Articles on osteoporosis

5 Myths About Osteoporosis

Dr. A N Roy, Rheumatologist
 1. Osteoporosis is a Woman’s Disease.Osteoporosis strikes men too. Worldwide it affects one in five men versus three Women.Osteoporotic fractures in older men (> 50 Years) are common and associated with considerable mortality and morbidity, including reduced function and mobility, pain, hunch back and respiratory compromise. The result is diminished quality of life and loss of Independence.Following hip fracture, men are twice as likely to die when compared to women.The lifetime risk of a man suffering an osteoporotic fracture is greater than his likelihood of developing prostate cancer.One-third of all hip fractures worldwide occur in men.2. Osteoporosis is a natural part of ageing and you can’t prevent it. Breaking a bone after a minor fall or bump is NOT normal at any age.   There are actions that can be taken early in life to reduce the risk of getting osteoporosis.  Adopting a bone-healthy lifestyle at all ages is the first step to prevention. Risk Modifiable risk factors that can be addressed are : eating food rich in bone-healthy nutrients , including Calcium and Vitamin D ; avoiding negative life style habits    e.g. :excessive use of alcohol and smoking; getting regular weight-bearing and muscle strengthening exercise.3. Osteoporosis is not an urgent health concern and an immediate action is not necessary.Worldwide, populations are ageing rapidly and life expectancy in men is increasing steadily. From 1950 to 2050 there will have been a 10-fold increase in the number of men aged 60 years or over –the age group most at risk of osteoporosis.In Europe the total number of fractures in men will increase by 34% from 2010 to 2025. In some other regions of the world the numbers of men with osteoporosis and fracture is escalating at a far greater rate.Healthy, active ageing must be prioritized so that men and women can lead active, independent lives as they age. Without effective prevention strategies, an enormous increase in fractures will place a heavy burden on individuals, families and communities as well as on health –care budgets. 4. Osteoporosis cannot be diagnosed or treated.Simple tests exist to help identify those with osteoporosis as well as fracture risk, and effective treatments are available.Men over the age of 50 years who have had a previous fracture are at double the risk of subsequent fracture compared to those who haven’t fractures. A prior fracture is a clear sign that men must talk to their doctor, get tested and treated appropriately.Taking the IOF-One –Minute Osteoporosis Risk test is a good way to identify personal risk factors. In men two common risk factors are hypogonadism (Testosterone Deficiency) and long term corticosteroid use, among others.Men with risk factors discuss their bone health with their doctors. The doctor may order a dual-energy- x-ray absorptiometry (DXA) test to measure Bone mineral Density and/or assess future fracture probability using the FRAX calculator. Following a clinical assessment, medication may be prescribed.5. Osteoporosis has a minimal impact on men and the family unit.Men play a critical role in families as fathers and sons, providing care and support to other family members. Worldwide, a significant number of working days and productivity is lost due to fractures (e.g. Spinal) in men between the ages of 50-65 years.Healthy ageing and maintenance of independence is important to older men and their families. After sustaining a hip fracture, approximately 10-20% of formerly community dwelling men will require long term nursing care.Men have a lower life expectancy than women so hip fractures cause them to lose a greater proportion of the number of years of life left than they do in women.Improving the health of men through early detection of osteoporosis and timely treatment can result in reduced morbidity and mortality resulting in benefits for men, families and Society.

Osteoporosis - Know It, to Ungrow It

Dr. Raviraj Francis, Physiotherapist
Osteoporosis is the most common metabolic bone occours bcos of reduction in bone density due to reduction in bone mass.... clinically putting it we can say that 'when the rate of bone formation cannot match up with the rate of bone reabsorption' osteoporisis occours.CausesPost menopausalSenilityBed ridden for a Long timeProtein deficiencyHyperthyroid stateLong term steroid therapyCLINICAL FEATURES-it is fairly an asymptomatic disorder unless complications occour.... usually a fracture occours bcos of loss of bone mass which renders the bone weak hence even a slight trauma can cause fracture.. Thigh bone,lower back and forearm fractures are common.Knee pain in post menopausal women is fairly common.INVESTIGATIONS done to arrive at a Provisional Diagnosis would includeSerum Calcium/phosphate levels,Bone mass density-it is a Gold standard as far as quantification of bone mass is considered...levels below -2.2 indicate a certain osteoporotic cause.Bone biopsyNeutron Activation Analysis (less popular)TREATMENTAs it is a multifactorial condition hence the treatment also has to be multidiciplnary..(services of General physician to Orthopadecian to Physiotherapist can be availed)Common general treatment includesCalcium supplementationHigh Protein dietHarmonal injections (Androgens & estrogen)Vitamin DAlandronateCalcitonin & fluorideAlong with this...proper exercise regime Active,static,closed chain kinematic,Aquatic exercises are beneficial for gaurded activity and bone formation.Use of orthosis (knee cap,lumbo sacral belt) and bracing also brings about much needed relief to the person.'Osteoporosis can be a debliting and irritating disease but with proper diet,precautions,orthosis,supplementation and exercise the person can live a Normal Life.

