Osteoporosis is recognized as the most common form of metabolic bone disease, with an estimated 200 million people affected worldwide. Osteoporosis is also one of the leading Health problems in Women today, and the data says that more than 41 million women worldwide will be affected within the next 20 years if current trends are not reversed.
Osteoporosis is usually a silent disease. People suffering from Osteoporosis may feel and look well but, on the inside, their bone density may be gradually decreasing. By the time a fracture occurs, the osteoporosis can be in an advanced stage in such people.
So, it’s important to increase awareness and be proactive about preventing, identifying and treating Osteoporosis.
Let’s understand more about Osteoporosis.
What is Osteoporosis?
Osteoporosis is a bone condition where the bones become thin and brittle over time, and more susceptible to breakage.
Hip, wrist or spine related fractures are usually related with Osteoporosis.
How Osteoporosis Develops inside the body?
Osteoblast and Osteoclast are the two most important types of bone cells which constitute the bone tissues.
Osteoblasts are responsible for the formation of bone whereas Osteoclasts are responsible for the breakdown of the bones. This coordinated action between osteoblast & osteoclast is known as Bone Remodeling.
Osteoporosis occurs when Osteoclasts start happening at a higher speed and Osteoblast slows down.
In simple words, Osteoporosis occurs when the rate of bone breakdown is higher than the rate of bone formation.
Who are at Risks of suffering from Osteoporosis?
- People over 50 years of Age
- People with Family History of Osteoporosis/Hip fracture
- People who have History of Fractures or had fracture as an Adult
- Women in early Menopause or in menopause
- People who Smoke & Drink too much Alcohol
- People who have Vitamin D deficiency
- People who have Imbalance in Hormone levels (Sex hormones, thyroid, Parathyroid, adrenal glands)
- People who have Low Calcium intake
- People with Eating Disorders
- People with some Medical Conditions/Gastrointestinal surgeries that result in less nutrient absorption
- People on Steroids and other medications like exposure to Breast Cancer drugs
- People with Medical conditions like Celiac Disease, IBD, Kidney or Liver disease, Cancer, Lupus, Multiple Myeloma, Rheumatoid arthritis
- People who do not do physical exercises (weight bearing exercises)
Why are Women at greater risk of getting Osteoporosis than Men?
Being Woman puts you at risk of developing osteoporosis and brittle bones, 4 times more than Men.
Given below are some possible reasons why Women are more prone to Osteoporosis than Men:
->The skeletal structure of women is smaller & lighter than men, this is the main reason why women have lesser bone mass than men and hence more susceptible to Osteoporosis.
->Anorexia, Bulimia and other eating disorders are more prevalent in women. These disorders in early stage of life, when the skeleton is in the process of growing, severely reduce the potential to achieve peak bone mass and this can lead to Osteoporosis in women as young as the early 20s
->In particular, bone mass decreases more rapidly during pregnancy, delivery, and menopause in Females
->Gradual bone loss is common with aging. Men & Women tend to lose bone with age but women tend to lose bone at a younger age and at a more rapid pace than Men and they also have higher bone resorption markers(osteoclasts)
->Some young women have a low bone density which increases their chance of getting osteoporosis later in life
->When women reach Menopause or for some during peri-menopause also their chances of getting osteoporosis becomes very high.
Why does Menopause pose the greatest risk of Osteoporosis?
After menopause, the body produces less estrogen and progesterone – two common female sex hormones that help keep bones strong.
Estrogen deficiency leads to the release of inflammatory cytokines that cascade bone resorption activities & overall bone loss.
If a female reaches menopause early, then it can cause early bone loss.
Women lose more than 30% of their bone mass within five years after menopause.
Estrogen deficiency is not linked with Menopause only, if a young woman is deficient in Estrogen irrespective of reaching menopause or not then also bone loss happens.
What are the Symptoms of Osteoporosis?
Typically, the chances of getting symptoms in early stages of Osteoporosis is rare.
But as the Osteoporosis progresses it makes your bones weak and brittle, and then your body starts giving signs and symptoms that may include:
- Bone fractures
- Bone pain & tenderness
- Weak & brittle nails
- Loss of height over time
- Spinal deformities/a stooped posture
- Back pain, caused by a fractured or collapsed vertebra
- A bone that breaks much more easily than expected
What are the complications of Osteoporosis?
The complications of Osteoporosis are quite serious. The spine or hip bone fractures are the most serious complications of Osteoporosis.
Hip fractures often are caused by a fall and can result in disability and even an increased risk of death within the first year after the injury.
The Spinal Bones known as Vertebrae become weak and crumple, and then we see flares of back pain, people losing height and people hunching forward.
In some cases, the spinal bones become so weak that they are easily fractured even if there is no event of falling.
How to prevent Osteoporosis through Nutrition?
Eating a balanced diet is the basis of keeping all the lifestyle disorders at bay. But considering the quality of soil and the food we get in today’s time it has become impossible to achieve the optimum nutrition from the food itself. Not only this, the kind of food habits the millennials currently have is mostly empty calories and this is the reason you see people suffering from nutritional deficiencies though they eat a lot.
The bone density nutrients are very important for not only a strong skeletal system, but these minerals & vitamins have many other important functions in our body. Completing their daily recommended intake is not easy with the help of only food, why?
