“You can’t help getting older, but you don’t have to get old.” _ George Burns
Aren’t we all always looking for tips to stay and look young? The market is flooded with beauty products to achieve this result; the media is overflowing with information to stay “fit”; and billions are spent on cosmetic surgeries to pull off what make up and exercise cannot.
The body is a continuously evolving system, and everyday billions of cells die, another billion new ones taking up their space. As we grow older, this process goes on, but there are lesser new cells generated, and this is inevitable.
Bone being a living tissue, also ages and weakens as we grow older. This is inescapable, but osteoporosis (brittle bones) is preventable!
In our quest to stay young, let us not forget the primary scaffolding of our body that upholds all else!
-Dr. Harshada Rajadhyaksha
Osteoporosis is a “silent disease”, as it progresses without any symptoms until fracture occurs. Your wrist, hip and spine are the common sites for osteoporotic fractures. Post spine and hip fracture, immobilization being essential for healing, still has a detrimental effect on health and quality of living.
Bone is a highly dynamic organ. It constantly undergoes resorption and regeneration. By third decade of life, bone attains its peak mass. As age progresses, in both men and women, balance between resorption and regeneration becomes progressively negative. Post menopause, there is an abrupt drop of oestrogen. Oestrogen hormone plays a crucial role in bone modulation. Thus, we can see old age and oestrogen deficiency are the most critical factors for developing osteoporosis. Besides this, risk factors affecting bone density include genetics (Europeans, Asians), lifestyle (smoking, alcohol, low vitamin D levels due to less sunlight exposure, calcium deficient diet), low physical activity and certain medications.
Confirmatory tests include Bone Mass Density (BMD) analysis which determines both osteoporosis and its early signal osteopenia.
Osteoporosis has no cure but yes we can definitely stop /slow down its progress. Early detection is the best prevention. There are injections available for people who are highly osteoporotic, probably due to any medical condition like prostate / breast cancer, even may be due to prolonged immobilization as that itself causes disuse osteoporosis. These injections needs to be taken on yearly basis to improve bone density as in these scenarios prevention of associated complications is the primary concern.
For elderly population, due to improper muscle strength, balance, coordination there is increased fall risk. Even minimal stress during a fall has a good potential to cause fracture in osteoporotic bones. Simple steps like railings in bathrooms, rooms, maintaining adequate space and good footwear will help reducing the fall risk, thus preventing any incidence of fracture.
One should start working towards modifiable risk factors such as lifestyle modifications. This may include smoking cessation, avoidance of excessive alcohol. In terms of nutrition, one should have calcium and Vitamin D rich foods but also adequate calorie intake to prevent malnutrition. Prevention can be started from any age as goals differ for age groups. For childhood and adolescence – achievement of peak bone mass, middle age – preservation of bone and muscle strength and mass, old age –optimization of gait and balance, muscle strength.
Exercise plays a key role in building and maintaining bone health. Research has proved resistance, aerobic, high impact training, whether done in isolation or combination can improve bone density in osteoporotic persons. One should not rush into unaccustomed exercises (swimming, cycling may be good for your heart but not appropriate to improve bone density). It is important to do what is the most appropriate.
Everything in moderation is always better. Combination of healthy lifestyle, proper nutrition and appropriate goal oriented exercise can prove to be extremely beneficial. No two osteoporotic individuals are same and hence one can always look out for an expert advice for an individualized program.
- Dr. V. Sivajanani