What is Osteoporosis? What are the best ways to reduce the risk of having Osteoporosis?
Osteoporosis is a bone disease, characterized by too little bone mass. Any bone can be affected by it. It occurs when one looses too much of bone, makes too little bone or both. Bones weaken when there are low levels of calcium, phosphorus and other minerals in them. Although the normal bones have the appearance of honey comb martix but due to the deficiency of these minerals, the bones become porous. As a result, the bones become weak and can break from a minor fall. Osteoporosis means porous bones, which means that the bones have lost density or mass and the structure of the bones have become abnormal.
Bone is continuously changing in structure,i.e., new bone is forming and old one is broken down. The process is called bone remodeling. A full cycle of bone remodeling takes about 2 to 4 months. In young persons, the process is faster. The bone density is highest around mid-30 but after that the process of new bone formation becomes slower than bone loss.
Although it is thought of as women's disease but many men also suffer from it. The estimates indicate that about half of women older than 50 and one in four men will break a bone because of osteoporosis.
Osteoporosis is a silent disease. Often breaking a bone is the first clue that one has osteoporosis. There are a variety of risk factors, some common ones are mentioned below.
- Being female
- Certain races like southeast asian, white races
- Family history
- Being over 50 years of age
- Low body weight or being small and thin
- Broken bones
- Lack of vitamin D and calcium in the diet
- Long term use of some medications like corticosteroids, chemotherapeutic drugs, thyroid hormone
- Sedentary lifestyle
- Chronic alcoholism
Tests for detection of osteoporosis should be performed for the following-
- Older than 65 years regardless of risk factors
- Post-menopausal women having at least one risk factor, including fractures
- Vertebral abnormality
- Prolonged use of medicines like corticosteroids etc.
- Type 1 diabetes, liver disease, kidney disease, thyroid disease or a family history of osteoporosis
- Early menopause
How to reduce the risk of osteoporosis- The following steps should be taken to prevent it-
- Not enough calcium and vitamin D- Calcium and vitamin D are essential for building stronger and denser bones. Adequate amounts of vitamin D help in the absorption of calcium from the diet. Men and women under age 50 require 400 to 800 IU and age 50 and older require 800 to 1000 IU of vitamin D daily. Women under age 50 and age 50 and older require 1000 mg and 1200 mg of calcium daily respectively. Men under age 71 and age 71 and older require 1000 mg and 1200 mg of calcium daily respectively. So, one should take enough calcium as per one’s daily requirements.
- Not enough fruits and vegetables- Foods that are rich in calcium, vitamin D and other nutrients are important for bone health and overall health. Low fat dairy products such as milk, yogurt, cheese, fish mainly fatty ones like salmon, mackerel, sardines and fruits and vegetables like beans, spinach, wheat bran are rich sources of calcium.
- Too much protein, sodium and caffeine- It is important to get enough of protein but not too much of it for bone health and overall health. High protein diets that contain multiple servings of protein and meat with each meal can also cause the body to loose calcium. Coffee, tea, soft drinks contain caffeine which may decrease calcium absorption and lead to bone loss. So take these in moderation. Eating foods that have lot of salt (sodium) may cause the body to loose calcium and lead to bone loss. So limit the amount of processed and canned foods. Aim to get 2400 mg. or less of sodium per day.
- Physical inactivity- Weight bearing and strengthening exercises build and maintain bone density. So do an exercise schedule incorporating weight bearing, muscle strengthening and balance and posture exercises regularly.
- Drinking too much alcohol- Drinking heavily can lead to bone loss. So limit alcohol to no more than 2 drinks for men and 1 drink for women per day.
- Smoking- Smoking is also known to deplete calcium and lead to bone loss. So quit smoking.
- Avoid caffeine- Excessive consumption of caffeine is quite harmful and promotes osteoporosis.
- Losing weight- Losing lot of weight will also result in calcium loss from the bone. So it is important to take foods rich in calcium, while undertaking a weight loss program.
- Certain medication- Cancer chemotherapeutic drugs, lithium, methotrexate, heparin, proton pump inhibitors (PPI), steroids, thyroid hormones in excess, aluminum containing antacids may cause bone loss and lead to osteoporosis. So be careful when taking these drugs.
- Diseases- Many diseases can lead to osteoporosis. Some common diseases that can cause osteoporosis are autoimmune disorders like rheumatoid arthritis, multiple sclerosis, ankylosing spondylitis, celiac disease, gastrointestinal diseases like crohn’s disease, ulcerative colitis, weight loss surgery, diabetes, hyperthyroidism, cushing’s syndrome, leukemia, sickle-cell disease, thalassemia, AIDS, multiple sclerosis and some cancers. So be careful about calcium loss while managing these diseases.