Lets see some very important Bone Density Nutrients & their functions
Calcium is an essential element in the human body. Though it has many roles in the body but here we are talking about bone density.99% of the Calcium is deposited in our bones and teeth. Our body’s Calcium balance is maintained by the Calcium present in the plasma, if the blood plasma Calcium goes down the body absorbs Calcium from bones as it cannot function without Calcium. Therefore, adequate amount of Calcium is required not just for good bone density & teeth health but maintaining a good plasma balance as well so that there is no bone resorption activity.
Generally, Calcium intake is very low for every age group. 1200 mg/day is recommended daily allowance (RDA). But you will be shocked to know that for 60-70% of teenage girls and for 70% of post-menopausal women the average dietary calcium intake is far below the recommended amount.
Due to the limited availability of calcium-rich foods and current dietary habits, it has become next to impossible for people to take sufficient dietary Calcium. Thus, there is a role for calcium supplementation which is safe & should be considered for optimal bone health.
Vitamin D helps in Calcium absorption in intestines and brings it to the blood. If someone is deficient in Vitamin D then Calcium absorption won’t happen in Intestines
Dietary sources of Vitamin D are mostly fish, meat & eggs. Vegetarians lack these & non-vegetarians do not eat meat daily and not in that quantity that they can fulfill Vitamin D daily requirement. It is difficult to consume sufficient amounts of Vitamin D from dietary sources for non-vegetarians as well except those who eat sufficient amounts of meat daily.
It has been recommended by the Endocrine society that 1500-2000 IU of Vitamin D is required daily. Not only this, as per the current research the supplemental Vitamin D is associated with decrease in mortality. Therefore, 400 IU to 1,000 IU of Vitamin D supplementation per day is reasonable for the majority of healthy individuals.
Once the Calcium has been transported to Blood then Vitamin K2 transports the serum Calcium from blood to the bones. If someone is deficient in K2 then high serum Calcium creates issues like kidney stones, arterial calcification (increases heart attack risk by 50%), etc
The recommended daily intake of Vitamin K is 90 µgm (micrograms) per day for Women and 120 µgm per day for Men.
Vitamin K has no toxicity except for those using warfarin or any other anticoagulant, so supplementation with 100 µgm/day would suffice to achieve slightly more than the recommended daily allowance and may benefit the bone structure.
Magnesium allows your bones to absorb Calcium more readily, so it is an important contributor to bone health.
Dietary sources of magnesium include almonds, cashews and peanuts.
The recommended dietary intake of Magnesium for optimum health is 320-420 mg. However, more than half of the population consumes less than 245 mg per day. Thus, supplementation with 250 mg/day of Magnesium is good to support bone health, and for other aspects of general health.
As we saw how important these Bone Density Nutrients are, their recommended dosages & how they cannot be fulfilled only through Diet, hence Supplementation comes into picture.
How to choose a Calcium Supplement?
When you choose a Calcium, supplement don’t go with Calcium Carbonate as it has low bioavailability. Prefer Calcium Citrate which has better bioavailability.
- It should have 200-400 IU Vitamin D3
- It should have 25-200 mcg K2 (MK-7)
- If it has Magnesium & Phosphorus, then it completes major nutrients for bone density.
- Along with a nutritionally dense diet, activity also plays a very important role in preventing Osteoporosis.
How Exercise helps in preventing Osteoporosis?
Weight Bearing Exercise is considered an effective means to stimulate bone Osteogenesis.
Strength and Resistance Training are the most studied techniques to increase bone mass. They can be utilized only if they are used and adjusted with the proper form & technique.
Weight-bearing aerobic exercises i.e., walking, stair climbing, jogging and Tai Chi. Walking alone will not help in improving bone mass; however, it will help in delaying the progressive loss.
Some of the other lifestyle habits that will help in preventing Osteoporosis are
Manage your stress well. The body releases Cortisol when under stress, Cortisol inhibits bone-building Osteoblast activities which results in bone loss. People suffering from Cushing syndrome are an example of High Cortisol & Osteoporosis.
Limit your Alcohol & quit smoking. Nicotine in tobacco has been shown to decrease estrogen secretion, which affects Calcium and Vitamin D metabolism.
Dietary habits such as increased frequency of eating out, low nutrient density, and fast-food intake significantly lower Bone mass density.
What are the tests to check Osteoporosis?
Presence of Osteoporosis can be checked with the help of Bone density tests, commonly called DEXA Scans.
A DEXA Scan is a low dose X-ray which checks an area of the body such as hip, hand or foot for signs of how much calcium and other types of minerals are in an area of your bone, mineral loss & bone thinning.
DEXA helps in detecting Osteoporosis and predict your risk of bone fractures.
As we saw Osteoporosis is one of the most ignored Health conditions and is affecting people at a rapid rate specifically women and the fractures happening at alarming rates and associated morbidity or mortality is a proof of it.
Also, it doesn’t show any early symptom & by the time it is detected it is already too late.
But it can be prevented through good Nutrition & Lifestyle changes that I talked about in this post and the goal of this post was to create awareness and help you guys in opting for Preventive Care measures.
I hope I was able to touch base almost all the important aspects of Osteoporosis, you can comment your questions or concerns here or can reach out to us in case of further queries.
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