Love Your Bones - Say No to Osteoporosis

Dr. S.Sham , Rheumatologist
World Osteoporosis Day which is being celebrated on October 20th of every year since 1997, is actually a year long campaign to create awareness about the disease. It is important, as the need of the hour for people to understand the immense burden caused by osteoporosis and the ways to overcome it.Osteoporosis is a medical condition which leads to reduced bone mass with micro architectural deterioration and hence increasing the risk of fracture. So such fractures which occur due to trivial trauma (eg: falling from a walking height) are called fragility fractures. The sites more prone are spine, femur andradius. Osteoporosis  is usually known as the "silent killer" as it doesn’t show any prior symptoms and the person comes to know about it only after he sustains a fracture. We have so many diseases in our country so why is this so important? The current population of India is around 1.2 billion. By 2020, there will be around 76 million people with their age greater than 65 years, which is quite a significant number.Worldwide it seems every 3 seconds one sustains an osteoporotic fracture. Approximately one in three women and one in five men aged over 50 years will suffer an osteoporotic fracture in their remaining lifetime. A prior fracture is associated with a 86% increased risk of any fracture. More than 50% of hip fractures in the world will occur in Asia by 2050 and the mortality rate is around 20-24% in the first year. Aren’t these statistics quite alarming?The most sad part is  that we all have accepted this as a natural process of ageing. Whatever be our age, we shouldn’t break our bones with a trivial fall. If we do, then our bones are weak and it is not normal. It can be detected early and a fracture can be prevented with adequate treatment.It’s widely known that osteoporosis usually affects the older people. But it’s actually a disease of the young with consequences in the older age. We usually attain the peak bone mass at 20 – 30 years of age, after which there is a gradual decline in the bone mass. So in the earlier stages of life, with the help of a good diet and healthy lifestyle one can attain the maximum bone mass. If they do so, the chances of them having a low bone mass  later in life will be less.Similarly it’s usually thought as a disease of postmenopausal women. Yes of course the women are at a higher risk but men are no safer and are at a greater risk of getting a prostate cancer. Actually the mortality and morbidity post fracture is more in men. ‘Usually women maintain their health whereas men just go for repairs’. This attitude should change among men and they should also screen for osteoporosis rather than getting medical attention after a fracture. There are a lot of secondary causes for osteoporosis like drugs, various rheumatological,endocrine diseases etc. which have to be thought of particularly in males and those with fragility fractures at a younger age.So it’s high time everybody becomes aware about this disease and its consequences. It can be screened effectively by DEXA scan. After detecting osteoporosis it can be effectively managed with the likes of Calcium, Vitamin D, Bisphosphonates,Parathormone analogues, Monoclonal antibodies etc. As we all know ‘prevention is better than cure’, one should try to maintain a healthy lifestyle by regular exercises, requisite sun exposure, adequate dietary intake of calcium and vitamin D. So let’s promote the caption ‘Love your bones’ i.e. the global symbol of bone health.

