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The time to fight is now
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Don’t underestimate the high cost of osteoporosis: it’s a disease more deadly than breast and ovarian cancer combined.
By Renz. J. Juameza and Salima Ladak-Kachra
Sometimes what we can’t feel can be the most hazardous risk to our health. Like osteoporosis, a disease that progresses without symptoms or pain until bones start to break. We can’t feel bone loss or bones becoming weaker. And we don’t naturally shrink or grow stooped or frail with age. These are consequences of osteoporosis.
Porous bone. That’s the literal translation of the word “osteoporosis.” But to sufferers of the disease it means brittle bones that lead to fractures, especially at the hip, spine and wrist. It afflicts a staggering one in four females and one in eight males over age 50. As many as 40 per cent of women over 50 will suffer an osteoporotic fracture in their lifetime — a cause of more deaths than breast and ovarian cancer combined. The annual cost of treating the disease loads a $1.3-billion burden on the health-care system.
While osteoporosis has no single cause, there are associated risk factors. More common ones include genetics, a Caucasian or Asian heritage, aging past 65, prolonged use of corticosteroid drugs like prednisone and, for women, menopause. During menopause, women’s estrogen levels drop. Estrogen is a bone protector and without it, women can lose from three to five per cent of their bone mass annually for the first five years after menopause.
Usually after age 65, men and women lose one percent of their bone mass annually. Several lifestyle habits can contribute to weak bones, including excessive smoking, drinking caffeine and alcohol, and inactivity.
Since osteoporosis can develop undetected for years until a fracture strikes, early diagnosis is imperative. It’s necessary to assess your risk for the disease and the density of your bones to determine whether you need to take steps to maintain bone mass. Presently, the best method to do this is the bone mineral densitometry (BMD) test, which uses an X-ray to take a picture of the bones, usually around the spine and hip. It’s quick — often less than 20 minutes — accurate and painless. Your physician can use the BMD results to predict your risk of fracture, monitor your rate of bone loss, confirm the presence of osteoporosis and evaluate the effectiveness of treatments.
Osteoporosis can be prevented in most people, which is important since, to date, there’s no cure. A comprehensive prevention program includes a balanced diet rich in calcium and vitamin D, weight-bearing exercise, a healthy lifestyle, BMD testing and medications when appropriate. Consider your bones like a bank account where deposits and withdrawals are made in bone tissue. Before age 30, you make more deposits than withdrawals, building your bone until it reaches its maximum strength and density. After that, the withdrawals increase. Make as many deposits as you can so there’s plenty of bone to draw on in later years.
Warning: Without enough calcium in your diet, your body takes what it needs from your bones, eventually to the point where your bones become weak and brittle. And not only does calcium uphold a healthy skeleton, it helps blood clot and hearts beat. So, grate some cheese on that salad, drink skim milk or eat your favourite fruit yogurt —enough to get about 1200 mg daily for men and women over 50, and 1000 mg if you’re under 50.
To properly absorb calcium, you need vitamin D, safely obtained either through diet or the skin. Fifteen minutes in the sun each day is plenty of time to manufacture and store all the necessary vitamin D. However, experts believe that Canadian sunlight may be unreliable because it isn’t strong enough to kickstart our bodies into producing vitamin D. The alternative is to get vitamin D from supplements or in fortified foods such as milk, orange juice and certain fish. We should receive 400 to 800 IU of vitamin D per day.
Be proactive and take steps throughout your lifetime to deter the gradual bone loss that can lead to osteoporosis. Whatever your age, the time to start is now.
Active Prevention
Exercise improves bone health, muscle strength, co-ordination and balance, and ultimately leads to better overall health. Like muscle, when bone is exercised, it becomes stronger. Young women and men who exercise regularly generally achieve greater peak bone mass — maximum bone density and strength — than those who don’t. After age 30, bodies may begin to lose bone unless regular exercise prevents it.
The best exercise for bones is weight-bearing — anything that works against gravity, like walking, stair-climbing, tai-chi, dancing or skiing. Resistance exercises such as weight training or lifting canned goods are also excellent stimulants for bone growth. Activities like swimming and cycling are nonweight-bearing. While these may not directly benefit bones, their cardiovascular benefits will improve your ability to perform other activities.
Before starting any exercise program, consult your doctor, particularly if you have heart trouble or high blood pressure. With osteoporosis, not all activities are safe. People with low bone mass should avoid high-impact exercises to lower risk of breaking a bone.
Renz J. Juaneza, B.Sc., MSc., MRT(N), and Salima Ladak-Kachra, MRT(N), CNMT, are nuclear medicine technologists who specialize in osteoporosis testing and education at The Bone Wellness Centre, Toronto.
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