It is a condition found primarily
among middle aged and elderly postmenopausal women.
Osteoporosis is a disorder
characterized by a decrease in total bone mass without a change in chemical
composition. It occurs when the rate of bone re- absorption exceeds the rate of
formation. Because of the reduction in number of cells, there is a decrease in
thickness of the cortex, a thinning of the trabeculae and increased porosity of
bone. As a result fractures occur with greater frequency. Common fractures
sites include the vertebrae, femur and radius and often these occur in spite of
little or no trauma. The rate of femoral fractures alone doubles for each
decade after the age of 50.
The cause of osteoporosis may be
age related changes such as decreased estrogen production associated with
menopause. The decline in circulating 17-beta-estradiol is the predominant
factor in the accelerated bone loss that begins after the menopause and
continues for 6 to 8 years. Decreased intestinal absorption of calcium and
production of Vitamin D, reduced physical activity and increased parathyroid
hormone secretion may also cause osteoporosis. Some factors that increase risk
include gastrectomy, hyperthyroidism, rheumatoid arthritis, immobilization and
chronic inadequate calcium intake.
Vertebral fractures are also
common in people with osteoporosis. The compact bone mass in the vertebrae is
responsible for humped backs characteristics of many elderly people.
Dissolution of the jawbone is another frequent symptom of osteoporosis. It is
major contributing factor in periodontal disease, resulting in premature loss
of teeth.
It is sensible to encourage all
old people and especially those with radiological evidence of osteoporosis, to
be as physically active as possible. The more they are on their feet, less is
the risk of pathological fractures of the femur and spine.
An osteoporotic bone has lost
both calcium and protein and so it is not unreasonable to think that a diet low
in calcium and protein might accelerate the osteoporotic process, though there
is no evidence to prove that increase in calcium intake reduces the incidence
of osteoporosis in old people.
It is sensible for old people to
take a diet with ample calcium that is to drink a glass of milk regularly. Some
old people have a markedly reduced capacity to absorb calcium from the gut and
in such patients therapeutic doses of calcium salt might be of benefit.
Since etiology is unknown, it is
common sense to prescribe a diet adequate in calcium and protein.
The National Institute of Health
consensus conference on osteoporosis recommended a daily calcium inta
Every woman should be aware of
the bone thinning disorders known as osteoporosis. This preventable condition
affects one in four women over age 60, and is a major cause of fractures of the
spine, hip, wrist, and other parts of the skeleton. Exactly what causes osteoporosis is not fully understood.
Decreasing hormones levels, inadequate calcium in the diet, lack of exposure to
sunlight (which helps the body manufacture the vitamin D necessary for calcium
absorption), and inactivity may play a role.
Bones are self-maintained
throughout life by a continual process known as remodeling, in which small
amounts of old bone are removed and new bone is formed in its place. Beginning
at about age 33, however, a little more bone is lost than is gained.
Certain dietary and exercise
practices can help prevent or slow the loss of bone, and are also prescribed in
treating osteoporosis:
· The
daily diet should include foods that are high in calcium. Dairy products such
as milk, cheese, buttermilk, and yogurt are the best sources of this mineral.
Other sources include dark green leafy vegetables (such as collards, turnip,
greens, spinach, and broccoli), salmon, sardines, soybeans, and tofu.
· Although
the current recommended dietary allowance (RDA) for calcium is 800 mg per day,
many researchers now believe that women over 40 need 1000 to 1500 mg daily. One
cup of milk has about 300 mg of calcium. Other foods provide the mineral in
smaller amounts. If the daily diet does not provide enough calcium, doctors may
prescribe calcium supplements.
· It
is also important to get adequate amount of vitamin D; scientists recommend 400
IU daily. Vitamin fortified milk and cereals, egg yolk, saltwater fish, and
liver are rich sources. Frequent, brief exposure to sunlight will help to meet
the daily need for this vitamin.
· Regular
exercise is another important preventive measure because it stimulates
formation of new bone. Activities that place moderate stress on the spine and
the long bones of the body are best. Simple exercises to maintain strength in
the shoulders, chest, back, and arms also are helpful.
· Although
protein is an important daily requirement, excessive intake can lead to loss of
calcium. Women following diets which are high in protein should consider
cutting back. Protein is found primarily in meats, poultry, fish, and dairy
products. However, since dairy products are also important sources of calcium,
this is not the food to cut back on. Forty-four grams of protein each day are
sufficient for adult women; 56 gm are recommended for adult men. Once chicken
breast has 26 gm of protein; a cup of milk has 8 gm.
- Cigarette smoking and drinking alcoholic beverage or beverages containing caffeine can increase body’s requirement for calcium.
