03 December 2008

Osteoporosis - a growing problem

Many people accept that becoming smaller and hunched over is a normal part of the ageing process, as are hip replacements. These perceptions are wrong.

Many people accept that becoming smaller and hunched over is a normal part of the ageing process, as are hip replacements. These perceptions are wrong.

Osteoporosis (which literally means porous bone) is associated with a reduction of bone density, weaker muscles and a greater inclination to fall. After menopause, women can lose 1 – 5 percent of their bone mass every year. Some women can therefore lose half of their bone mass within ten years. Half of all women over 50 and a quarter of men over the age of 55 develop osteoporosis.

The medical costs resulting from hip replacements and hip fractures can be high. Furthermore, osteoporosis can reduce someone's mobility greatly and fractures resulting can lead to serious complications or even death. All these can be prevented, according to specialists from the Tygerberg Hospital's Metabolic Unit.

What causes osteoporosis?
Bone loss takes place when new bone are formed too slowly (as in men with osteoporosis), or old bone cells are be destroyed too quickly. This happens in women older than 40, due to lower oestrogen levels, according to the Tygerberg specialists.

How great is your risk for osteoporosis?
If you answer 'yes' to one or more of the following questions, you have a high risk to develop osteoporosis and should consider taking preventative measures now:

  • Are you a white or Asian man or woman who gets little exercise?
  • Are you slender and tall?
  • Do you smoke?
  • Do you drink more than five cups of coffee per day?
  • Do you drink more than three units of alcohol per day?
  • Does mother, or grandmother or any other family member show any signs of osteoporosis or a hunched-over posture?
  • Do you have no children?
  • Are you menopausal or post-menopausal?
  • Do you menstruate irregularly?
  • Do you have an eating disorder?
  • Are you diabetic, or have an overactive thyroid gland?
  • Are you on long-term cortisone treatment?

What you can do to prevent osteoporosis
The following steps are simple and can save you the cost and the inconvenience of having a hip replacement in the latter part of your life:

  • Make sure that you take in sufficient calcium. All young people from age 14 upwards need between 1000 and 1500 mg of calcium daily in order to build up maximum bone density. That means having between three and four cups of milk (skim milk if you tend to be overweight), yogurt or cottage cheese every day.
  • Women over 40 should take in at least 2000 mg calcium per day. If it is difficult to make this part of your daily diet, a good calcium supplement, that contains at least 500 mg of calcium per tablet, should be considered. Milk, cheese, sardines, tofu and green vegetables are all rich in calcium.
  • Men between the ages of 30 and 50 need 1000 mg of calcium daily and men over 50, 1200 mg of calcium per day.
  • Talk to your pharmacist about using biphosphonates (such as alendronate or alendronic acid), which delay the breakdown of bone cells. Grains, legumes, fish, meat and dairy products are rich in phosphates. (There is still no sufficient proof that plant oestrogens of progesterone creams can give protection against bone density loss.)
  • Make sure that you get enough vitamin D. Most people, except those in countries bordering on polar regions, are exposed to sufficient sunlight in order to produce vitamin D. However, older people who spend a lot of time indoors, might need additional vitamin D. Use a soft margarine that contains a vitamin D-supplement.
  • Additional magnesium may be needed by diabetics, alcoholics and people who take diuretics. Nuts, seeds and grains are all rich in magnesium. Chicken, fish and red meat increase the absorption of magnesium and other minerals.
  • Reduce alcohol intake and stop smoking. Research has shown that between 20 and 25 percent of men who drink four or more units of alcohol per day, suffer some from of bone loss.
  • Exercise at least twice per week. Weight-bearing exercises such as running, and resistance training, where you have to push against your body weight or against weights, apparatus or elastic bands, are essential for building strong bone structure.


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Healthy Bones

Tereza is the CEO of the National Osteoporosis Foundation and worked as a Nursing Sister in the field of Osteoporosis for 18 years prior to her appointment with the Foundation. She used to be the Educational Officer for the Foundation and co-wrote the patient brochure on Osteoporosis. Read more

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