What is Osteoporosis?
Osteoporosis, literally translated, means ‘porous bone’. It is a condition where bone loses minerals over time and as a result becomes weakened. This weakening of the bone means that those suffering from osteoporosis are more likely to sustain a fracture.
There also exists the term ‘Osteopenia’ which means that there is some bone mineral loss but it is not yet sufficiently low to be classed as Osteoporosis. A diagnosis of Osteopenia, while not serious, should serve as a warning and measures should be put in place to prevent further bone mineral loss.
The areas most commonly affected are: the ribs, wrists, vertebrae, head of the femur.
How is Osteoporosis diagnosed?
According to The World Health Organisation, Dual Energy X-ray Absorptiometry or DEXA scanning is the “gold standard” in the diagnosis of Osteoporosis. A DEXA scan is quick and painless and is the most reliable technology available to determine bone mineral density.
Osteoporosis is considered to be a silent condition. Often, the first sign of osteoporosis is suffering a fracture following a relatively minor fall. Back pain may also develop in advanced cases where vertebral crush fractures occur. This may be associated with a loss in height as well as postural changes such as thoracic kyphosis (an increased rounding of the upper back).
Women over the age of 65 and men over the age of 70 are encouraged to go for DEXA scanning. People may present much younger if Osteoporosis is suspected, based on symptoms or if they have one or more risk factors.
Risk Factors for Osteoporosis
- History of prolonged steroid use
Low body weight
Excessive alcohol consumption
Family history of Osteoporosis
Who is likely to be affected?
According to the International Osteoporosis Foundation, Osteoporosis affects over 200 million people globally. A decrease in bone density is a normal part of ageing and can start as early as 40 years old.
For women, the rate of bone mineral loss will accelerate after menopause. It is thought that 1 in 3 women will develop the condition. The bone mineral loss associated with the advancing age of men is mainly due to reduced physical activity. Compared to women, only 1 in 5 men will develop Osteoporosis and they tend to develop the condition much later in life.
Ethnicity also affects incidence with white and asian women being most commonly affected.
The Prevention and Management of Osteoporosis
The World Health Organisation recommended a balanced diet for the prevention of Osteoporosis. This should provide us with the recommended daily allowance of calcium. The Irish Osteoporosis Society recommended that calcium to be consumed as part of our normal diet and supplementation should only be considered when this is not deemed possible. A balanced diet should prevent low body weight throughout the life.
While proper nutrition is essential for healthy bones, when it comes to the prevention of osteoporosis, exercise is the key element! People are encouraged to be physically active throughout their lifeIt is when we apply force through our bones that new bone growth is stimulated. It makes sense then that exercise must involve some form of impact eg walking, running, skipping etc. Low impact exercise such as swimming or cycling will do little or nothing to stimulate bone growth. Resistance training however will to some degree as muscles will pull on their attachment sites and exert a force in this way.
Like so many conditions, early detection is key. If you have one or more of the risk factors listed above or if you have sustained a fracture from a minor incident, speak to your doctor about having a DEXA scan.
Vitamin D, or ‘the sunshine vitamin’ as it is affectionately known is essential to the body for the absorption of calcium. Vitamin D is synthesised in the body following exposure of the skin to sunlight. In areas where there is little sunshine, Vitamin D supplementation should be considered.
Falls prevention strategies should be implemented where there is a risk of falling combined with a diagnosis of Osteoporosis. This may include balance training and general strength and conditioning. Where the risk of remains high, further measures should be taken to avoid fracture, such as wearing hip protector garments or using mobility aids.
Avoidance of smoking and high alcohol intake
This one is self explanatory.