A silent threat to bone health

Out of 6 crore cases of osteoporosis in India, 80 per cent are of women. Elderly and postmenopausal women are more at risk

AN old man falls in the bathroom and fractures his hip. An 80-plus woman, travelling in a car, has vertebral compression fracture (spinal). These are relatively common in an ageing population. A major reason behind frequent fractures in the elderly is the weakening of bones due to osteoporosis.

What is osteoporosis

In normal bones, solid bony tissue is separated by tiny spaces. In an osteoporotic bone, due to depletion of bony tissue, the spaces are quite wide, leading to weak bones that are prone to fracture even with minor trauma.

A normal bone keeps on rebuilding the bony tissue continuously. The age of 25-35 years is known as the age of peak bone mass. Women are affected by osteoporosis earlier (usually six years after the onset of menopause) than men due to hormonal changes. While men are affected after the age of 60, sexagenarian women suffer from severe osteoporosis because of its longer duration.

Before the actual onset of established osteoporosis, the bone passes through a transitional stage known as osteopenia.

As life expectancy has increased in India, the diseases of the elderly, including osteoporosis, have shown an exponential rise. In recent years, osteoporosis has emerged as a major public health problem and fractures in the elderly have risen manifold.

As per WHO estimates, one in three postmenopausal women suffer from osteoporosis. This number is likely to be higher in India due to poor nutritional practices among women. Out of a total of around six crore osteoporotic patients in India, 80 per cent are women. Further, the onset of osteoporosis in India is observed to occur 10–20 years earlier than in Western countries.

Risk factors

The risk factors include smoking, alcohol consumption, sedentary lifestyle, poor nutrition, calcium and vitamin D deficiency, long-term intake of some drugs and certain hormonal diseases.

Osteoporosis is known as a silent killer because it does not have any symptoms. The disease only comes to light when one suffers an osteoporotic fracture due to some minor injury. The common areas are the spine (vertebral column), the hip region and wrist. Other areas like shoulder, ankle and elbow may also suffer. Even jaw bones are affected and the anchorage of teeth in the jaw bones starts becoming loose. In severe osteoporosis, the teeth start falling.

Prevention and treatment

A lifestyle disease, osteoporosis is largely preventable by having a healthy lifestyle, avoiding alcohol and smoking, along with regular physical activity (walking/yoga/light weight training), can keep your bones healthy

In addition, regular exposure to direct sunlight of at least 30 per cent bare skin (not covered with clothes and not through glass) for at least 30 minutes every day helps to keep vitamin D levels normal that are essential to prevent osteoporosis. Calcium is an important constituent of the bony tissue and a balanced diet containing milk products, green vegetables and protein prevents nutritional osteoporosis. However, rising consumption of junk food, particularly among the young when bone growth is maximum, is creating a severe nutritional imbalance and may lead to even greater number of osteoporosis cases in the future. However, with the increase in surgical expertise and advanced technology, the osteoporotic fractures have become treatable effectively now.

As prevention remains the best medicine, a periodic screening after menopause in women and men after the age of 60 years (at earlier age for high-risk individuals) helps to detect the onset of osteoporosis that is treatable with drugs and healthy lifestyle.

— The writer is director, orthopaedics, Fortis, Mohali

https://www.tribuneindia.com/news/features/a-silent-threat-to-bone-health-572330