“OSTEOPOROSIS” literally means “porous bone.” It is called a silent disease because there are often no symptoms of bone loss until the bones become so weak that a sudden strain, bump, or fall causes a fracture. Such fractures are typically of the hip, ribs, vertebras, or wrist. People tend to associate osteoporosis with frail, elderly women. However, as Anna’s case illustrates, osteoporosis can also strike the young.
A Serious Health Threat
The International Osteoporosis Foundation reports that “in the European Union, someone has a fracture as a result of osteoporosis every 30 seconds.” In the United States, 10 million people have osteoporosis, and another 34 million are at risk because of low bone mass. Furthermore, the U.S. National Institutes of Health reports that “one out of every two women and one in four men age 50 and over will have an osteoporosis-related fracture in their lifetime.” And the outlook is not improving.
The Bulletin of the World Health Organization states that the number of fractures resulting from osteoporosis is expected to double worldwide over the next 50 years. This projection is likely based on the expected increase in the elderly population. Still, the consequences are frightening. Osteoporosis has a high rate of disability, even mortality. Almost 25 percent of patients aged 50 or older who suffer hip fractures die as a result of medical complications within the year following the fracture.
Are You at Risk?
Recent studies reveal that heredity is a significant risk factor. When parents have a history of hip fracture, the risk of this type of fracture occurring in their children may even double. Another risk factor is malnutrition of a fetus, which results in lower bone density in childhood. Then there is the age factor. The older people get, the more fragile their bones generally become. Certain medical conditions, such as Cushing’s disease, diabetes, and hyperthyroidism, can also contribute to the development of osteoporosis.
Menopause in women results in a reduction of estrogens that protect bone mass. This is the reason why nearly four times more women suffer from osteoporosis than men. Estrogen deficiency brought on by the surgical removal of a woman’s ovaries can result in early menopause.
Risk factors for osteoporosis that an individual can change include eating habits and lifestyle. A diet low in calcium and vitamin D is a contributing factor to bone deterioration. An excessive consumption of salt may increase risk, since it increases the body’s excretion of calcium. Excessive consumption of alcohol, which is often accompanied by poor nutrition, also contributes to bone loss.
As mentioned at the outset, Anna suffered from osteoporosis as a consequence of an eating disorder. That disorder had led to nutritional deficiencies, low body weight, and even an absence of menstruation. As a result, her body had stopped producing estrogens, leading to the weakening of her bones.
An additional factor for developing osteoporosis is a lifestyle of limited physical activity. Smoking too is a significant risk factor, since it can decrease bone mineral density. According to the World Health Organization, about 1 in 8 hip fractures is attributable to smoking. However, studies reveal that when a person stops smoking, bone loss and the risk of suffering a fracture decrease.
Prevention of Osteoporosis
The foundation for preventing osteoporosis is laid in childhood and adolescence. That is when 90 percent of a person’s total bone mass is reached. Calcium, an essential nutrient for a strong skeletal structure, is stored primarily in the bones. Some of the principal sources of calcium are milk and dairy products, such as yogurt and cheese; canned sardines and salmon (eaten with the bones); almonds; oatmeal; sesame seeds; tofu; and dark-green leafy vegetables.
In order for calcium to be absorbed by the body, vitamin D is essential. This vitamin is synthesized in the skin by exposure to sunlight. Manuel Mirassou Ortega, a doctor of internal medicine and member of the Mexican Bone and Mineral Metabolism Association, explained: “Sunbathing for ten minutes a day contributes to preventing the development of osteoporosis, as it provides some 600 units of vitamin D.” This vitamin can also be found in such foods as egg yolks, saltwater fish, and liver.
The importance of exercise in preventing osteoporosis can hardly be overemphasized. During childhood and adolescence, exercise helps to increase bone mass, and in old age it helps to prevent loss of bone mass. Weight-bearing and resistance exercises—those in which muscles work against gravity or other forces without overstressing the bones and joints—are recommended the most. Walking, climbing stairs, and even dancing are simple but effective weight-bearing exercises.*
Prevention can certainly do much to combat this silent disease. As we have seen, this may include adjusting one’s diet and lifestyle to preserve bone mass and to increase bone strength. It is true that for most people who have fallen into a sedentary lifestyle, such a way of life may be very difficult to change. But what benefits come to those who make the effort to do so! Among other things, they may avoid being one of the many millions worldwide who suffer from osteoporosis.
in Awake! June 2010