Introduction
Normally with age, renewal of bone structure slows. As a result, the bones lose density. If this process intensifies, the cellular structure weakens, causing the bones to grow brittle and fragile. The result is osteoporosis -- a bone disease in which the bones are porous and break easily.
Osteoporosis can lead to fractures in the hip, spine and wrist, making mobility difficult and compromising the independence of those with the condition. It occurs most often in women over 60, but can also affect older men.
Symptoms
While the process of osteoporosis itself is not painful, its effects can cause pain and suffering. Collapsing vertebrae can pinch nerves to cause lower-back or sciatic pain. The most serious complications of advanced osteoporosis are fractures that occur because of the brittleness of the bones. Especially vulnerable are the spinal vertebrae and the hips. Shrinking height, a stooped posture and a curved upper back or hump are all signs of osteoporosis.
Causes/Risk Factors
People are generally more susceptible to osteoporosis if they don�t achieve their ideal bone density during the crucial childhood and adolescent years. In childhood and adolescence, new bone grows more rapidly than existing bone is absorbed into the body. After age 30, a reversal takes place in this process. Bone dissolves and gets absorbed faster than new bone is produced. Men and women both begin to lose a small amount of bone mass (approximately 0.4 per cent) each year after turning 30. As a result, bone density diminishes.
Women are four times more likely to develop osteoporosis than men; however, the likelihood of developing the disease increases with age for both sexes. Bone-density loss accelerates in women around menopause because ovaries reduce their production of estrogens, which protect against bone loss. A deficiency in calcium, vitamin D and phosphorus can also speed up the process.
In addition to genetics, lifestyle factors such as diet and exercise can also affect a person's chances of developing the disease. Smokers lose bone thickness more rapidly than non-smokers. Some studies have linked cola drinks to low bone mineral density in women. Alcohol consumption can also affect bone thickness and increase the risk of a fall. On the other hand, moderate use of alcohol has been associated with thicker bones. Most doctors suggest limited use of alcohol.
Small-framed or thin people are more susceptible to osteoporosis due to smaller bones, less bone mass and less body fat. Health conditions such as hyperthyroidism or rheumatoid arthritis can also raise a person's chances of getting osteoporosis.
Certain medications can cause thinning of the bones: the use of corticosteroids for six months or more; medications for endometriosis; aromatase inhibitors; thyroid replacement medication at a higher dose than required (this should be monitored by checking the levels every year); Depo-Provera after long-term use; antacids containing aluminum when overused; and anticonvulsant medications. As well, some surgical procedures may heighten the risk of osteoporosis, such as removal of ovaries before menopause.
What You Can Do
Engage in 30-60 minutes of physical activity daily. Walking, dancing and weight-bearing exercises all help to strengthen your bones.
The body naturally produces vitamin D with exposure to sunlight. Enjoy the outdoors, but wear a hat, sunglasses and sunscreen and avoid being directly in the sun.
Don't smoke and avoid secondhand smoke. If you do smoke, take steps to quit immediately.
Limit your alcohol and caffeine consumption.
Prevent falls by installing handrails and light fixtures throughout your home.
Avoid carrying heavy loads and learn to use proper lifting techniques.
Postmenopausal women should consider taking a bone density test. It will tell you whether or not you have or are at risk for osteoporosis. Ask your doctor about scheduling a test.
What You Can Eat
Three requirements must be addressed in a diet for the prevention and treatment of osteoporosis. One is getting enough of the bone-forming minerals calcium and silica. The other two involve getting the nutrients needed for calcium utilization, and avoiding acid-forming foods which deplete calcium from the bones.
Silica plays a valuable role in the maintenance of strong bones. A good dietary source of silica is rolled oats, in the form of porridge or soaked overnight to make a Swiss-style muesli.
Calcium is also needed for strong bones. Good dietary sources include green, leafy vegetables, especially parsley, kale, watercress, Chinese cabbage and broccoli, seaweeds such as dulse and nori, beans, cereal grasses, dairy products and whole grains such as barley. Whole grains must be soaked to be good calcium sources. This neutralizes the phytic acid in the grains, which otherwise binds calcium, making it unusable by the body.
Calcium can only be assimilated by the body if enough magnesium and vitamin D are present, which is why people whose diets are rich in dairy products can still suffer from calcium loss from the bones. Cold-water fish, egg yolk, halibut liver oil and cod liver oil all contain vitamin D.
Magnesium stimulates calcitonin production and therefore increases calcium in the bones, drawing it out of soft tissues. Although milk has added vitamin D, its magnesium content is very low. Adding wheat germ to muesli with milk will correct the imbalance, because wheat germ is high in magnesium. Vegetable sources provide a valuable source of calcium and magnesium. Broccoli, barley or barley grass, almonds, cashews, beans, tofu, herring, sardines and dried seaweeds are rich in both calcium and magnesium. Barley sprouts are also rich in vitamin C, which helps keep calcium in the bones. Wheat germ, millet, oats, rye and fish are other excellent sources of magnesium.
Animal products and fruits are the least valuable magnesium sources, except for figs, which contain calcium, magnesium and phosphorus in a near-perfect balance for bone formation. Some phosphorus is needed for bone formation, but too much inhibits calcium absorption. A diet rich in red meat usually contains too much phosphorus.
Plant estrogens, found in sweet potatoes and soybeans, help replace lost estrogens, which helps regulate calcium absorption. Post-menopausal women should also include folic acid and pyridoxine (vitamin B6) in their diets. Nutritional yeast added to soups and salads will provide the body with adequate amounts of these nutrients.
What You Can Take
If you're not getting enough calcium and vitamin D in your diet, you may require supplementation. Ask your doctor if supplementation might be beneficial for you.
Further Resources
Contact Osteoporosis Canada at www.osteoporosis.ca or 1-800-463-6842.
