BONE IS A LIVING TISSUE THAT CHANGES
Osteoclasts remove old bone, osteoblasts help create new bone. Bone remodeling is completed every 3 to 4 months in a healthy young adult. Osteoclasts & osteoblasts become less efficient with age. With osteoporosis, bone loss occurs more rapidly causing thinner, weaker & brittle bones. During menopause, estrogen levels decrease dramatically, casing a faster rate of bone loss.
OSTEOPOROSIS STATISTICS
- Osteoporosis affects 2 million Canadians
- Typically 1 in 4 women over the age of 50; 1 in 8 men
- The cost of treatment is ≈ $1.3 billion each year in Canada
- Disfigurement, decreased self-esteem, decrease or loss of mobility, and a decrease in independence may occur.
- 80% of hip fractures are thought to be osteoporosis-related.
- Hip fractures can lead to death in up to 20% of cases and disability in 50% of survivors
DIAGNOSIS AND TESTING
Bone Mineral Density (BMD) test using bone densitometry is a safe, painless test for osteoporosis. The most common BMD test is the dual energy x-ray absorptiometry (DXA). The patient lies on a table for several minutes while a small x-ray detector scans the spine/hip with a very small amount of radiation.
ROLE OF VITAMIN D
• Vitamin D – important for the normal growth & development of our bones/teeth.
• It helps the body maintain normal levels of calcium & phosphorous by influencing absorption in the intestines. Vitamin D3 increases calcium absorption by as much as 30 – 80 percent.
• 25 minutes a day of sun exposure allows the body to make enough vitamin D. However, sunscreen and increased levels of colour/melanin in the skin can interfere with this process. Therefore it is important to consider dietary sources
• The need for vitamin D also increases after the age of 50. It is now recommended that Canadians aged 19 to 50, including pregnant or lactating women, receive 400 international units (IUs) of vitamin D3 per day. Adults over 50 should receive 800 IUs. These levels can be obtained by a variety of foods or additional supplementation
OSTEOPOROSIS- Major risk factors
- Age 65 or older
- Vertebral compression fracture
- Fracture with minimal trauma after age 40
- Family history of osteoporotic fracture
- Long-term use of glucocorticoid therapy such as prednisone
- Medical conditions that inhibit absorption of nutrients
- Primary hyperparathyroidism
- Osteopenia apparent on x-ray
- Hypogonadism (↓ testosterone in men, loss of menstrual periods in younger women)
- Early menopause (before age 45)
Risk factors for fracture:
- decreased bone mineral density
- Prior fragility, trauma fracture
- Long-term, (> 3 months continuously) use of glucocorticoid therapy (prednisone)
- Family history of osteoporotic fracture
Calcium
Calcium is in almost every cell in the body & bones require calcium for strength. Calcium is found in the skeleton and teeth, in the cells & in the blood. The body carefully regulates the supply of calcium by absorbing it from the food we eat, taking calcium from our bones, or slowing down the amount that leaves the body. Main goal is to maintain an adequate calcium supply so that the reservoir (bone) is not depleted. Bone density depends upon calcium intake at a younger age. The greater the peak bone mass, the less likely bones are to become porous & fragile later in life. Calcium is absorbed less effectively as we age, but studies of older adults show that adequate calcium intake can slow bone loss and decrease the risk of fracture.
CALCIUM CONTENT IN FOOD
• Calculate your daily calcium intake and see if you are achieving the recommended levels.
• Dairy products (milk, cheese & yogurt) are excellent sources of calcium, easily absorbed by the body.
• Calcium-fortified soy beverages and orange juices may contain as much calcium as milk.
• Vegetables also provide calcium, as do fish products containing bones (canned salmon and sardines) and meat alternatives such as lentils and beans.
• Calcium loss through the urine is thought to be increased by the consumption of excess salt and caffeine.
• Over 90% of sodium comes from food rather than from table salt. Therefore, it is advisable to keep the intake of salt and salty foods to a minimum.
• Consuming more than four cups of caffeinated drugs a day – coffee, sport drinks, colas can affect calcium absorption.
• People that are unable or choose not to eat dairy foods must monitor calcium intake very carefully & consider a calcium supplement to meet the daily requirement.
OSTEOPOROSIS AND PHYSICAL ACTIVITY
• Physical activity – important factor in risk reduction & treatment of osteoporosis
• Physical activity assists in building & maintaining healthy bones, as well as improving muscle strength.
• Physical activity places an increased “load” or force on bones. Bones respond by forming new bone and remodeling for strength.
• Physical activity improves balance and coordination which, reduces the risk of falls that can end in fractures. Improved strength, flexibility & posture can reduce pain & enable people with osteoporosis to be able to do daily tasks easier.
Cameron Edgar