Prevent Osteoporosis Through Your Diet

Dr. Geetanjali, Dietitian/Nutritionist
World Osteoporosis Day 20 October 2016Osteoporosis is a medical condition in which the bones become brittle and start thinning due to the loss of tissues. Doctors advise food rich in calcium, vitamin D and vitamin C to help maintain healthy bones as well as to reduce the risk of this condition. Regular muscle-strengthening exercises are also helpful in preventing osteoporosis. According to recent studies, the following foods help prevent osteoporosis and relieve painful symptoms.MILKIt is no big surprise that the superstar of foods for osteoporosis is milk. Milk brims with bone strengthening calcium which is a crucial nutrient for healthy bones. Milk is packed with Vitamin D, which is important for the absorption of calcium in the body, improves bone health and also boosts the immune system. If you are worried about the weight gain factor, go for low-fat or skimmed milk.FISHA perfect osteoporosis diet should always include fish as it is an impeccable source of calcium. Fish, especially Salmon is packed with vitamin D, an important nutrient which helps the body absorb and process calcium. Sardines are also a rich source of calcium. The calcium in fish helps maintain bone mass and also maintain bone structure.ALMONDAlmonds are a great source of Vitamin E, manganese, calcium and riboflavin, and are an inseparable part of the osteoporosis diet plan. It supports bone health in many ways. Almonds are a chock-full of essential nutrients that help build strong and healthy bones. For people suffering from osteoporosis, it is must to incorporate a handful of almonds in their daily diet plan.EGGS An ideal diet for osteoporosis is never complete without eggs. Eggs are packed with Vitamin D, Vitamin K, Vitamin E, Vitamin A, phosphorous, folate and selenium. They are one of the best natural sources of protein which protects our bones and promotes healthy hair and nails. The phosphorous in the eggs is an important component for healthy bones and aid in strong bone formation.YOGURT Yogurt is one of the most noted food items that can be incorporated in your diet to reduce the problems of osteoporosis. Yogurt is a milk product and is a great source of animal protein. It also contains several other nutrients like calcium, potassium, Vitamin B2, Vitamin 12, Vitamin D and magnesium. In women, during their menopause, there is a notable decrease in the estrogen levels which in turn can cause thinning of bones, yogurt restores the estrogen levels and ensures bone health.BANANASBananas are very nutritious fruits and one of the most effective foods to prevent osteoporosis. One of the main reasons to incorporate bananas into the osteoporosis diet plan is its high potassium content. Regular intake of banana helps the body to absorb calcium and other essential bone healthy nutrients that ensure bone health and lowers the risk of osteoporosis.CABBAGE Cabbage is one of the best foods for osteoporosis and ensures strong, healthy bones. It is a great source of fibre, vitamin B6, vitamin D, folate, iron, magnesium, calcium and potassium. Folate plays a pivotal role in carrying out many bodily functions like bone repair and bone maintenance. Cabbage also helps in the process of bone metabolism.

Preventing Osteoporosis by Eating the Right Type of Food

Ms. Swati Kapoor, Dietitian/Nutritionist
Lately women in the early 30's are suffering from osteoporosis. The earlier average age was from 50 years, around the same time menopause would set in. The reason is with menopause the body experiences a dramatic drops in estrogen production that results in bone loss. This was labeled  as  a growing old diseases since the two big reasons for developing osteoporosis are when the body fails to form enough new bone or when the old bones are reabsorbed by the body, but not anymore.Calcium and phosphate are two minerals that are essential for normal bone formation. Throughout youth, your body uses these minerals to produce bones. Mineral intake during adolescence and early adulthood lays the foundation of healthy bones for the coming years.  Not getting enough calcium and body not being able to absorb enough calcium from the diet adversely affects the bone production and bone tissues.Bone is a dynamic living tissue that becomes strong when exercised or used and becomes fragile when unused. Mostly we are advised to eat foods rich in calcium for bone development but equally excluding foods that lead to loss of bone mineral in the body like sugar, sodas, table salt, coffee and alcohol. But are you forgetting nutrients which directly or indirectly benefit the bone health like vitamin D for better absorption of calcium, vitamin K which activates osteocalcin which is a bone protein which bonds calcium, vitamin C which improves bone absorption and other bone minerals like magnesium, phosphorous, boron etc.Though dairy is the most popular source of calcium, many other nutrients required for prevention and better bone health can be consumed from plant based sources like vegetables and fruits which are rich in various nutrients. Optimum levels of the following nutrients in your diet will improve your bone health as well as overall fitness.Women are more prone to developing osteoporosis than men due to two reasons first they are genetically born with a lower bone mass than men and secondly estrogen levels. Estrogen plays an important role in keeping bones strong and healthy, in both men and women. Changing levels of estrogen especially in women make them more vulnerable to this disorder.Foods bad for bone healthSalt: Over consumption of salt than the daily requirement could make you lose calcium. You require 2400 milligram of sodium in a day. Not only you consume sodium through salt in foods but foods naturally contain salt which could create an excess. Eat salt in moderation to avoid loss of calcium.Soda: Sweetened soft-drink and aerated drinks cause loss of calcium in the body and has been observed while excreted in urine. The phosphoric acid which is the fizziness in soda drinks could lead to faster loss of calcium.Caffeine: Caffeine in excess of 100 milligram can cause loss of some calcium in the body. Caffeine is not consumed by the body just through coffee but some iced teas, energy drinks and other drinks contain them.Alcohol: Alcohol blocks calcium absorption in the body and restricts bone building minerals to be absorbed properly. Bones become weak faster and can cause trouble while healing of bones due to alcohol consumption during fracture.Some vegetables which immensely improve bone health and maintain them and avoid loss of bone minerals in the body are green peas, cabbage, broccoli, lettuce, spinach, asparagus, oats, parsley, lemons, milk and dairy etc. Though milk and dairy are the best sources but these vegetables have various nutrients to support good bone health and prevent osteoporosis. Exercising, the often most forgotten factor, is critical to bone health as it helps in improvement of bone density and better absorption of nutrients.


