For years scientists branded osteoporosis and resulting hip fractures as a disease suffered exclusively by post-menopausal women. For once men didn’t object to this exclusion.

But fact differs from fiction: one third of all fractured hips and vertebrae due to osteoporosis occurs in men. Until recently, scientists attributed almost all cases of osteoporosis in men to some or other underlying illness (such as elevated cortisone levels, intestinal diseases affecting the absorption of calcium and vitamin D, excessive calcium loss with or without kidney stones and cancer).

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New international research data now disregards this notion: in one third of all males with osteoporosis, the only underlying factor is an unhealthy lifestyle.

With osteopororis increasing at a faster rate than expected from even an aging population, it becomes apparent that even healthy bones can be gained by a healthy lifestyle.

Why osteoporosis in men?
Osteoporosis is associated with decreased bone mass and quality, decreased muscle power and an increased tendency to fall. Although the process of bone loss is not fatal, the resulting medical cost and immobility due to fractures can have a significant impact on one’s life.

Bone loss follows when the fine balance between two processes – depositing new bone tissue and re-absorption of old bone cells – are out of tune. New bone tissue can be deposited too slowly or older bone re-absorbed too rapidly. Osteoporosis in men is the result of a decreased depositing of new bone tissue. The onset is usually in the early forties when testosterone levels might start decreasing.

According to Dr Magda Conradie, consultant at the Tygerberg Hospital Metabolic Unit, osteoporosis in women can be linked to increased re-absorption of bone tissue due to decreased oestrogen levels.

The onset in men is 10 to 15 years later than in females because men – by mere bulk and heavier frames - have more skeletal bone to lose. Small wonder that small, lean men are more prone to osteoporosis than heavy set men with big frames.

Lifestyle factors and prevention
Several factors are associated with age-related osteoporosis in men:

• a genetic predisposition (from the mother’s genes)
• lowered levels of androgen/testosterone usually in tandem with small testes
• insufficient physical activity
• smoking
• drinking
• low calcium intake
• deficient absorption of calcium
• decreased levels of Vitamin D

Concentrate on the changeable factors:

• Weight and muscle power: lack of physical activity and exercise lead to decreased muscle power and a higher tendency to fall. Walking, cycling or swimming 30 to 40 minutes at least 3 times per week is recommended. Weight bearing exercise will strengthen the muscles.
• Diet and calcium: insufficient intake or absorption of calcium results in bone loss. Men 30 -50 years need 1000mg calcium daily; men older than 50 need 1200mg calcium per day; men younger than 50 need 200 international units (IU) of vitamin D per day, and men older than 50 need 400 - 600 IU vitamin D daily.
• Toxins (smoking and alcohol): symptoms of bone loss were present in at least 25 tot 50 % of patients with a high alcohol intake. Four drinks daily lead to bone loss as a result of the inhibition of new bone deposits as well as lowered testosterone levels in both older and younger males. Alcohol intake also increases the tendency to fall.

(Mari Hudson, Health24, reviewed by Metabolic Research Unit, Tyberberg Hospital & University of Stellenbosch)
 

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