How to strengthen your bones
Question: Why are the bones of old people rather weak? Is it normal for our bones to become weaker as we age? — Leony O., Cebu City
Osteoporosis is not a normal accompaniment of old age, it is a disease. It is the most common disease of bones and it affects people of all races, but is more prevalent among Asians—including Filipinos—and Caucasians.
Osteoporosis is four times more common in women than in men. Women are particularly vulnerable to the disease after menopause—and especially if the menopause came early—because at menopause they cease to produce estrogen, the female hormone, which has bone-strengthening effects. People with a family history of the disease and who are thinly built are likewise susceptible to osteoporosis.
Osteoporosis is likewise accelerated by certain disease conditions (e.g., chronic kidney disease and some endocrine disorders) prolonged intake of certain drugs such as corticosteroids, and some bad habits such as sedentary lifestyle, a diet that is poor in calcium and/or vitamin D, excessive alcohol consumption and smoking.
Bones that are osteoporotic are weak and brittle. They break easily that is why osteoporosis is the underlying cause of most painful and crippling fractures—especially of the hip, spine and wrist—among middle-aged and old people. Among menopausal women, experts estimate that half will suffer an osteoporotic bone fracture within their remaining lifetime.
Osteoporosis is often “silent.” It produces no symptoms until it has progressed to an advanced stage when the weakened bones break (fracture) or collapse spontaneously or with very little force. One of the most dreadful fractures that can affect elderly people with osteoporosis is hip fracture, which usually results in serious disability that necessitates confinement to bed or wheelchair and dependence on caregivers. Bones weakened by osteoporosis can also get deformed and lead to, among other conditions, an abnormal curvature of the spine that causes a person to stoop.
To diagnose osteoporosis, any of a number of tests that measure bone mineral density (BMD) can be utilized. These, which are also useful in monitoring response to treatment, employ either x-rays or sound waves. They are all painless, practically harmless and need only a few minutes to perform.
Who should undergo BMD test? All women above 65; postmenopausal women even if they are below 65 as long as they have one or more of the risk factors for osteoporosis; and men over 70.
For people with osteoporosis, drugs that either slow the progressive thinning of bone or help rebuild bone are available.
Osteoporosis is a preventable disease. The following measures, which are most effective if adopted early in life, can keep a person’s bones strong and healthy into old age:
• A balanced diet rich in Calcium and vitamin D. The recommended calcium intake of people over 50 is 1,200 mg per day while the recommended daily allowance for vitamin D is 400-800 IU. Good sources of calcium include dairy products (milk, yogurt, cheese and ice cream), dark green, leafy vegetables (e.g., broccoli and spinach); sardines and salmon with bones; soya beans and calcium fortified juices, cereals and breads. Calcium and vitamin D supplements can be taken if the diet is suspected to be inadequate in these micronutrients. Vitamin D is produced by the skin when it is exposed to sunlight, thus most Filipinos are able to obtain enough vitamin D naturally. But studies have shown that vitamin D production decreases with age, hence, some old people may need to take vitamin D supplements.
• Regular, weight-bearing exercise
• Moderate alcohol consumption
• None smoking
• Judicious intake of medications such as corticosteroids that are known to promote osteoporosis.
-Article courtesy of Manila Bulletin.
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