteoporosis and its social and economic cost can be reduced in the future. Since being founded in 2000, the not-for-profit organisation has accomplished a great deal, bringing awareness, education and advocacy for osteoporosis. It is committed to supporting and funding research into prevention, diagnosis and management with the input of some of Australia's leading experts on their medical and scientific committee. I hope that their work will be supported by all members in this place now and into the future.

Greg Hunt (Flinders, Liberal Party, Shadow Minister for Climate Action, Environment and Heritage) Share this | Link to this | Hansard source

It gives me great pleasure to follow the member for Hindmarsh in speaking on this motion. He has done the parliament a service and he has done the elderly community of Australia a service with this motion. In particular, I want to place on the record the elements of the motion. First, the House joins Osteoporosis Australia and the International Osteoporosis Foundation in promoting World Osteoporosis Day on Thursday 20 October 2011 and going forward on similar dates in future years. Second, more than 1.2 million Australians have osteoporosis—that is five per cent and above of the population. Third, an Australian is admitted to hospital with an osteoporotic fracture every six minutes. Fourth, half of all women aged over 60 and one-third of men will have an osteoporotic fracture in their lifetime. Fifth, after suffering a hip fracture, about one-quarter of people will die within a year. I assume this applies to the cohort over the age of 60; but if it does not it is even worse. My assumption is that for the over 60s that is an extraordinary figure, and it was one which was a revelation to me. Sixth, we recognise and support Osteoporosis Australia in its campaign to raise awareness about this silent disease, which affects our health and independence as we age. Seventh, we acknowledge how simple it is to prevent osteoporosis, with calcium from eating the right foods, vitamin D from safe levels of sunlight and regular weight-bearing exercise throughout life. Finally, the House supports action which works to ensure that all Australians are aware of the risk factors and the measures they can take to prevent this debilitating disease.

Mr Acting Deputy Speaker, let me address this motion from three levels—firstly, as a representative in the national parliament looking at the national challenge; secondly, and in particular, as the member for Flinders, which has the oldest population of any seat in Victoria and, on the latest figures I have seen, the fifth oldest population of any seat in Australia; and, thirdly, as the son of Alan, who is now 84 and who has great challenges—but we are working through them—with his own fitness and ability to move, things which are in part linked to the challenges of ageing, of frailness, of control and of exercise.

Let me begin at the national level. The member for Hindmarsh raises an issue which has not, I believe, to date been given the airing it deserves: 1.2 million people have a significant condition which is a vulnerability in many cases and an affliction in many others. The vulnerability is something which can be treated—not cured as such, but managed. The three things which are identified in this motion as being fundamental—diet, sunlight, exercise—are elements which can be offered to our seniors, in particular those who face isolation. As we craft our aged and community care support services, both in residence and in assistance for those living at home, we need to build in the component of wellbeing, not just management. Wellbeing is the key element. It is osteo and it is other conditions which can and do afflict those who are over 60, increasingly those who are over 70 and especially those who are over 80. The answer here is not just education—although education of sons and daughters and of carers is critical—but active programs where these notions are built into the care and treatment of our seniors.

That brings me in particular to the electorate of Flinders. Flinders has listed on the electoral roll approximately 37,636 people aged 60 and over, although those numbers change on a daily basis. That is about 37 per cent of the entire enrolled population of the electorate, which is close to 100,000. That is a huge population requiring support and care. An incredible number are deeply active, but a significant number, particularly as they get beyond 70 and 80, are vulnerable not just to osteo but to other afflictions of mobility and movement—the ability to take care of themselves. It is the sad fact which accompanies ageing that the joy of being a grandparent is often accompanied by the realities of our physical beings.

