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Bone Health

Due to the HIV virus and antiretroviral medications people living with HIV experience earlier onset reductions in bone mineral density, leading to an increased risk of osteoporosis and bone fractures.

The risk of osteoporosis increases with age and the risk for women increases rapidly after menopause.

Other factors which increase the risk of bone mineral density loss include:

There are various tests and scans your clinicians can do to assess your bone health.

What can I do?

As well as managing the above risk factors with the support of your healthcare team you can think about dietary changes to support bone health. Including calcium rich foods, vitamin D sources, and a balanced diet.

Eat calcium rich foods 

Eating a balanced diet will ensure that your body obtains enough calcium to maintain strong bones. Your doctor may recommend calcium supplements if you are unable to meet requirements through your diet.   

Dietary sources of calcium include:  

  • Dairy products such as milk, yogurt and cheese 
  • Fish products with bones such as canned sardines 
  • Green leafy vegetables such as kale and okra 
  • Fortified dairy alternatives
  • Tofu 
  • Dried fruits 
  • Beans and pulses

The British Dietetic Association has some helpful information on meeting calcium requirements. 

Get enough vitamin D 

Vitamin D is important as it helps the body absorb calcium. We get most of our vitamin D from sunlight on our skin so it is recommended that you regularly expose your skin for a few minutes each day without sunscreen but make sure that you do this safely! The more the skin is exposed the better chance of making enough Vitamin D.  

During winter months in the UK, sun exposure is not enough to reach our vitamin D requirements, so it is recommended that everyone takes vitamin D supplements alongside a healthy diet. Melanin pigment reduces the skin’s ability to make vitamin D from the sun so, if you have dark skin, you should consider taking a supplement all year round. The same applies if you cover most of your skin when outdoors or if you spend a lot of time indoors.  

You can also try to include foods rich in vitamin D in your diet, for example: 

  • Oily fish such as salmon, mackerel and sardines
  • Egg yolks 
  • Liver 
  • Fortified products such as soya milk and margarine 
  • Cod liver oil

Limit salt intake 

Salt is thought to speed up the rate at which calcium is lost so try to reduce or avoid adding salt in cooking. You can add flavour to your foods by using herbs, spices, garlic, or lemon juice instead. For adults, the recommended intake for salt is 6g per day, the equivalent of approximately 1 teaspoon. Find more advice on salt here

Get active 

Staying active helps your bones stay strong. Weight bearing exercise such as walking, dancing, jogging, tennis, and golf are good examples of exercise where your muscles are forced to work against gravity. Other types of exercise such as weight training and day to day activities like cleaning, gardening, and carrying and lifting can also help. 

Limit alcohol intake 

Excessive alcohol consumption is damaging to our bones. Limit your alcohol intaketo no more than two/three units per day for women and no more than three/four units per day for men. Try to have some alcohol-free days every week and avoid binge drinking. 

Stop smoking 

Get support to stop smoking.

Find out more..

Safe sun exposure from Cancer Research UK 

Guide to Menopause for Women Living With HIV from Sophia Forum

Arthritis advice from the NHS

Osteoporosis advice from the British Dietetic Association

Royal Osteoporosis Society