Bones are important elements in our body that are responsible for the movement of our body. Our bones work together with our joints, connective tissues and muscles to support our body weight, helping us to stand upright and to do everyday movement. Bones degenerate as we grow older.

With an increasing aging population and longer life span worldwide, osteoporosis which is a commonly known bone condition affects more people as they grow older. It is found that osteoporosis is more common among women, but it can affect men too. According to the International Osteoporosis Foundation, 1 in 3 women and 1 in 5 men worldwide suffer from osteoporosis over the age of 50 or experience osteoporotic fractures in their lifetime.

Although osteoporosis is a serious condition, it can be treated and also be prevented via healthy lifestyle and diet. In this article, we will be looking at the causes of osteoporosis and the common symptoms and discuss a few ways to manage, or even better, to prevent osteoporosis.

What is Osteoporosis? 

Osteoporosis is a disease that will cause bones to weaken and will form fragile bones with less bone mass and strength. Since bone is a living tissue, it is constantly being broken down and replaced. If the creation of new bones does not keep up with the loss of old bones, osteoporosis will occur.   

Fragile bones will more likely break or fracture even just from a mild stressor such as bending over or coughing. This will increase the risk of a sudden or unexpected bone fractures, most commonly affecting the bones of hips, wrist and spine. 

Why is Knowing about Osteoporosis Important? 

Bone fractures due to osteoporosis are not only painful; in serious cases it can also cause life-changing disability and loss of independence. Statistics have shown that osteoporosis will result in more days spent in hospital as compared to other diseases such as diabetes and heart attack. Prolonged hospitalization will incur additional medical costs which will not only be a burden to the healthcare system but also cause a financial strain on the patients. The patient may no longer be able to work or have reduced available days to work and support themselves due to hospitalization.  This may even lead to requiring financial assistance from their relatives and friends, and might lead to a direct economic loss. 

Bone fracture involving the bones of the hip or spine is the most serious complication of osteoporosis. Statistics have shown that hip fracture causes the most death, where up to 20%-24% of patients die in the first year after hip fracture. Even if patients survive from hip fractures, they are at risk of losing their independence, unable to walk independently and require assistance to carry out their daily activities such as driving or grocery shopping. Some may require nursing home care and as this is often not covered by medical insurance, it will become a heavy financial commitment. 

Besides affecting patients physically, fractures due to osteoporosis will also affect sufferers emotionally and mentally as it reduces their overall quality of life. Long-term loss of independence and mobility will often cause depression and a lack of self-worth. They will tend to isolate themselves from friends and family members, reduce social interaction and no longer want to do the activities they used to love or used to enjoy. This is why it is so important to notice the early warning signs and symptoms of osteoporosis and address it early enough to prevent fractures from happening. 

What are the symptoms of osteoporosis? 

Osteoporosis is often called a “silent disease” as many people do not notice that they are having osteoporosis since it has no obvious symptoms, until it is too late. Most people actually find out they have osteoporosis when they have a fall or suffer from a fracture. 

 Although no obvious symptoms can be determined, there are a few warning signs that may indicate that your bones are weak and fragile. Bones breaking easily, brittle fingernails, weaker grip strength and receding gums may be early warning signs of osteoporosis. As for later-stage osteoporosis, the most common warning signs are presentation of height loss and a curved spine. Some people may also suffer from lower back pain. This is because people who suffer from osteoporosis will have low bone mineral density and spinal fractures can occur even without a fall. These spinal fractures are compressed due to the force of gravity and cause the spinal column to become shorter, resulting in back pain, loss of height and a hunched forward posture.  

Who is at risk of osteoporosis? 

Although osteoporosis particularly affects women in their middle and later years, it can happen to anyone as men are also affected. Many factors can increase the likelihood but some of the risks which are unchangeable are: 

• Age. Osteoporosis is a common problem for aged people.  Bone mineral density will decrease when we age and this will increase bone fragility. Commonly, risk increases after mid-30s. 
• Family history. Osteoporosis does run in the family as there might be inherited factors involving bone development. If one or both parents have had a broken bone, there is a risk that some of the children may inherit the condition. 
• Gender. Females are more likely to get osteoporosis than men especially after menopause. This is because the hormones, namely estrogen and testosterone play an important role in maintaining bone mass and strength in both genders. After menopause, the level of estrogen will drop and this will result in acceleration in bone mass loss. 
• Body frame size. People with a smaller body frame size will have less bone mass than those who have a larger body frame. Thinner and lighter bones will have a higher risk of bone fractures. 
• Medical condition. Risk of osteoporosis will also be higher if you have certain medical problems. People with hyperthyroidism will have higher than normal thyroid hormone levels in their body. Thyroid hormones affect the rate of bone replacement. If the rate of bone loss is faster than the rate of bone production, patients will have a higher risk of developing osteoporosis. 