Against that background, there are two great tasks which I think are fundamental to the care and maintenance of our seniors within the electorate of Flinders, particularly in this area of osteo. The first is to push unceasingly for a southern peninsula aquatics centre. I am pleased that the council has approved a structure plan which will be the foundation for developing and ultimately achieving the goal of a southern peninsula aquatics centre. I am less fussed than some as to exactly where it is. My preference is the foreshore but, amongst the different options, that does not bother me. I do not want the perfect to be the enemy of the good. I would much rather achieve this earlier rather than later. That means, though, that we must keep pushing until we have the plan agreed within the council, approved by the state, and built and constructed. It is a goal to which I remain committed. It is a goal to which I will be committed. It is a goal which we will simply pursue as a community until it is achieved, because hydrotherapy is fundamental to seniors because of its ability to combat many of the early warning signs and many of the afflictions in terms of bodily trauma which come from osteo and related conditions of frailness.

Having such an aquatic centre is also, of course, incredibly good for families and for teaching young people to swim. It is a great asset as a tourism destination for the southern peninsula. But at this moment we are focused on the needs and care requirements of our 37,000 over-60s. A hydrotherapy centre would be a magnet for wellbeing on the peninsula.

Similarly, on Philip Island we have lost Warley hospital. Warley remains vacant. The owner would prefer to use it as a medical facility, and my view is that it can and should be used as an adjunct to the Bass Coast hospital network. That means it could be linked as a satellite to the Wonthaggi campus. A seniors rehabilitation centre would be a perfect use, although I am not being prescriptive. We have an empty, viable medical facility and so long as it is incorporated into the existing state system and so long as it is an appropriate satellite—it could be used for palliative care, rehabilitation, seniors' services; any one or a combination of these—it would be a great asset to an island with a significant elderly population. So, in the same way that we will keep fighting until we have a southern peninsula aquatic centre, there is just no question that as long as it takes, we will battle, work and push to have Warley hospital facility used as part of the Bass Coast hospital network. That is a goal from which we cannot walk.

I want to turn, lastly, to my role as a son. My father, Alan Hunt, is 84. He is much more frail now. I could not say whether he has osteoporosis. I am a dumb Australian male and my father is similarly—

Ewen Jones (Herbert, Liberal Party) Share this | Link to this | Hansard source

No-one's arguing!

Greg Hunt (Flinders, Liberal Party, Shadow Minister for Climate Action, Environment and Heritage) Share this | Link to this | Hansard source

Thank you, Member for Herbert; you did not have to agree so readily! My father is, similarly, an Australian male when it comes to knowing about his own body and health. I guess the answer is that he is certainly frail. He has struggled a lot but I am delighted that, through the work of my brother John and a small amount by me, we have been able to convince him to take up regular exercise in the form of training, which is exactly what was recommended by the member for Hindmarsh.

The member for Hindmarsh has made important suggestions. Osteoporosis Australia should be congratulated for those suggestions. I simply want to give the example of our own family, where the very suggestions at the heart of this motion are making a difference. And around Australia they can and should make a difference.

Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source

I congratulate the member for Hindmarsh for bringing this important motion to the House. It is a motion that identifies a disease that affects many Australians, particularly Australians over the age of 60—although the risk factor starts kicking in at around the age of 50. Twenty-three per cent of women over the age of 50 and six per cent of men over the age of 50 are living with osteoporosis. As we all know, 50 is not old in this era. By the time they get to 60 years of age, one-third of men have had a fracture caused by osteoporosis, and half of all women over the age of 60 have suffered a similar fracture. If you put this in health terms, you have to acknowledge that this is a very significant illness. It is one that affects so many Australians. It is one of those diseases that, I think, have largely been swept under the carpet. Not enough is known about it, yet it affects so many people.

Osteoporosis is when bones become fragile and brittle, leading to a high risk of fractures. Bones lose their minerals, such as calcium, and the body cannot replace them at the same rate that they leave the body. The most common sites for fractures are the hips, the spine, the wrists, the ribs, the pelvis and the upper arms. My mother-in-law has had a number of fractures to her hip. Also, my mother was diagnosed with osteoporosis and that led to her having some fractures. This is quite significant because if your parents have osteoporosis you are much more likely to suffer from the disease.

