Steering clear of osteoporosis


Deepika Rathod

Osteoporosis is a condition characterised by a decrease in bone density, decreasing its strength and resulting in fragile bones. Osteoporosis leads to abnormally porous bone that is compressible. This disorder of the skeleton weakens the bone and results in frequent bone fractures.

Osteopenia is another condition in which the bone is slightly less dense than normal but not to the degree in osteoporosis. It is a progressive bone disease which is characterised by decrease in bone mass and density which leads to increased risk of fractures later.

Osteomalacia also refers to softening and weakening of the bones, due to impaired bone metabolism which leads to inadequate bone mineralisation. Osteomalacia isn’t the same as osteoporosis. Problems with bone formation or with the bone building process causes osteomalacia. Osteoporosis is the weakening of living bone that has already been formed and is being remodelled.

Osteoporosis and other bone conditions basically occur due to calcium and vitamin D3 deficiency. Bones need calcium and phosphorus to remain healthy and strong, but the body also needs vitamin D to be able to absorb these two minerals. Without this necessary vitamin, bones can become soft and flexible.

Bone loss with osteoporosis occurs over years and can be severe, often so severe that the normal stress on bones from sitting, standing or coughing can result in pain and immobility. After the first fracture, you are at risk of more fractures. These future fractures may cause daily chronic pain, and in some cases, some degree of disability.

During menopause there’s a dramatic decline in oestrogen. This decline slows down the bone remodelling process and causes an accelerated rate of bone loss. This more rapid loss of bone continues for about 10 years after menopause. The rate of bone loss eventually returns to premenopausal levels, but bone formation does not. This causes postmenopausal women to have a much greater chance of having a fracture. Early menopause (before age 40) also increases the chance of osteoporosis and fractures. Having prolonged periods when menstrual cycle is irregular, can also cause loss of bone mass and osteoporosis.

It is important to improve the intake of calcium and vitamin D. Vitamin D is required for calcium absorption. Calcium is the most common mineral in the body, about 99 per cent of which is in bones and teeth, the remainder being in the blood and soft tissue, where concentration range is narrow to facilitate bodily functions. This is so important that the body will pull calcium from bones to maintain other levels if calcium intake is insufficient. It is best for the people to begin adequate calcium intake at an early age as the bone mass begins to decrease after the age of 30. The best sources of calcium include: sesame seeds, ragi, organic milk, paneer (cottage cheese), organic yoghurt, leafy greens, seafood/bony fish, legumes, etc. Apart from calcium, other minerals like magnesium, phosphorous and boron also contribute to the bone health. Hence including magnesium and phosphorus sources like whole grains, organic milk and milk products, lean cuts of meat, beans and lentils, nuts and leafy vegetables, etc, is important. Sources of vitamin D are present in food in very limited quantities. The best source is sunlight. One must ensure that the body is adequately exposed to sun during the day to synthesise a good amount of vitamin D. Foods like mushrooms, fatty fish (tuna, mackerel, salmon), cod liver oil, cheese,  egg yolks, etc, contain vitamin D is some amounts. In most cases additional supplementation of calcium and vitamin D is required to meet the needs. One should consume calcium/vitamin D3 supplements on an empty stomach as these nutrients are best absorbed in acidic medium.