Love your bones

WHO theme for Osteoporosis this year says “love your bones and protect your future”. It emphasised on one of the unattended part of our body upon which the entire human structure is made of. The incidence of osteoporosis is increasing world wide. So every year on 20th October various camps are arranged at different localities to create its awareness among the public. So here is my contribution for this day . Hope it would help you to understand the importance and take appropriate measures right from the start.

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What is Osteoporosis and its leading cause?

As defined by books, Osteoporosis is a progressive disorder of bones characterized by reduced bone mass and deterioration of microarchitecture predisposing it to increased fracture risk. It is most of times referred to as” silent disease” because it progress without any symptoms and is often diagnosed only after an incidence of fracture with some minor trauma. Bone is a dynamic tissue with a continuous remodeling leading to the formation of new bone and resorption of old bone which is carried out by cells osteoblasts and osteoclasts respectively.

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Not going much into hard core medical details, osteoporosis is mainly classified into two types – primary and secondary and treatment is given as per to the type.

Primary Osteoporosis is linked to the normal aging process and mainly presence of two hormones, oestrogen and progesterone, and the rate at which bone is lost. Deficiency of oestrogen among women and testosterone among men are main leading cause. Secondary osteoporosis is more common among men and is found to have an underlying cause like certain disease (like hypogonadism, hypercalciuria), medications (steroid medications, anticonvulsant medications, chemotherapy), excess alcohol consumption, smoking, immobilisation due to some disease condition.

Osteoporosis is most common among women mainly in post-menopausal. Some studies say that in population over the age of 50 years, it’s almost one among every three women are affected whereas incidence among men are one among five.

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Reason can be low calcium intakes with extensive prevalence of vitamin D deficiency, increasing longevity, early menopause, genetic predisposition, lack of diagnostic facilities, and poor knowledge of bone health have contributed toward the high prevalence of osteoporosis.

Components that make up the bone:

As we all know calcium is the main component of bones but other factors also plays an equally important role in the formation either directly or indirectly by enhancing the absorption of calcium.

Most important being Vitamin D ( for better absorption of calcium) typically produced in skin from sunlight. Others being vitamin C (collagen formation), phosphorus (integrity of bone),zinc (for better functioning of calcium and Vit D), magnesium ( promotes absorption of calcium), manganese (synthesis of connective tissue in cartilage and bone) and protein. Protein, a nutrient that is necessary for building and repairing body tissues including bones. Protein gives bone its strength and flexibility. So its very important to include variety of food containing these elements for good health of bones.

So what is the requirement of Calcium and Vitamin D?

Adults up to age 50 require 1,000 mg of calcium daily which is equivalent to a glass of milk of around 240ml. older adults will need about half a glass more of milk. As for vitamin D: We need 200 International Units (IU) of vitamin D a day until age 50. Beyond this age, the demand always is more.

Diagnosis

The diagnosis of an osteoporotic fracture is by clinical or radiological and or by Bone Mineral Density (BMD).The gold standard method of BMD testing is by dual X-ray absorptiometry (DXA). Its value is expressed in standard deviation (SD) units either as T-score or Z score

Treatment:

Osteoporosis is a costly debilitating disease, hence it is important to inculcate preventive measures, diagnose early and modifications of risk factors associated with osteoporosis.

  • For me, counseling to patients on nutritional factors, smoking, heavy alcohol consumption, and on eating pattern is the first step.
  • I would treat with pharmacologic agents only when the condition is already established. Calcium, vitamin D, and bisphosphonates are the commonest first-line therapies used and your doctor would preferably prescribe one or two among them depending on the condition. The use of other drugs such as hormone replacement therapy, estrogen agonists, calcitonin, parathyroid hormone, and denosumab is decided as per the affordability and availability of treatment options.

 

Do it in natural way:

Do it from start and even include the pattern among your kids. Even if 30 years, can go for a check up and modify your lifestyle and eating pattern accordingly. Below are certain naturally available bone friendly eatables.

  • Diet must provide adequate quantities of protein, vitamins and minerals especially calcium and vitamin D.
  • So your diet must include foods like milk, cheese, buttermilk, yogurt, dark green leafy vegetables, salmon, soybeans and tofu for enhancing the calcium intake and absorption.
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  • One should take Vitamin D fortified milk and cereal products, egg yolk, saltwater fish and liver which contains adequate amounts of vitamin D mainly essential among those who are mostly into indoor work or less exposed to sun. ladies should make a note that sunscreen hampers the absorption of vitamin D.
  • Regular exercise is another important preventive measure because it strengthens the supporting factors for bone and improves the blood circulation. Walking, climbing stairs, weight training, and dancing are some easy ways out.

Avoid:

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  • Smoking and drinking should be restricted as theses increases the demand of calcium. Excessive alcohol (more than 2 ounces a day) interferes with the calcium and vitamin D absorption. Studies have shown that men with alcoholism produce less testosterone, a hormone linked to the production of osteoblasts. In women, chronic alcohol exposure can trigger irregular menstrual cycles, a factor that reduces estrogen levels and increasing its risk for osteoporosis. Drinkers often avoid vegetables, salads and fruit in favor of fast food or a high protein diet. This is also a reason for low levels of calcium as well as other related problems.no-soft-drinks-clipart-1
  • Carbonated drinks are equally bad. Why? Firstly, they contain caffeine which itself is a risk factor.

Secondly the main culprit is phosphoric acid present in it which aids in resorption of bone and excreting out the calcium. This is really bad for your bones and teeth.

Thirdly the sugar! It contains high amount of sugar which has been found to be associated with an increase in urinary excretion of calcium. That’s one of the prime reason people with diabetes are often prone for weak bones.

 

            My last word to you in this regard will be, take precautions, go for early and regular tests, eat healthy, exercise regularly, avoid all risk factors and just postpone the weakness of bones and have a healthy and disabling free life!

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