There are steps we can take to address it, but I think I need to also point out that about 50 per cent of people with one fracture will have another. Once a person has a second fracture they are much more likely to suffer a cascading effect with fractures. It is essential that osteoporosis paretic fractures are identified and treated as quickly as possible, because once they have been identified the people who suffer from osteoporosis can be put on appropriate treatment.

Family history, medical conditions such as taking steroids, rheumatoid arthritis, the thyroid and a number of other diseases can make it much more likely that a person will develop osteoporosis, and it has different indicators for men and women. Your lifestyle contributes to it: smoking, excessive alcohol consumption, lack of calcium, lack of sunlight, which may cause vitamin D deficiency, and a sedentary lifestyle. I think vitamin D deficiency is a very important issue to identify. These days we are encouraged to use blockout sunscreen and that is blocking out vitamin D. There has been a large increase in the number of people who have been identified as suffering from vitamin D deficiency. This needs to be made public.

The ways to prevent osteoporosis are with calcium and calcium absorption, which is where vitamin D comes in, because vitamin D facilitates calcium absorption. People need to increase their calcium intake and make sure they have food that is rich in calcium. Also, I must not miss the importance of exercise, particularly weight-bearing exercise and resistance exercise, which are essential.

I congratulate the member for Hindmarsh for bringing this motion to the House. I encourage all members to go back to their electorates and publicise the issue of osteoporosis and how to prevent it.

Luke Simpkins (Cowan, Liberal Party) Share this | Link to this | Hansard source

I would like to join with the member for Shortland and the member for Flinders in thanking the member for Hindmarsh for raising this important issue. When you hear about this disease, osteoporosis, you think of something that affects those in their twilight years. But it surprised me greatly. In our positions here in this great place we find that, until someone comes to see us about a matter or the matter is drawn to our attention, we do not really have such a great understanding of it until we meet someone whose life is affected by it. But it is certainly the case that when you look at the details, at the circumstances surrounding osteoporosis—for instance, on the Osteoporosis Australia website—you begin to realise how very important it is that we as parents should even start thinking about these things for our children. I am the father of a nine-year-old and a 13-year-old—both daughters—and I was really surprised to learn that most of the bone mass development in children occurs in the preteen years. For my nine-year-old, that is right now, so I am very encouraged that she drinks a lot of milk and that she is very much into her sport, because this is exactly the time when the bone mass is being built at its best.

It was also interesting to look through the different ages on the Osteoporosis Australia website. This is mainly about women. Although osteoporosis does affect men, we retain our bone mass until we are quite a bit older compared with women. If you are doing everything possible as a woman, you can still develop some bone mass as late as your thirties, but from then on—I will not say it is 'downhill'; it would be a bit rough to say that—bone mass is beginning to decline. Even in the early forties, we are talking about one or two per cent a year. That is very scary stuff. Then when you get beyond the forties and into the fifties and the sixties, when we are talking about somewhere between one and five per cent loss of bone mass each year, it is hardly surprising that we see the number of fractures we see. I understand that close to 25,000 hip fractures take place a year, and most of these are in women.

As other speakers have said, when we hear about these sorts of numbers and the costs to the health system, as well as the impact on people's lives, it is very important to really start thinking about what we can do to alleviate these problems. We hear about the need for calcium. As we heard from the member for Shortland, we also must have exercise. As parents, we should provide that right now, from the youngest ages—resistance training, such as a bit of weight lifting, as well as load bearing, such as walking and activities like that. These are really important things to do right now. Again, we are faced with the requirement to look at the balancing of sun exposure to make sure people have the vitamin D they need, which also helps with bone mass and the development of bones.

It is a challenge when we are in an environment where, between 10 and two o'clock during the day, if you are out in the sun without protection you face real risks of melanoma and other skin problems. My GP recently said to me, when I went for a blood test and found out I had a vitamin D deficiency, 'You need to get out in the sun more.' I was looking at my arms, which have quite a bit of sun damage from years of abuse out in the sun. I was a bit worried about that, but he said, 'No, what you need to do is get out early in the morning so you can get the less-damaging sun on your arms and on your face.' He probably did not realise that just a week before I had been quite badly sunburnt! But these are very important things. When you combine all these together, this is the right way to act against osteoporosis.