Besides unchangeable factors, other dietary and lifestyle factors can also increase your risk of getting osteoporosis: 

• Low calcium intake. Bones are made up of calcium and calcium is an important mineral needed during bone production. If the amount of calcium is inadequate in our blood, our body will take the calcium from our bones. People who lack calcium for a long time will have a reduction in bone density, early bone loss and increased risk of fractures.  
• Leading a sedentary lifestyle. Physical activities act as a stimulus for our body to produce strong bones. Without regular exercise, sedentary adults are at risk of thinning and aging bones. Loss of muscle mass will also occur with inactivity and this will expose the bones to higher impact forces with less support by the muscles and bones will become easier to break. 
• Excessive alcohol consumption. Studies have indicated that heavy alcohol consumption especially during adolescence and young adulthood can affect bone health and may increase the risk of osteoporosis later. 
• Taking certain medication. Long-term steroid use will have a major impact on bone density as steroids have a major effect on how our body uses calcium and vitamin D. This interference of bone building process will lead to bone loss, fractures and osteoporosis. 
• Eating disorder. Low bone mass is common in people with eating disorders. People with eating disorders tend to eat very little to limit their calories intake. Most often their diet will lack nutrients such as essential vitamins and minerals to maintain a healthy body, including minerals that are needed for bone production. This will increase their fracture risks. 

The good news is that these osteoporosis risk factors are modifiable and measures can be taken to reduce your risk of getting osteoporosis. 

How to prevent Osteoporosis? 

There are many measures and lifestyle changes for the prevention of osteoporosis.  Here are some recommendations to help reduce the risk of fractures and to prevent osteoporosis, at whatever age and whichever gender, male or female. 

• Staying active. Weight-bearing and strength training exercises are best for your bones as they make you more flexible and make your bones stronger, reducing the chance of fall and fractures. 
• Increase your intake of calcium. Having a healthy and balanced diet every day which includes calcium rich food such as milk, green leafy vegetables and salmon is important to maintain strong and healthy bones.  Consider taking calcium supplements if you are not getting sufficient calcium from your diet. 
• Get some sun.  We obtain most of our vitamin D from the sun and since vitamin D helps our body to absorb calcium, it will help to promote bone density. 
• Reduce the intake of alcohol. Drink alcohol in moderation as excessive consumption of alcohol will increase our risk of getting osteoporosis. 
• Preventive fall hazard. Remove tripping hazards, install non-slipping mats and install brighter light bulbs are some of the ways that we can prevent falls and reduce the risk of fractures. 

Osteoporosis, although a serious condition; can be prevented with an early diagnosis by assessing the bone mineral density and if fractures occur, to go for early treatments of osteoporosis.  Increasing awareness among the general public will increase awareness and will be useful in preventing osteoporosis.  

 Always consult your healthcare professionals, doctors or pharmacist for any tips on how to take good care of your bones before it is too late, and if you are diagnosed, to get advice on the management of osteoporosis. 

Reference

1. International Osteoporosis Foundation: IOF. IOF International Osteoporosis Foundation. (2022, August 11). Retrieved August 12, 2022, from https://www.osteoporosis.foundation/
2. Pouresmaeili, F., Kamali Dehghan, B., Kamarehei, M., & Yong Meng, G. (2018). A comprehensive overview on osteoporosis and its risk factors. Therapeutics and Clinical Risk Management, Volume 14, 2029–2049. https://doi.org/10.2147/tcrm.s138000
3. Sozen, T., Ozisik, L., & Calik Basaran, N. (2017). An overview and management of osteoporosis. European Journal of Rheumatology, 4(1), 46–56. https://doi.org/10.5152/eurjrheum.2016.048  
4. U.S. Department of Health and Human Services. (n.d.). Alcohol and other factors affecting osteoporosis risk in women. National Institute on Alcohol Abuse and Alcoholism. Retrieved August 8, 2022, from https://pubs.niaaa.nih.gov/publications/arh26-4/292-298.htm#:~:text=Human%20and%20animal%20studies%20clearly%20demonstrate%20that%20chronic%2C%20heavy%20alcohol,and%20weakens%20bones’%20mechanical%20properties