Avoiding the silent thief

The best way to prevent osteopotosis later is to have healthy bones now

AMY REDEKOPP

Osteoporosis is a devastating disease that aff ects 1.4 million Canadians, with an additional two million more Canadians likely to develop the disease. It is a very painful disease that leads to fractures, disability, and deformity.

Often called the “silent thief” because symptoms often go unnoticed until a fracture occurs, osteoporosis is a disease that is characterized by weak, brittle, porous bones. As the condition progresses, the bones become frail and have increased susceptibility to becoming fractured. If diagnosed after a fracture occurs, the disease is likely in its advanced stages.

Both men and women are prone to osteoporosis, but statistically women are at greater risk. One in four women have osteoporosis, compared to the one in eight men who have the disease.

Bone tissue is a major component of our structural makeup, and is considered a living tissue. Bones are constantly undergoing structural changes. There are two main “construction workers” that are responsible for the changes that the bone undergoes. Osteoclasts are the cells that break down older bone tissue, whereas osteoblasts are the cells that build new bone to replace. The breakdown and rebuilding of bone is referred to as bone remodelling, and in young adults these processes are in equilibrium.

Peak bone mass occurs in early adulthood, and having high bone density reduces the risk of developing osteoporosis. As we age, the body’s ability to build new bone naturally decreases, which leads to the gradual decline of bone mass. Th is natural aging process, combined with osteoporosis, leads to the rapid decline of bone mass, resulting in fragile, porous bones.

Estrogen is a female hormone that stimulates bone growth. Th is hormone is produced in abundance in females until menopause is reached. After menopause, production of estrogen lowers, resulting in decreased osteoblast activity (rebuilding). Decreased estrogen levels are one of the factors that contribute to the high number of females with osteoporosis.

Major risk factors for osteoporosis include: being over the age of 65, vertebral fractures, family history, malabsorption diseases such as celiac disease and Crohn’s, early menopause, and the tendency to fall. Minor risk factors include: rheumatoid arthritis, hyperthyroidism, low body weight, low calcium intake, alcohol consumption, and smoking.

As previously mentioned, symptoms of osteoporosis are often unnoticed until a fracture occurs. Advanced symptoms such as a fracture of the hip or wrist, loss of height, posture changes, and back pain are symptoms that occur in older adults.

The most accurate technique used to diagnose this disease is called the bone mineral density test. Th is test measures the amount of bone mass in the hip or lower spine. The results of this procedure are compared to the general population to determine if you fall into the normal bone density range. After your results are established, your physician can predict if your risk of fracture is low, moderate, or high over a 10-year time span.

Osteoporosis is a preventable disease if certain measures are taken earlier in life. These preventive measures include lifestyle changes such as obtaining recommended amounts of calcium and vitamin D, being physically active, and avoiding smoking, alcohol, and caffeine.

Calcium is a mineral that builds strong bones and teeth. Calcium is stored in your bones, and if your body is not receiving enough calcium, it will be removed from your bones in order to complete the physiological processes that are facilitated by calcium. The body is only able to absorb a certain amount of calcium at a time, so it is important to spread out your intake of calcium-rich foods throughout the day. Depending upon age and physiological status (pregnancy, lactation), adults need between 1,000-1,500 milligrams per day. Dairy products, fi sh with bones, tofu, fortifi ed juices and cereals, broccoli, bananas, and oranges can be enjoyed to help you achieve your daily calcium requirements.

In order for your body to eff ectively absorb calcium, the recommended intake of vitamin D must be achieved. The Osteoporosis Society states that vitamin D increases calcium absorption by up to 80 per cent. Sunlight is a major source of vitamin D, and we can obtain our intake from being exposed to sunlight for 30 minutes a day. Foods that are rich in vitamin D include fatty fi sh, margarine, and fortifi ed foods. A multivitamin can be benefi cial for helping you achieve your vitamin D requirements.

Physical activity will not only help prevent osteoporosis, but will improve your quality of life. Weight-bearing activities such as walking, dancing, stair-climbing, and aerobics promote increased bone mass. Strength training can be performed by using your own body weight, resistance tubing, or weights to build muscle mass and increase bone density. Activities that require balance and coordination (such as tai chi and yoga) are benefi cial because they allow individuals to respond to sudden changes of motion, reducing the risk for falls and thus fractures. Stretching improves fl exibility and posture, relieves pain, and makes the accomplishment of activities of daily living easier. Before starting an exercise regime, however, you should consult with your physician.

Once diagnosed with osteoporosis, medicinal intervention is used to treat and delay the progression of the disease. There are several categories of drugs that are prescribed, each of them having unique characteristics (and potential side eff ects) to treat osteoporosis. Your physician will help you determine which treatment is right for you.

Osteoporosis affects a large number of the Canadian population. Th rough education, proper nutrition, and remaining physically active, your changes of developing this debilitating disease can be greatly reduced. Remember, the earlier you start to protect yourself against osteoporosis, the better your future bone health will be. The next time you are surrounded by your younger loved ones, pass this information along. You will be doing their bones a huge favour.