Gai Brodtmann (Canberra, Australian Labor Party) Share this | Link to this | Hansard source

I am delighted to be able to rise tonight in support of this motion on osteoporosis, and I commend the member for Hindmarsh for moving the motion. Like the speakers before me—and I imagine much of the House—I agree that osteoporosis is a significant health problem for Australians, particularly women. It is a pleasure for me, as someone who has a longstanding interest in women's health issues, to speak about it tonight.

As the motion notes, millions of Australians have osteoporosis, including many in Canberra. It is believed that half of all women and one in every three men over 60 will have a fracture as a result of osteoporosis, with a fracture occurring every six minutes or so. Further, 50 per cent of those who do suffer a fracture will suffer further fractures, with the risk growing for each subsequent fracture. This is known as the cascade effect. As an example, a woman who suffers a spinal fracture as a result of this condition is four times more likely to suffer another fracture in 12 months than the normal population. This incident rate increases to 11 times higher for people who have had three or more breaks, compared to someone who has had none.

Many people who have osteoporosis remain undiagnosed and, more alarmingly, those who suffer a fracture attribute the pain and other symptoms to simply growing old, never realising the problem. Indeed, I understand almost two-thirds of fractures go unreported, irrespective of the pain they undoubtedly cause. Our population will age. Increasingly, it is ageing and everyone is aware of that. The fact that our population is ageing and ageing well is a success story. But there are also a range of challenges. These challenges will only continue to grow should this issue remain unchallenged and untreated.

In researching my speech tonight I came across a report by Access Economics, in 2001, that outlined the significance of the problem. This report estimated that, unless more is done to challenge the growth of this disease, almost three million Australians will have osteoporosis by 2021. Further, the rate of fracture would go from every five to six minutes, as it is now, to about every 3½ minutes. As a member for Canberra this is a real concern for me because, like the rest of Australia, we have an ageing population. I recently went to a Property Council seminar on demographic issues around Canberra and it was noted that we have an above-average ageing population. So this is a real challenge for Canberra in the future.

This report also estimated that, in 2001, the cost to the Australian economy was almost $2 billion in direct costs, with a loss of over $5½ billion in indirect costs through loss of income, costs of carers, modifications and equipment. I understand that these figures are somewhat dated but they serve as a good snapshot of the scope of the problem before us. It is obviously an immense problem, which may seem insurmountable. However, this simply is not true and we can lower our risk of osteoporosis. A number of risk factors lead to the development of this disease. Some of these are predetermined and are not able to be prevented, such as family history, genetics and gender. As I and other speakers have mentioned before, women are more susceptible than men to the condition.

However, there are many other factors that we can control. A lack of physical exercise in our younger years has been shown to be a significant risk factor for the development of osteoporosis. Ensuring that we have an active lifestyle that includes exercise is a great way of reducing the risk. Added to this is ensuring that we all eat a balanced and healthy diet, with the appropriate intake of calcium and other vitamins that will ensure good bone development.

As has been mentioned by the member for Shortland and the member for Cowan, it has also been shown that a lack of vitamin D is associated with a reduction in bone mass density, so ensuring appropriate and adequate exposure to sunlight will help. Like the member for Cowan, I am concerned about the number of people who are actually taking vitamin D pills these days, particularly in a country such as Australia. I do understand the challenges of skin cancer, but it concerns me. It is important that we get out in the sun at the right time of the day.

