Osteoporosis is a disease in which the density and quality of bone are reduced, leading to weakness of the skeleton and increased risk of fracture, particularly of the spine, hip and wrist. Osteoporosis is a global public health problem which currently affects approximately one in three women and one in five men, and is increasing in significance as the population of the world both grows in size and is living longer. Bone loss doesn’t have any symptoms, and often the first sign of having osteoporosis is a fracture. For all these reasons, osteoporosis is often referred to as the "silent epidemic".
Skeletal system in our body comprises of 206 bones which give a structure to our body and therefore keeping this fit, healthy and strong is of foremost importance. In men after the age of 60 yrs., bone health usually starts deteriorating which we call as osteoporosis or osteopenia. Osteopenia is the first stage of demineralisation of bones and if not corrected in time can lead to osteoporosis. Demineralisation is the process wherein calcium from the bones starts reducing leading to brittle and fragile bones causing easy breakage.
In case of women, demineralisation occurs at faster rate after menopause i.e. after the age of 45. In studies among adults, one three-year study in healthy young women aged 30-42 years showed that enriching the diet with dairy foods prevented bone loss in the spine, compared with control subjects who did not increase their dietary calcium intake. So for women early measures to maintain bone health is very important aspect.
Like any organ in the body, the skeleton needs a balanced diet containing both macro nutrients(energy, protein, fat and carbohydrate) and micro nutrients (vitamins and minerals) for its normal development and maintenance.
Calcium,Phosphorus along with other minerals like Vitamin D is essential to maintain bone health, if dietary part is concerned. Along with that exercise is also equally important to give rigidity to the bones. Utilization of calcium is closely linked with that of phosphorus since most of calcium is deposited as calcium phosphate in the bones. Vitamin D is freely available from the sunlight whereas phosphorus is available through dietary sources.
Recommended dietary allowance (RDA)
- Calcium: Adults: 400 mg/day, Pregnancy / lactation: 1000 mg/ day
- Phosphorus: It is based on the maintenance of normal serum phosphorus levels in adults (2.5-4.5 [mg/d L)
- Vitamin D: 600 I U
Below are the listed modifications that need to be followed in order to achieve and maintain strong bones in early 30’s.
- Dietary modifications: Foods that enhance bone health should be included in daily diet on regular basis. Some of the calcium rich food groups along with sources and values are:
- Milk and its products: 200 ml of whole milk will give 226 mg of calcium and 130 mg of phosphorus. Whereas 100 g of paneer will give 208 mg of calcium and 138 mg of phosphorus. Similarly curd will give 83 mg of calcium and 93 mg of phosphorus. Buttermilk being the least in phosphorus giving 30 mg and 116 mg of calcium. Yogurt gives 382 mg of phosphorus and 110 mg of calcium.
- Green leafy vegetables: Amaranth being the richest source of calcium (800 mg/100 g) and phosphorus (50 mg/100 g) is followed by fenugreek 395 mg of calcium and 51 mg of phosphorus. Other rich sources are spinach and broccoli with 73 mg and 47 mg of calcium and 21 mg and 41 mg of phosphorus respectively.
- Nuts and oil seeds: sesame seeds are the richest source of calcium (1450 mg/100 g) and phosphorus ( 570 mg/100) followed by coconut and niger seeds each giving 400 mg and 300 mg of calcium and 210 mg and 224 mg of phosphorus respectively.
- Pulses: Rajmah is rich source of calcium (260 mg) whereas soybean is rich source of phosphorus (690 mg), also green gram whole (moong) is good source of both the minerals.
- Cereals: Ragi is rich source of calcium (350 mg) and rajgira is good source of phosphorus (557 mg)
- Exercise: Exercise like jumping, running, dancing, walking, yoga, help young people to acquire both bone density and mass. The bones become stronger and less vulnerable to osteoporosis later in life. Exercise builds muscle tone and improves balance, thereby preventing falls, which are a major trigger of fractures. This is particularly important among older people. High level physical activity is associated with reduced risk for hip fracture (but not wrist or vertebral fractures).
- Also cold drinks containing caffeine should be avoided since they contain phosphoric acid which increases the excretion of calcium through urine.
- Limit drinking alcohol and smoking: Drink Less for Strong Bones. Heavy drinking is a health risk for many reasons, including the effects on bones. Research shows that chronic heavy alcohol use, especially during adolescence and young adult years can dramatically affect bone health and increase the risk of osteoporosis later in life.
- When you imbibe too much of alcohol every day – the stomach does not absorb calcium adequately. Alcohol interferes with the pancreas and its absorption of calcium and vitamin D. Alcohol also affects the liver, which is important for activating vitamin D -- which is also important for calcium absorption