Long, warm evenings, weekends spent in the garden and the annual summer holiday ensure that July and August are the months when someone’s flesh is bared to the scrutiny of neighbours and holiday makers. The trick is to keep a presentable figure without so depleting the diet of essential nutrients that it is not only the fat and flab which shrink away but also the bones. Little does it benefit women if the price for a trim waist line now are bones which will snap in middle age, or in men ten years later, because osteoporosis has taken its toll.

Friends, family and the media enthusiastically promote ways to get other people into shape, but in their eagerness to help them lose a few pounds, they recommend cutting down on those foods, which are rich in calcium and vitamin D.

The starved young female fashion models who grace the pages of the glossies often tolerate an inadequate diet while in their teens or twenties, but by the time they are thirty bone scans reveal that many are already displaying early signs of osteoporosis.

Osteoporosis is a progressive disease in which bone mass – in essence the weight, density and strength of the bone – is lost with a resulting increase in its fragility and liability to fracture. The importance of osteoporosis is underrated and its full extent is often not realised until it reaches a point at which limbs break and backs become so hunched that shelves are no longer within reach.

Every year 60,000 hips, 50,000 wrists and 40,000 spinal bones fracture are the result of osteoporosis. Few people realise that osteoporosis not only leads to fractures and a diminishing stature but also to an increased tendency to fall when they grow older. Thirty percent of people over 65 and who are no longer living in their own familiar homes have a serious fall each year. By the time they are eighty nearly fifty percent tumble annually. Six percent of significant falls result in a fracture.

Recently investigations with the latest scanners have shown that osteoporosis is well established by the thirties in some women. Even at this age a longed for summer adventure holiday sailing in the Mediterranean, cycling across France or working out in Club Med. may end up with the unwanted souvenir of a broken bone and holiday memories clouded by the recollection of hours spent in fracture clinics.

The first rule for maintaining bone strength is to take ready, steady exercise. Not all exercise is equally good. Exercise to help the bones must be weight bearing, no amount of swimming, during which the water takes the person’s weight, will preserve the density of the spine and hip bones. Brisk walking, even gentle jogging, is ideal. Exercise, particularly when undertaken by women, mustn't be too violent or even too prolonged.

Over exercised women no longer ovulate regularly –excessive exercise plays havoc with their hormone balance. Several Olympic games ago I looked after a squad of women competing in one of the sports. Of the 22 in the squad only two menstruated regularly, in the others their levels of training had produced athletically well tuned muscular bodies but the lack of oestrogen may well have given them a lifetime of problems with their bones.

The next essential ingredient for ensuring healthy bones is an adequate supply of vitamin D. Vitamin D is necessary for the absorption of calcium and phosphorus, and the deposition of both in the bones. Vitamin D works hand in hand with calcium, so that deficiency of either will lead to bone fragility. Vitamin D comes in 2 forms - Vitamin D3 (cholecalciferol) and D2 (calciferol). D3 is the naturally occurring form of the vitamin that is manufactured by the body when sunlight acts on a sterol in the skin. It is therefore the preferred form if you are taking a supplement. People at risk of osteoporosis are strongly recommended to take calcium and vitamin D supplements.

When taking additional vitamins and trace elements it is much better to take a broad range supplement, which covers the whole spectrum. Typically the inclusion of magnesium with the calcium may be useful - sixty to sixty five percent of the body’s store of magnesium is in the bones, 27 percent in muscle and only six percent in other tissues. Likewise boron plays an important role in bone physiology. For instance when boron intake in the young is inadequate overall growth is retarded and there are bone abnormalities. Copper and zinc are also important in small quantities. Too little copper and there can be an abnormal fragility of bones together with a loss of elasticity in connective tissue. Zinc is part of the complex copper/zinc biochemical balance of the body so that copper levels also need to be kept up to strength.

Finally in order to maintain healthy bones a good all round diet including some cheese, milk, (skimmed for those with low density cholesterol problems) fish and eggs (preferably those rich in Omega-3), oxidant rich fruit and vegetables, together with such favoured supplements as soya all help to preserve bone health.

The role of HRT is more controversial, it may be important at the time of the menopause – preferably used in patch form – but probably shouldn’t be taken after the mid to late fifties. Fosamax weekly, an oral bisphononate taken once a week, is tending to replace HRT. Calcium supplements shouldn’t be swallowed on the same morning as the weekly Fosamax tablet as it prevents its absorption.

Given these lifestyle and dietary precautions holiday makers to the beaches of Europe will not look out of place whether at Margate or Mallorca, and will not have to fear that they will swell the queues at the local orthopaedic out patients in a few years time.