Throughout our lifetime, old bone is removed and new bone is added to the skeleton. During childhood and teenage years, new bone is added faster than old bone is removed. As a result, bones become larger, heavier, and denser. Bone formation continues at a faster pace until peak bone mass (maximum bone density and strength) is reached around age 30. After age 30, wear and tear of bones begins to exceed bone formation. Bone loss is most rapid in the first few years after menopause but persists into the postmenopausal years. Osteoporosis is more likely to develop if you did not reach optimal bone mass during your bone building years. Certain factors are linked to the development of osteoporosis. These are called “Risk factors”. Many people with osteoporosis have several of these risk factors, there are some risk factors that you cannot change, and others that you can.
Risk factors you cannot change
Gender:–Your chances of developing osteoporosis are greater if you are a woman. Women have less bone tissue and lose bone more rapidly than men because of the changes involved in menopause.
Age:– The older you are, the greater your risk of osteoporosis. Your bones become less dense and weaker as you age.
Body size:– Small, thin–boned women are at greater risk.
Ethnicity:– Caucasian and Asian women are at highest risk.
African–American and Latino women have a lower but significant risk.
Family history:– Susceptibility to fracture may be, in part, hereditary. People whose parents have a history of fractures also seem to have reduced bone mass and may be at risk for fractures.
Risk factors you can change
Sex hormones: Abnormal absence of menstrual periods, low estrogen level (menopause), and low testosterone level in men. Anorexia.
Diet: A lifetime diet low in calcium and vitamin D.
Medicines: Use of certain medications, such as glucocorticoids (cortisone, prednisone, hydrocortisone, dexamethasone, and methylprednsone) or some anti convulsants. An inactive lifestyle or extended bed rest. Cigarette smoking. Excessive use of alcohol.
Prevention
You should consider several factors to reach optimal peak bone mass and continue building new bone tissue as you get older, there are.
Calcium. An inadequate supply of calcium over the plays an important role in the development of osteoporosis. Nutrition surveys have shown that many people consume less than half the amount of calcium recommended. Good sources of calcium include low fat dairy products, such as milk, yogurt, cheese and ice cream, dark green, leafy vegetables, such as broccoli, collard greens, lettuce and spinach, sardines and salmon with bones, tof, almonds, and foods fortified with calcium, such as orange juice, cereals and breads. Amaranth, fenugreek and drumstick leaves are particularly rich in calcium and among root vegetables tapioca is also a good source. The millet ragi is a rich source of calcium too. Depending upon how much calcium you get each day from food, you may need to take a calcium supplement. Calcium needs change during one’s lifetime. The body’s demand for calcium is greater during childhood and adolescence, when the skeleton is growing rapidly, and during pregnancy and breastfeeding. Postmenopausal women and older men also need to consume more calcium. This may be caused by inadequate amounts of vitamin D, which is necessary for intestinal absorption of calcium. Also, as you age, your body becomes less efficient at absorbing calcium and other nutrients. Older adults also are more likely to have chronic medical problems and to use medications that may impair calcium absorption.
| Recommended Calcium Intakes | |
| Ages | mg/day |
| Birth–6 months | 210 |
| 6 months–1 year | 270 |
| 1–3 | 500 |
| 4–8 | 800 |
| 9–13 | 1300 |
| 14–18 | 1300 |
| 19–30 | 1000 |
| 31–50 | 1000 |
| 51–70 | 1200 |
| 70 or older | 1200 |
| Pregnant or lactating | |
| 14–18 | 1300 |
| 19–50 | 1000 |
Vitamin D:– Vitamin D plays an important role in calcium absorption and in bone health. It is synthesized in the skin through exposure to sunlight. Some people are able to obtain enough vitamin D naturally, due to their work schedules, studies show that vitamin D production decreases in the elderly, in people who are housebound. These individuals may require vitamin D supplement to ensure a daily intake of between 400 to 800 IU of vitamin D.
Exercise:– Like muscle, bone is a living tissue that responds to exercise by becoming stronger. The best exercise for your bones is weight–bearing exercise, which forces you to work against gravity. These include walking, hiking, jogging, stair–climbing, weight training, tennis, and even dancing.
Smoking:– Smoking is bad for your bones as well as for your heart and lungs. Women who smoke have lower levels of estrogen compared to nonsmokers and frequently go through menopause earlier. Smokers also may absorb less calcium from their diets.
Alcohol:– Regular consumption of alcohol may be damaging to the skeleton, even in young women and men. Those who drink heavily are more prone to bone loss and fractures, both because of poor nutrition as well as increased risk of falling.
Medications that cause bone loss:– The long–term use of glucocorticoids (medications prescribed for a wide range of diseases, including arthritis, asthma, Crohn’s disease, lupus, and other diseases of the lungs, kidneys, and liver) can lead to a loss of bone density and fractures. Other forms of drug therapy that can cause bone loss include long’term treatment with certain antiseizure drugs, such as phenytoin (Dilantin®) and barbiturates, gonadotropin releasing hormone analogs used to treat endometriosis, excessive use of aluminum–containing antacids, certain cancer treatments, and excessive thyroid hormone. Please do not to stop or alter your medication dose on your own.
Prevention Medications:– Various medications are available for prevention, as well astreatment, of osteoporosis. Treating osteoporosis requires a comprehensive program that includes proper nutrition, exercise, and safety issues to prevent falls. Your doctor may prescribe medication to slow or stop bone loss, increase bone density, and reduce fracture risk.
Osteoporosis is often called the “Silent disease” because bone loss occurs without symptoms. People may not know that they have osteoporosis until their bones become so weak that a sudden strain, bump, or fall causes a hip fracture or a vertebra to collapse. Collapsed vertebra may initially be felt or seen in the form of severe back pain, loss of height, or spinal deformities such as kyphosis, or severely stooped posture. Doctors may recommend that you have your bone mass measured. Bone mineral density (BMD) tests measure bone density in the spine, wrist, and/or hip (the most common fractures in osteoporosis), while others measure bone in the heel or hand. These tests are painless, noninvasive, and safe.
Bone density tests can. Detect low bone density before a fracture occurs. Confirm a diagnosis of osteoporosis if you have already had a fracture. Predict your chances of fracturing in the future. Determine your rate of bone loss and/or monitor the effects of treatment if the test is conducted at intervals of a year or more.
Fall Prevention: Is a special concern for people with osteoporosis as it can increase the likelihood of fracturing a bone in the hip, wrist, spine or any other part of the skeleton. It is important that individuals with osteoporosis be aware of any physical changes that affect their balance or gait. Falls can also be caused by impaired vision and/or balance, chronic diseases that impair mental or physical functioning, and certain medications, such as sedatives and antidepressants.
Use a cane or walker for added stability, wear rubber–soled shoes for traction, walk on grass when sidewalks are slippery in the monsoon, be careful on highly polished floors that become slick and dangerous when wet. Don’t clutter the floor Be sure stairs are well lit and have handrails preferably on both sides, install handles on bathroom walls near tub, shower, and toilet, use a rubber bath mat in the bathroom, keep a flashlight with fresh batteries beside your bed; Consider purchasing a cordless phone so that you don’t have to rush to answer the phone when it rings or you can call for help if you do fall.