Five things everyone should know about osteoporosis

Osteoporosis, a condition characterised by fragile bones, low bone mass, deterioration of bone tissue, and an increased risk of fracture, impacts millions of people around the world. It is also more likely to impact women; according to some studies it affects almost four times the number of women over 50, compared to men.

The name osteoporosis is derived from two words — osteo meaning bones and porosis which means porous. Dr. Abhishek Kumar Mishra, an orthopaedic and joint replacement surgeon at the Apollo Spectra Hospital, says that with osteoporosis, the propensity of the bone to get a fracture, even with a minor injury, increases, and predisposing factors such as age, race, and sex, all contribute to your chances of being impacted.

“The older you get, the higher the chance of you having osteoporosis. Apart from these predispositions, a lack of physical activity, lack of vitamin D in the diet, and a short physical frame or stature, make you more prone to osteoporosis. Petite women are more likely to get osteoporosis as compared to those who are tall and heavily built,” he says.

In India, the disease affects about 46 million women above the age of 50. Here are five important things people should know about osteoporosis:

1. It can start with osteopenia

Osteopenia can be a precursor to osteoporosis. Someone with osteopenia has less dense bones than they should normally, but it is not quite osteoporosis yet as it isn’t severe.

“After 55, women should undergo the DEXA scan or the bone density test at least once to determine the baseline level of the strength of the bones. And if they are diagnosed with osteoporosis and osteopenia, there have to be corrective measures. Osteopaenia is a lower degree of osteoporosis. It is a harbinger of osteoporosis, it can lead to osteoporosis if not corrected,” Dr. Mishra says.

2. It impacts more women than men

According to the National Osteoporosis Foundation (NOF), a U.S.-based health organisation, women have smaller, lighter bones compared to men, making them more prone to the condition. Secondly, after menopause as estrogen production declines, it causes bone loss, making older women more susceptible to osteoporosis.

According to the International Osteoporosis Foundation, about 30% of postmenopausal women in the U.S. and Europe have osteoporosis. “At least 40% of these women and 15-30% of men will sustain one or more fragility fractures in their remaining lifetime,” the organisation says.

Dr. Mishra explains that both men and women build their bone stock till they are 30. After which the bone tissue depletes faster than it forms.

3. What you eat deeply impacts the bones

A healthy diet rich in nutrients such as calcium, potassium, magnesium, phosphorus, and vitamin D is essential for healthy bones. 

“If you eat a well-balanced diet with plenty of dairy, fish, fruits and vegetables, you should get enough of the nutrients you need every day, but if you’re not getting the recommended amount from food alone, you may need to complement your diet by taking multivitamins or supplements,” says NOF.

It recommends foods like dairy products — low- and non-fat milk, yogurt and cheese — and fish like salmon, sardines, and tuna, for calcium and vitamin D needs. It also suggests vegetables like spinach, okra, sweet potatoes, tomatoes, chinese cabbage, dandelion greens, mustard greens, red and yellow bell peppers, broccoli, and fruits like oranges, grapefruits, strawberries, papaya and pineapples, for healthy bones.

4. Staying active

Both exercise and nutrition are key to the prevention of osteoporosis. Bone is a living tissue and exercise helps strengthen it. According to The National Institutes of Health (NIH) Osteoporosis and Related Bone Diseases ~ National Resource Center (NIH ORBD~NRC), a part of the U.S. Department of Health and Human Services, young people who exercise regularly are able to achieve peak bone mass compared to those who lead a sedentary lifestyle. People can prevent bone loss if they exercise regularly. “Exercising can also help us maintain muscle strength, coordination, and balance, which in turn helps to prevent falls and related fractures. This is especially important for older adults and people who have been diagnosed with osteoporosis,” it says.

5. Menopause and osteoporosis

The female hormone estrogen protects women’s bones. As its production falls post menopause, it causes bone loss. This increases the chance of osteoporosis. To protect yourself from osteoporosis, Dr. Mishra recommends staying physically active, and taking calcium and vitamin D supplements, if your dietary intake is not adequate (only to be done in consultation with a doctor).

In certain postmenopausal women, especially those who have experienced early menopause, Hormone Replacement Therapy (HRT) is recommended for the prevention of osteoporosis. “Since low estrogen levels are the main cause of postmenopausal osteoporosis, menopause hormone therapy is considered as the first line choice for prevention of osteoporosis and its effectiveness has been demonstrated by various studies. However, hormone therapy is recommended for women who are less than 60 years old and/or less than 10 years post-menopausal,” says a study published in the US National Library of Medicine National Institutes of Health.

Sources:

1. Gender Disparities in Osteoporosis. Khaled A. Alswat
2. Epidemiology and treatment of osteoporosis in women: an Indian perspective. Anuradha V Khadilkar and Rubina M Mandlik
3. National Osteoporosis Foundation (NOF) 
4. NIH Osteoporosis and Related Bone Diseases ~ National Resource Center
5. Primary osteoporosis in postmenopausal women. Meng-Xia Ji and Qi Yu

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