World Osteoporosis Day 2020

Osteoporosis is a silent disease as it does not cause any symptoms. You may come to know about it only after you experience a fracture. To spread awareness about this disease, World Osteoporosis Day (WOD) is observed on 20th Oct every year. It marks the beginning of a yearlong campaign dedicated to increasing the global cognizance of the prevention, diagnosis and treatment of osteoporosis. WOD aims to make osteoporosis and fracture prevention a global health priority by involving health care professionals, policymakers, patients as well as the entire population. 

How widespread osteoporosis is?

Let us look at some data:

  • Worldwide, more than 8.9 million fractures occur every year due to osteoporosis, resulting in one fracture every 3 seconds 

  • It is estimated that Osteoporosis can affect 200 million women worldwide

  • 1 in every 3 women and 1 in every 5 men over the age 50 will have an osteoporotic fracture in the world

  • It is estimated that by 2050, the incidence of hip fracture in men will increase by 310% and in women by 240% 

What is osteoporosis?

Word “Osteoporosis” means porous or spongy bone. It is characterized by reduced bone mass and structural worsening of the bone tissue which increases the risk of fractures mainly in the hip, spine or wrist. Although it can affect people of any age, it is more commonly seen in older age especially women. It has been estimated that globally around 200 million people have osteoporosis and women have 4 times higher risk compared to men. 

Our bones are constantly growing and renewing which involves the continuous bone formation and bone resorption. In young age (below the 20s) bone formation is faster than bone resorption and our bones are dense. After we cross the early 20s, this process slows down and peak bone mass is reached by the age of 30. After that, bone resorption is faster than bone formation. Osteoporosis develops if bone loss happens too quickly or when bone formation happens too slowly. Also, it may develop if optimal peak bone mass was not attained during the early years of life. 

What are the risk factors for Osteoporosis?

There are some factors which can increase your risk of developing osteoporosis. Some of these factors cannot be controlled and some can be changed. 

Risk factors that cannot be controlled:

  • Sex: Females are at higher risk of developing osteoporosis

  • Age: Older people have a higher risk than young people 

  • Body size: People with small body frames have a higher risk because they have less bone mass

  • Family history: You have a higher risk if your parent or sibling has osteoporosis

  • Race: Caucasians and Asians have a higher risk

Risk factors that can be changed:

  • Hormones: Low estrogen level during menopause in women and low testosterone level in men can increase the risk 

  • Calcium and vitamin D: Consuming a diet low in calcium and vitamin D can make you more prone to bone loss 

  • Eating disorders: Severely reducing food intake to lose weight can cause osteoporosis

  • Medicines: Long term use of drugs like steroids and anticonvulsants can reduce bone density

  • Lifestyle: Sedentary lifestyle or prolonged bed rest can weaken your bones 

  • Smoking: It can lead to increased bone loss

  • Alcohol: Excessive alcohol consumption is harmful to bones

What are the complications of Osteoporosis?

If left untreated osteoporosis can worsen with time. As bones become weaker and thinner, they tend to break more easily. A fracture can happen due to a fall or even due to strong cough or sneeze. Compression fractures can also happen which can cause back or neck pain and loss of height. This happens when vertebrae in your backbone break due to normal pressure of the spine. 

Hip fractures can happen due to a fall and lead to serious condition and may even cause death within the first year of injury.

How can I prevent Osteoporosis?

A nutritious diet and physical activity are the two main factors responsible for keeping your bones strong and healthy. 

Calcium: Calcium is an important nutrient for bone growth. Many studies have shown that calcium deficiency is related to low bone mass, increased bone loss and fractures.  National nutrition surveys have demonstrated that most people consume less than half the recommended amount of calcium. 

You may also need a calcium supplement each day to meet the recommended requirement. Your doctor can advise you on supplements depending on your age, built and level of physical activity. 

Calcium requirement is higher during childhood and teenage as the body is rapidly growing. Also, during pregnancy and breastfeeding, you need more calcium. Older men and postmenopausal women need to be extra cautious about their calcium intake and should always take calcium supplements. 

Recommended calcium intake for men and women between the age of 18 and 50 is 1000mg/day. This value increases to 1200 mg/day for women after 50 and men after 70 years of age. 

Vitamin D: It helps your body in calcium absorption and improves bone strength. We get vitamin D from sunlight but most of us don't go outside in sunlight or apply a sunscreen which hampers vitamin D synthesis. The recommended daily intake of vitamin D for adults between the ages 51 to 70 is 600 IU and above age 70 is 800 IU. It can be achieved through food and supplements. To maintain your bone health and prevent osteoporosis, you should talk to your doctor about Vitamin D supplements.

Exercise: Regular exercise makes your muscles and bones stronger. Resistance and weight-bearing exercises are highly beneficial for bones. They include walking, jogging, dancing, climbing stairs and weight training. 

How can I know how strong my bones are?

Your bone mass can be measured through the Bone Mineral Density (BMD) test. It can identify osteoporosis and your risk of getting fractures. It is a painless procedure and utilizes a low dose of x-ray. This test can 

  • Detect osteoporosis before any symptoms appear

  • Determine the density of your bones

  • Evaluate the rate of bone loss

  • Monitor the effect of osteoporosis treatment 

How is Osteoporosis treated?

Treatment of osteoporosis includes:

  • Proper nutrition

  • Calcium and Vitamin D supplements

  • Exercise

  • Medicines

  • Prevention of fall 

 

 

Dr. Gaurav Rastogi

Consultant - Orthopaedics

Manipal Hospitals, Dwarka, Delhi

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