Dr. Vishwas Virmani, Physiotherapist
Three factors essential for keeping your bones healthy throughout your life are:Adequate amounts of calciumAdequate amounts of vitamin DRegular exerciseCalciumMen and women between the ages of 18 and 50 need 1,000 milligrams of calcium a day. This daily amount increases to 1,200 milligrams when women turn 50 and men turn 70. Good sources of calcium include:Low-fat dairy products (200 to 300 milligrams per serving)Dark green leafy vegetablesCanned salmon or sardines with bonesSoy products, such as tofuCalcium-fortified cereals and orange juiceIf you find it difficult to get enough calcium from your diet, consider taking calcium supplements. However, too much calcium has been linked to heart problems and kidney stones. The Institute of Medicine recommends that total calcium intake, from supplements and diet combined, should be no more than 2,000 milligrams daily for people older than 50.Vitamin DVitamin D improves your body's ability to absorb calcium. Many people get adequate amounts of vitamin D from sunlight, but this may not be a good source if you live in high latitudes, if you're housebound, or if you regularly use sunscreen or avoid the sun entirely because of the risk of skin cancer.Scientists don't yet know the optimal daily dose of vitamin D. A good starting point for adults is 600 to 800 international units (IU) a day, through food or supplements. If your blood levels of vitamin D are low, your doctor may suggest higher doses. Teens and adults can safely take up to 4,000 international units (IU) a day.ExerciseExercise can help you build strong bones and slow bone loss. Exercise will benefit your bones no matter when you start, but you'll gain the most benefits if you start exercising regularly when you're young and continue to exercise throughout your life.Combine strength training exercises with weight-bearing exercises. Strength training helps strengthen muscles and bones in your arms and upper spine, and weight-bearing exercises — such as walking, jogging, running, stair climbing, skipping rope, skiing and impact-producing sports — affect mainly the bones in your legs, hips and lower spine.Swimming, cycling and exercising on machines such as elliptical trainers can provide a good cardiovascular workout, but because such exercises are low impact, they're not as helpful for improving bone health as weight-bearing exercises are. There is evidence that competitive cyclists have reduced bone mineral density. They should combine strength training and weight-bearing exercises and consider a test for osteoporosis.

Remember Osteoporosis Today, Besides Fractures Low Calcium Causes Heart Failure.

