What is osteoporosis?

Osteoporosis is a skeletal disease in which a decrease in bone mass density occurs. This makes the bones more porous, increases the number and size of cavities or cells inside the bones, makes them more fragile, makes them more resistant to impact and breaks more easily.

What are the symptoms of this disease?

Osteoporosis is called a silent epidemic because it has no symptoms until bone loss is so severe that fractures occur. The most common fractures are vertebral, hip and wrist fractures (Colles’ fracture or distal end of the radius). Hip fracture is particularly important because it is considered a serious event because it requires surgery, hospitalization and a loss of quality of life for the patient, even if only for a short period of time.

Who is affected by osteoporosis?

The disease mainly affects women after menopause, but may also affect men, adolescents, and even children.

Millions of women suffer from osteoporosis, with a prevalence in the postmenopausal population of 25% (1 in 4). It is estimated that this disease causes about 25,000 fractures each year. About 1 in 3 women and 1 in 5 men over age 50 will have an osteoporotic fracture in their lifetime.

Although it is a silent disease, rheumatologists now have a wide range of tools for early diagnosis and adaptation of treatment, either to prevent bone loss or to combat osteoporosis.

There are lifestyle habits that can help improve bone quality such as: adequate calcium intake, physical exercise and not smoking. The specific amount of Calcium varies with age, but many adults will need 1,000 to 1,500 mg per day. This intake can be made with natural foods rich in calcium (especially milk and its derivatives) or as supplements in the form of medicines (calcium salts). In the latter case, there should be a control by your doctor over the amount and pattern of administration.

Similarly, vitamin D is a key substance for bone. Its daily needs are achieved mainly by the formation of the same in the skin when it receives the effect of solar radiation.

How to prevent osteoporotic fracture?

It is normal to feel worried or even scared after being diagnosed with osteoporosis. However, the good news is that with the right information and support from your doctor, you can significantly improve your bone health and reduce your risk of future fractures with a combination of medication, diet, exercise and lifestyle modifications. If I have osteoporosis, how can I prevent a fracture?

Medications and medications

There are several medications available to prevent and treat osteoporosis, including: bisphosphonates; estrogen agonists/antagonists (also called selective estrogen receptor modulators); parathyroid hormone; estrogen therapy; hormone therapy, etc. Your doctor can help you understand the benefits and risks of each of these medications and select one that is right for you.

In men, reduced testosterone levels may be related to the development of osteoporosis. Men with abnormally low testosterone levels may be prescribed testosterone replacement therapy to help prevent or reduce bone loss.

Diet

In addition to taking your medications, one of the most important things you can do is to follow a diet rich in calcium and vitamin D, maintain adequate daily protein intake, control your sodium intake, and get plenty of exercise.

Calcium

Calcium is needed to keep your bones healthy and strong throughout your life. Unfortunately, most Americans do not get enough calcium in their diets. Dairy products such as milk, cheese and yogurt are excellent sources of calcium, and some non-dairy foods such as broccoli, almonds and sardines can provide smaller amounts.

In addition, many foods you enjoy, juices, breads and cereals, are now fortified with calcium. Calcium supplements can ensure that you get enough calcium every day, especially if you are one of those people with a lactose allergy. A daily intake of calcium of 1000 mg (milligrams) is recommended for men and women up to age 50, increasing to 1200 mg for women over 50 and men over 70.

Calcium supplements are available over-the-counter in a wide range of preparations. Many people wonder what calcium supplements they should take. The “best” supplement is one that suits your needs based on tolerance, convenience, cost and availability. In general, it is advisable to choose calcium supplements from reputable brands. Also, you will absorb calcium better if you take it several times a day in smaller amounts of 500 mg or less at a time.

Vitamin D

Vitamin D plays an important role in helping your body absorb calcium. The relationship between calcium and vitamin D is similar to that of a closed door and a key. Vitamin D is the key that opens the door, allowing calcium to enter the bloodstream. As we age, our bodies become less able to absorb calcium, making it more necessary to get enough vitamin D. The recommended daily intake of vitamin D is 600 IU (international units) up to 70 years of age.
Men and women over the age of 70 should increase their absorption to 800 IU daily. Many people get this amount from eating foods fortified with vitamin D, such as milk. In addition, many calcium supplements are fortified with vitamin D.

Sodium

Sodium is a major component of table salt and affects our need for calcium by increasing the amount we excrete in our urine. As a result, people with diets high in sodium or table salt seem to need more calcium than people with diets low in sodium to ensure that they generally consume enough calcium for their bones.

Protein

Excess protein also increases the amount of calcium we excrete in the urine, but it also provides benefits for bone health. For example, protein is necessary for the healing of a fracture. In addition, studies have shown that older people with a hip fracture who do not consume enough protein in their diets are more likely to experience loss of independence and even death after their fracture. The recommended daily intake of protein is 56 grams for men and 46 grams for women.

Exercise

It is perfectly understandable to want to avoid a new fracture. No one who has broken a bone wants to feel that pain and loss of independence again. However, living a life without exercise is not an effective way to protect your bones. Staying physically active reduces the risk of heart disease, colon cancer and type 2 diabetes. It can also protect against breast and prostate cancer, high blood pressure, obesity, and mood disorders such as depression and anxiety. If that’s not enough to convince you to stay active, consider this: exercise is one of the best ways to preserve bone density and prevent falls as you age.

What type of exercise is best to reduce my risk of another fracture?

Exercise can reduce the risk of fracture in two ways: by helping to build and maintain bone density and by improving your balance, flexibility and strength, all of which reduce your chances of falling.

Bone is a living tissue that responds to exercise by strengthening itself. Just as a muscle becomes stronger and larger with use, a bone becomes stronger and denser. There are two types of exercise that are important for building and maintaining bone density: weight and endurance.

Load-bearing exercises are those in which your bones and muscles work against gravity. Examples include walking, climbing stairs, dancing and playing tennis. Resistance exercises are those that use muscle strength to improve muscle mass and strengthen bones. The best example of a resistance exercise is weight training, either with free weights or weight machines.

Exercise can also help you significantly reduce your risk of falling by participating in activities that improve your balance, flexibility and strength. Balance is the ability to maintain the stability of your body by moving or standing. You can improve your balance with activities like tai chi and yoga.

Flexibility refers to the range of motion of a muscle or group of muscles. Flexibility can be improved through tai chi, swimming, yoga, and gentle stretching exercises. Strength refers to your body’s ability to develop and maintain strong muscles. Weight lifting will increase your strength.

 

Sources:

https://www.agingcare.com/articles/a-guide-to-preventing-future-fractures-133150.htm

http://www.wellnessproposals.com/health-care/handouts/arthritis-musculoskeletal-skin/preventing_fracture.pdf