Debility, illness and loss of independence are assumed to be an inevitable part of ageing. In Indian society , where there are no health benefits and minimal social security, old age can be frightening. Unfortunately, young people do not realise that if they take remedial action, some of the incapacitating changes of ageing like osteoporosis are preventable.
Osteoporosis occurs because of calcium deficiency — the bones became fragile and brittle. This means that the slightest trauma can lead to a fracture. In India, the incidence of osteoporosis is high and, with our ageing population, it will only climb.
Patients do not realise that anything is wrong until the first fracture. The trauma that caused the break need not be severe; a trivial fall may be sufficient. The commonest sites are the wrist and the hip. Treatment usually requires setting the bone surgically and screwing it into place. Healing is a long-drawn-out and painful process. Fear of surgery may lead people to native bonesetters, who set fractures with bandages and egg whites. But these ancient treatments are not successful in osteoporosis, especially when the fracture occurs in a deep-seated bone like the hip.
Apart from fractures, early signs of osteoporosis are a decrease in height as the spinal vertebrae grind into each other. This also results in a stooped appearance with a “dowager’s hump”.
The only way to avoid osteoporosis is to have enough calcium, which is necessary not only for healthy bones but also for the proper functioning of cells and enzymes. If there isn’t enough calcium in the blood, the body gets it from the bones. If this calcium is not replaced, the bones become increasingly fragile. Bones are built up in childhood, adolescence and the early twenties. So it should be ensured that the body gets enough calcium during this period. The final strength of the bones is determined by genes but diet and lifestyle can modify this.
The body gets calcium from dairy products such as milk and cheese (processed as well as cottage). Other calcium-rich foods are sardines, custard apples and green leafy vegetables. To absorb dietary calcium, the body also needs 400 IU of vitamin D, 400mg of magnesium and 110 micrograms of vitamin K. The skin can synthesise sufficient vitamin D from sunlight but the problem is that most people either work indoors or use sunscreen and umbrellas. The other source of vitamins is green leafy vegetables. However, the requisite amounts of these vitamins are usually not available in a normal diet. Therefore, you need calcium supplements, most of which contain additional vitamins and minerals to aid absorption.
Calcium supplements are best absorbed if taken after meals in 500mg doses several times a day. Other minerals such as iron and zinc interfere with calcium absorption. Even though many people need supplements of all these elements, they have to be given separately or at least 12 hours apart. A common mistake is to try and combine all these ingredients into one giant biologically ineffective capsule or tablet.
The other thing that can interfere with calcium absorption is too much protein, caffeine (coffee and cola) or alcohol in the diet. There is a demonstrated difference between the bone density of people who drink colas every day and those who drink it once a month.
Osteoporosis can also occur as a side effect of medication like corticosteroids (called secondary osteoporosis). These are prescribed for ailments such as arthritis or asthma and patients are sometimes not aware that they have been given steroids on a long-term basis. Sometimes, it is part of the unlabeled medication dispensed by practitioners of alternative medicine.
Some antacids contain aluminium, which acts as “bone poison” and interferes with the incorporation of calcium into the bones, increasing the risk of osteoporosis. Thyroid disorders or malfunctioning parathyroid glands can also increase the risk of developing the disease. Lactose (milk) intolerance results in an inadequate intake of milk and dairy products with subsequent calcium deficiency.
It is never too late to contain osteoporosis. Physical activity helps bones retain and even gain density all through life. Effective exercises are running, jogging, skipping, stair-climbing, tennis and badminton. Exercise also improves muscle strength and coordination so that falls and injuries are less. One should exercise for an hour every day, all through life. Although exercise at any age is a boon to health, to build bone strength one needs to be regular and consistent.
Daily calcium requirement
• 1-3 yr: 700mg
• 4-8 yr: 1,000mg
• 10-20 yr: 1,300mg
• 20-70 yr: 1,000mg
• Women over 50: 1,200mg
• Men over 71: 1,200mg
- Calcium Supplements osteoporosis or a heart attack? (bigsexymedia.com)
- Preventive Medical Center of Marin Asks: Got (too much) Milk? (prweb.com)
- Osteoporosis Tips: Diet and Exercise for Stronger, Healthier Bones (webmd.com)
- Building Stronger Bones (webmd.com)
- Low-Cost Ways to Protect Your Bones (webmd.com)
- Preventing Osteoporosis Through Food Avoidance (friendseat.com)
- Increasing daily calcium will not reduce the risk of fractures in later life (eurekalert.org)
- Take Care Of Your Bones (healthinmotion.wordpress.com)
- Foods that Keep Bones Strong (macseattle.wordpress.com)