Osteoporosis

Osteoporosis: How to prevent osteoporosis

Date: 19 June, 2006

The International Osteoporosis Foundation has
revealed how it is receiving more and more worrying
reports of under-diagnosis and inappropriate care
for sufferers of the devastating brittle bone
disease.

Weve covered numerous e-Alerts in the past on this
debilitating condition, whereby the bones become
brittle and porous and more prone to breakage.
According to the National Osteoporosis Society one
in three women and one in twelve men in the UK will
develop osteoporosis during their lifetime.
Worryingly, the condition is increasing in
prevalence by around 10 per cent each year, which is
mainly attributed to poor dietary and lifestyle
choices. 


The latest damming report by The International
Osteoporosis Foundation came to light at the World
Congress on Osteoporosis that was recently held in
Toronto, Canada. Delegates in Toronto heard the
results of three surveys designed to assess
preventative measures, diagnosis of osteoporosis,
and treatment, which were conducted in Belgium,
Canada, and Germany.


The Canadian study showed that 61 per cent of 125
patients who suffered a low-trauma fracture of
wrist, hip, spine or shoulder in 2003 did not
receive a bone density scan to test for
osteoporosis. The majority were also not told to
increase calcium or vitamin D intake, or to
undertake exercises to maintain bone strength.
In Germany the rates were even lower: Out of 761
postmenopausal women who suffered a wrist fracture
questioned, less than four per cent were offered a
scan and less than 10 per cent received supplement
advice.


In Belgium, two thirds of post-menopausal female
outpatients were offered supplements or drugs
regardless of whether or not they had been diagnosed
with osteoporosis. This may, perhaps, be good news
for prevention, but Florent Richy of the University
of Liege was condemnatory of the overall public
health approach:


The findings show that while we have the weapons to
diagnose and treat osteoporosis, we are not yet able
to direct them where they are needed most.

Osteoporosis: What to do if you think you may be at risk

Risk factors for the disease include low body weight
(thin small-framed women have less bone mass which
puts them at greater risk), certain medicines such
as steroids, the menopause (due to declining levels
of oestrogen, a hormone which stimulates osteoblast
cells that can rebuild bone), and a sedentary
lifestyle (made worse by smoking and consuming
alcohol and caffeine).

A reliance on processed convenience foods also puts
you at risk, as these meals are severely depleted of
many essential nutrients such as calcium,
magnesium and vitamin D that are needed for good
bone health.

You should be aware that osteoporosis rarely
produces any symptoms, as bone loss normally occurs
very gradually. However, signs that indicate you
should see your doctor include a sudden loss of
height, chronic back pain and a change in posture.
You should also make your doctor aware if you have a
family history of the disease, as it can run in
families.

Osteoporosis is diagnosed using a Bone Mineral
Density (BMD) test, which usually involves X-rays of
the spine and hip area. An ultrasound test may also
be conducted (normally performed on your wrist or
heel), which also measures bone density.

Osteoporosis: Its never too early to start taking preventative
measures

Prevention also came under the spotlight at the
conference in Toronto, with the presentation of
study data that indicates the important role of
vitamin D consumption for children, as poor skeletal
growth in infancy was seen to increase the risk of
future fractures.


Vitamin D is present in oily fish, eggs, liver, and
fortified cereals.


Nicholas Harvey of the MRC Epidemiological Resource
Centre in Southampton, UK and colleagues looked at
vitamin D levels taken during late pregnancy, infant
bone density in 556 babies soon after the birth, and
levels of calcium transporter in the placenta.


They found that baby girls born to women with low
vitamin D levels tended to have bones of lower
density. Higher levels of calcium transporter were
also linked to higher infant bone density.


What we hypothesise is that the mother’s vitamin D
levels somehow influence the amount of calcium
transporter in circulation, said Harvey.


In parallel with this, Dr Kassim Javaid, also from
the Southampton centre, compared the weight and
length data from 13,345 children born in Helsinki,
Finland, between 1934 and 1944, at birth and during
childhood with later hip fracture incidence. They
found that those with a lower weight in infancy and
early childhood tended to have more hip fractures in
later life.


Now we have evidence that the bone mass you have at
the age of 80 reflects what you started with very
early in life, said Dr Javaid.

Osteoporosis: Take these steps to help strengthen your bones

While you cant turn back the clock, there are steps
you can start taking right now to lower your risk of
osteoporosis.

Maintain a healthy lifestyle Dont smoke and limit
your intake of alcohol and caffeine, as they reduce
your bodys ability to absorb vital bone-building
nutrients.


Avoid sugar and refined carbohydrates from your
diet, as studies have shown that they acidify the
blood and cause calcium to leach from your bones
thereby lowering overall bone mass (Biosci.
Biotechnol. Biochem. 1995; 26(3):395-400; American
Journal of Clinical Nutrition 1989;50(5):955-61)).

Exercise should be incorporated into your lifestyle
too. Weight-bearing exercises are best as they help
to increase the strength and thickness of your bones
as well as your muscles (Endocrinol Metab Clin N Am
1998, 27 (2) 369-387). However, check with your
doctor first before starting on a strenuous exercise
regime.

Calcium, Vitamin D and Magnesium can help prevent
the loss of calcium from your bones, especially
after the menopause (Endocrinol Metab Clin N Am
1998, 27(2) 389-398). Increase your dietary intake
of calcium to keep your bones strong, by eating more
cheese, sardines, broccoli and dark leafy
vegetables. Supplementing with this essential
mineral is also advisable: take 1,000mg of calcium a
day; women over 50 (especially post-menopausal
women) and men over 65 should take a higher dose of
1,500mg.

Vitamin D3 is also important for maintaining healthy
bones and protecting against fractures. Take 400IU
of Vitamin D3 a day. Magnesium also helps your body
absorb calcium take between 400 and 600mg each
day. Dietary sources include, chickpeas, dried figs,
prunes, pumpkin seeds and peanuts.

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