Osteoporosis has become one of the major diseases affecting women in the western world, with a woman’s risk of sustaining a hip fracture equal to the combined risk of developing breast, uterine and ovarian cancer.
It is now estimated that one out of every three postmenopausal women will have a spinal fracture, which may occur spontaneously or as a result of minimal trauma. An increasing public awareness of the incidence of osteoporosis and its debilitating consequences, is resulting in an effort to learn more about the disease in order to take better pro-active steps towards preventing it.
The first step towards preventing osteoporosis is to understand it. Osteoporosis is a disease in which bone mass is decreased substantially, resulting in an increased risk of fracture coinciding with chronic pain and disability.
Osteoporosis is commonly referred to as “the silent disease” and unlike osteo-arthritis which exhibits symptoms such as swollen joints, stiffness and pain, can progress painlessly until a fracture occurs. In order to avoid jeopardising long term health, mobility and independence, individuals must assess their risk and take the appropriate steps towards preventing this crippling disease.
Although osteoporosis can affect men and women of any age and any race, there are various factors that contribute to a higher risk of developing osteoporosis.
- a family history of osteoporosis
- petite, thin women who are small-framed
- early menopause/irregular menstrual cycles
- insufficient calcium intake
- lack of exercise
- excessive alcohol intake
Although some of these risk factors, such as family history and early menopause, are beyond the individual’s control, important lifestyle changes, for example, eating a balanced diet high in calcium and participating in regular, weight-bearing exercise, can significantly alter one’s risk of developing the disease.
The role of exercise in the prevention and treatment of osteoporosis is multi-faceted, and age-dependant. Regular physical activity may be more beneficial for increasing bone mineral density in children and adolescents, while in postmenopausal women exercise may only preserve bone mineral density.
As bones respond to the stresses placed on them by increasing their density and becoming stronger, weight-bearing exercise (that is, exercise where your body bears its own weight, such as walking, tennis, dancing), is of paramount importance. In addition to weight-bearing exercise, weight-training is also recommended due to the positive stimulus of the mechanical pull of the muscles on the bone.
Therefore, moderate exercise in adulthood is unlikely to result in large increases in bone mass, but rather reduces bone loss that occurs with ageing. It is also important in maintaining muscle strength, co-ordination and balance, thereby reducing the frequency and severity of falls in older adults. Evidence suggests, however, that the benefits are not maintained once the exercise programme has stopped.
It is important to keep in mind that even individuals with none of the risk factors mentioned above, may develop osteoporosis and risk factors alone cannot be used as a means of identifying persons at high or low risk for fracture. A bone density scan is currently the best predictor of future fracture risk.
Ordinary x-rays are an inadequate method of detecting osteoporosis risk as they do not detect a change in bone loss until 30-40% of bone density is lost. Tests need to be conducted at regular intervals over a year or longer to determine the rate of bone loss and to monitor the effects of treatment.
- Lisa Micklesfield, MSc (Med).
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