Osteoporosis is a condition where a person has low bone mass due to loss off bone or the lack of production of bone, or both. It is a condition known as the "silent thief", as the condition can progress over years undetected and when a fracture occurs, and it is too late to get treatment. According to Osteoporosis Canada, it is estimated that 2 million Canadians are affected by osteoporosis with 1 in 3 women and 1 in 5 men suffering from an osteoporotic fracture in their lifetime.
Risk Factors for Osteoporosis
The government of Canada public health lists the following risk factors:
Younger adults (age < 50 years):
A bone density test is the only test that can diagnose osteoporosis before a broken bone occurs. This test helps to estimate the density of your bones and your chance of breaking a bone. NOF recommends a bone density test of the hip and spine by a central DXA machine to diagnose osteoporosis. DXA stands for dual energy x-ray absorptiometry.
The National Osteoporosis Foundation recommends you get a bone density test if you break a bone after the age of 50, if you are a postmenopausal women under the age of 65 with risk factors, if you are a man between 50-69 with risk factors. Women over 65 and men over 70 are also candidates for the test.
Consequences of Osteoporosis
Fracture is the biggest risk for people with osteoporosis. An astounding 80% of fractures in people over 50 years of age are contributed to osteoporosis. The most common areas to fracture are the spine, shoulder, wrist and hip.
Hip fractures are common, with roughly 70% to 90% of the 30,000 of them a year in Canada, contributed to osteoporosis. 28% of women and 37% of men who suffer a hip fracture will die within one year and also have a 50% chance of another hip fracture within 5 years.
Spinal fractures also contribute to a lot of disability. The pain and loss of mobility has a direct impact on quality of life. Spinal fractures have a 20% re-occurrence rate in the first year, causing progressive spinal deformity and lack of mobility.
Treatment for Osteoporosis
No single cause for osteoporosis has been identified but there are a number of preventative things you can do. Peak bone mass is achieved for women at the age of 16-20 and for men at the age of 20-25. This means building strong healthy bones during childhood and adolescence is essential to help avoid osteoporosis as an adult. Osteoporosis has been called a "pediatric disease with geriatric consequences".
Diet is an essential start in the prevention of osteoporosis. Calcium rich foods are essential for your body to create bone mass. How much calcium do we need? Dietary guidelines state that age 19 to 50 you require 1000 mg, age 50 plus you require 1500 mg, and pregnant or lactating women require 1000 mg.
Calcium rich foods include dairy products and green leafy vegetables. If you can't consume dairy products, try calcium fortified almond or soy milk. Canned salmon or tuna is also a great source of calcium. According to the National Osteoporosis Foundation "Recent research has found that olive oil, soy beans, blueberries and foods rich in omega-3s, like fish oil and flaxseed oil may also have bone boosting benefits. While additional research is needed before the link between these foods and bone health can definitively be made, the many overall health benefits of these foods make them excellent choices to add to your diet".
Foods that should be avoided in excess include caffeine, alcohol, wheat bran, soft drinks, and high protein diets.
A nutritional guideline resource can be found at https://www.nof.org/healthy-bones-guide/
In childhood and adolescence, exercise will stimulate the body to create more bone mass. In adulthood, exercises help in the prevention of further bone loss but unfortunately has minimal effect of producing more bone mass. However, it is never too late to start exercising. It is important to consult with your healthcare provider to determine your limitations with an exercise program. This is very important if you have cardiovascular conditions. Research shows that weight bearing exercises are the best for osteoporosis. There is low impact and high impact type weight bearing exercise. Low impact include: Tai Chi, Palates, yoga, walking, stair stepper, and glider workouts. High impact include: aerobics, running, dancing, racquet sports, weight lifting and climbing stairs.
There are many other benefits to exercise as it also helps with muscle strength and balance which directly helps to prevent falls.
Osteoporosis medications slow down the breaking down of bone. Bones naturally break down and re-build, but as we get older the rebuilding of bone can't keep up with the break down.
Bisphosphonates are the most common medications prescribed for osteoporosis treatment. These include:
Your doctor might also prescribe different medications depending on your kidney function, hormonal levels, and if you are using steroid medications.
Osteoporosis is "The Silent Thief". Children and adolescents need calcium rich balanced diets to help grow strong bones. As adults we need to keep active with weight bearing exercises and work outs that promote the preservation of strength and balance to help reduce fall risks. Avoid smoking, excess alcohol along with a healthy diet. If you have risk factors for osteoporosis, contact your medical doctor for possible bone density screening and treatment.
Activity fact: Fractures from osteoporosis are more common than heart attack, stroke and breast cancer combined! Get active and keep strong.