Dr. Neelam Nath Bhatia, General Physician
Calcium and fat soluble Vitamin D are important for healthy bones to regenerate.Wear and tear is more in women during reproductive years due to extra demands of lactation and pregnancy with a growing up baby taking up resources from mother.A Recent Study has suggested that extra intake of oral tablets of calcium can be Dangerous for the heart.Another study has suggested that 'weak' bones are related to more incidences of a Heart Failure !Decide for yourself about How to keep both Bones and Heart Healthy.Eat a Calcium rich food and Dairy products minus fats are Still the rich source of calcium which can be digested with advancing age.Fresh Oxygen is as Important for bone and heart health. Keep walking regularly in a place with fresh plants with clean leaves. No need to inhale dusty air due to plants in a nearby park having dusty leaves all around.Seasonal Fruits and Vegetables are good sources of calcium. Remember that Calcium is a mineral and one needs a good supply of inherent enzymes to digest the Calcium well.Vitamin D is manufactured by our liver and it is called Sunshine Vitamin as Sun helps to produce this vitamin.  Sun Exposure should be uninterrupted for at least half an hour, and I suggest to women to Expose their backs to sun ,it gives exposure to larger area and 'saves' the face from getting tanned !Vitamin K , another fat soluble vitamin is present in good fats like pure ghee or butter and nuts.Vitamin K helps Better Absorption of Vitamin D.Besides these 2 essential vitamins for bones , calcium as a mineral ,helped by Zinc and Magnesium.Normally around Menopause time , presumption is that every woman is prone to fractures besides having a weak heart. Calcium along with Vitamin D are given as a routine supplements.Can we do without supplements ? If No Supplements are given--There is risk of Fractures to bones and Risk of a Heart Failure,specially if woman is also having high BP , Diabetes and has a strong family history of Heart AttacksIf supplements are given , calcium can get Deposited within blood vessels.Follow the middle path.Depend more on food and less on supplements but do take a low dose if bones are found to be weak on testing .No Need to take a Weekly Dose of 60,000 I U but one can have around 500 IU of Vitamin D per day.Low Dose of Vitamin D supplement may be safe if taken along with fat soluble Vitamin K through good fats.Regarding Calcium supplements ,do take but only If Tests Reveal Weak Bones.

Eating to Prevent Osteoporosis

Dr. Vishwas Virmani, Physiotherapist
Good eating habits are directly related to the prevention of osteoporosis in both men and women. It is often thought that only women suffer from this disease, but this is not true. While women are more prone to develop osteoporosis, men also suffer from this preventable disease.Osteoporosis causes bones to lose mass and density. As the bones become porous and brittle, the chance of fracture is greatly increased. To lessen the risk of osteoporosis, try to get at least 1,000 mg (adults ages 19-50) to 1,200 mg (adults over 51) of calcium each day. Use the SparkPeople nutrition tracker to analyze your average intake.If you're not meeting your needs, include additional milk and dairy products such as milk, cheese, yogurt, or pudding. Don’t forget foods made with milk such as cheese pizza, lasagna, and yogurt shakes. Other foods that are good sources of calcium include calcium-set tofu, canned salmon and sardines with the bones, calcium fortified juice, and broccoli.Calcium is what strengthens our bones and protects the internal organs. When there is a loss of calcium, we lose strength, and bones become brittle and break more easily. Some simple variations to improve your diet are as follows:For breakfast, use milk instead of water with your cereal and oatmeal. Drink plenty of calcium-fortified orange juice.For lunch, eat yogurt as your dessert, choose milk instead of soda and add cheese to your sandwich.For dinner, prepare canned tomato soup and macaroni and cheese with milk. Have pudding made with milk or frozen yogurt for dessert.Here is a list of examples of the proper foods you should integrate into your diet to help ward off osteoporosis and become healthier:Whole grains – brown rice, oats, corn, barley, buckwheat, wheat, ryeVegetables – broccoli, carrots, spinach, lettuce, onions, celery, string beans, artichoke, summer squash, endive, cucumbers, asparagus, peppers, parsley, sprouts, and tomatoesBeans – split peas, lentils, kidney beans, navy beans, chickpeas, black beans, white beans, soy beans, and tofuNuts and seeds – sunflower, sesame or pumpkin seedsWater – 8 glasses a dayLastly, if you really don't like dairy products or they don't like you, then try some of these tips to increase the amount of calcium in your diet without upsetting your stomach:Use milk in preparing hot chocolate, mashed potatoes, oatmeal, and soups.Make a fruit smoothie using yogurt and frozen fruit for a light refreshing meal or snack.Use nonfat plain yogurt to replace part or all of the sour cream, mayonnaise or cream cheese in recipes.Use canned salmon, instead of tuna for sandwiches and casseroles.Serve a stir-fry packed with calcium-rich foods like broccoli, bok choy and tofu.Make a sandwich spread from calcium-fortified cottage cheese and chopped veggies.Mix part-skim ricotta cheese with cinnamon and raisins to spread on bagels or English muffins.