Finally, avoiding smoking and excessive drinking also reduces the risk. These are simple, yet very effective ways of reducing the risk of contracting osteoporosis. They are not daunting. They do not require a huge lifestyle change but they can prevent osteoporosis. It is a simple message and one that all Australians should hear. (Time expired)

Michael McCormack (Riverina, National Party) Share this | Link to this | Hansard source

I endorse the remarks of the member for Canberra and support the motion moved by the member for Hindmarsh. Osteoporosis is often called 'The Silent Thief' because bone loss occurs without symptoms. Individuals may not be diagnosed with osteoporosis until their bones are so weak that a strain, bump or fall causes a fracture. Osteoporotic related fractures cost the Australian community an estimated $1 billion per year in direct costs. The total cost, which includes factors such as carers and lost income, is currently estimated to be $7 billion a year. Aside from these financial costs, fractures due to osteoporosis can lead to changes in posture, muscle weakness, loss of height, bone deformity of the spine, chronic pain, disability, loss of independence and even premature death. Currently in Australia two in three women and one in three men over the age of 60 will suffer an osteoporotic fracture in their remaining lifetime.

Osteoporosis occurs when bones lose minerals, such as calcium, more quickly than the body can replace them. This leads to a loss of bone thickness. As a result, bones become thinner and less dense so that even a minor bump or accident can cause serious fractures. Any bone can be affected by osteoporosis but the most common sites are the ribs and bones in the hip, spine, wrist, pelvis and upper arm.

According to Osteoporosis Australia, every five to six minutes someone is admitted to an Australian hospital with an osteoporotic fracture. This is expected to rise to every three to four minutes by the year 2021 as the population ages and the number of osteoporotic fractures increases. About 50 per cent of people with one fracture due to osteoporosis will have another. People who have had two or more osteoporotic fractures are up to nine times more likely to have another fracture and the risk is 11 times greater for people who have had three or more fractures compared to someone who has not had one.

Earlier this year Wagga Wagga Base Hospital was chosen as one of three sites across New South Wales to evaluate a new chronic care program aimed at identifying people who may be at risk of osteoporosis. Our hospital, the Royal Prince Alfred Hospital in Sydney and the Royal Newcastle Centre were selected by the New South Wales Health's Agency for Clinical Innovation to implement and evaluate a four-month re-fracture prevention program. Wagga Wagga Base Hospital was chosen as a site for the trial to provide insight into the challenges in setting up and providing this service in a rural setting. If it is successful it will be implemented in other sites right across New South Wales.

The program, which began in September, aims to identify and prevent re-fractures in local residents who have already experienced a bone fracture and are living with or at risk of osteoporosis. The four-month trial is looking at a multidisciplinary approach to better identify and treat people with osteoporosis that will lead to improved outcomes for individuals and better use of health services.

Some fractures may be prevented with an early diagnosis of osteoporosis, suitable medication and treatment from an allied health team. According to Wagga Wagga Base Hospital acting physiotherapist in charge, Dr Claire Schofield, re-fractures in people living with osteoporosis are a growing burden on health services. This project aims to improve pathways for better care and prevention. New South Wales Health have said that the project team have been delighted with the response from the Wagga Wagga community and there has been an overwhelming response from the local Wagga GPs and medical staff across all settings. To date 88 patients have been followed up as part of the trial.

Thanks should be extended to Murrumbidgee Local Health District, Medicare Local, Wagga Wagga Base Hospital, Dr Schofield and the patients willing to participate in this wonderful trial. Because of its success, New South Wales Health's Agency for Clinical Innovation has extended funding until early April 2012 to gain valuable follow-up data from the participants.

World Osteoporosis Day is observed annually on 20 October and launches a year-long campaign dedicated to raising global awareness of the prevention, diagnosis and treatment of osteoporosis and metabolic bone disease. This year's theme was three steps to prevention: calcium, vitamin D and exercise. Calcium and vitamin D are essential for building and maintaining bone density. Exercise maintains and increases bone strength by escalating bone mass or by slowing age related bone loss. Muscle strength is also increased, which is important for supporting the joints and preventing falls. Calcium is more easily absorbed from dairy products than most other food groups. For Australians the main source of vitamin D is exposure to sunlight.

Osteoporosis can be one disease which we as a nation can fight right now. We are fortunate enough to live in a country filled with fresh and nutritious produce and have a constant stream of sunlight. These factors combined with an array of weight-bearing exercise throughout life can significantly reduce the risk of this silent disease which affects our health and independence as we age.

Debate adjourned.