Our bones are constantly changing, from the period of initial formation in the womb to peak bone mass, which occurs in our late teens to early 20s. Even throughout adulthood, we are almost constantly reabsorbing old bone and building new bone. For most healthy adults, this process is well-balanced, and we build and break down bone in an equal ratio so that bone is never really lost. But as we age, we steadily lose bone mass due to hormonal changes. This loss of bone mass with aging can lead to osteoporosis.
Osteoporosis is a disease characterized by weak, low-density bones. It’s generally a disease of the elderly, affecting one in three women over age 50 worldwide, and one in five men over 50. As bones weaken from osteoporosis, they become more prone to fractures even with minor trauma. These small fissures in fragile bones are troublesome at any age, but as people get older, they become serious concerns — one small hip, spine, or wrist fracture can be devastating; the pain can inhibit day-to-day living, and major hip fractures often require serious surgery for a partial or complete hip replacement. Therefore, it’s important to keep your bones healthy, even if you’re well below your 50s and 60s, the typical age when osteoporosis becomes a concern.
While osteoporosis affects men, too, I focus on women below, as they are more at risk for the disease. After menopause, the hormonal changes in women’s bodies can accelerate bone breakdown and loss – this is a particular problem in India, where the disease is underdiagnosed and undertreated. In fact, a 2010 study found that Indian women have significantly lower bone densities and increased incidence of low bone mass when compared to other countries. While this is likely connected to poverty and malnutrition, the need for awareness across all socioeconomic levels is clear.
PREVENTION (FOR WOMEN UNDER 65)
Many factors influence bone remodeling and building, including genetics, diet, exercise, and lifestyle habits. Barring genetics, these are things well within your control, and little tweaks to your lifestyle can set you on the right track to avoid osteoporosis. First and foremost, make sure you are getting enough calcium and vitamin D – these two nutrients are essential to strong bones. (Learn more about calcium and vitamin D on The Swaddle!) You’ll likely be able to get the right amount of these nutrients in a generally balanced diet, so eating healthfully becomes even more important. This includes moderating your caffeine intake (only 1-2 caffeinated beverages daily), avoiding excessive amounts of alcohol (no more than 3 drinks daily), and no tobacco use.
Exercise also plays a major role in preventing osteoporosis. Regular weight-bearing exercises, like walking and jogging, help your bones grow stronger as they adapt to the push and pull of your weight and muscle during the activity.
PREVENTION AND MONITORING (FOR WOMEN OVER 65)
Once a woman hits 65, it is recommended she get regular bone density screening. Osteoporosis isn’t a disease with obvious early symptoms and without regular screening, the first sign of the disease could well be a dangerous fracture. A DEXA scan is typically done every two years for women over the age of 65 and also for younger women who may be at increased risk of osteoporosis. (Chronic steroid use, kidney disease, and being chronically underweight, among other less common factors, increase your risk of osteoporosis.) Your doctor will use the results of your scan in conjunction with the Fracture Risk Assessment Tool (FRAX), developed by the World Health Organization, to determine the probability of a 10-year risk of fracture. Depending on the results, your doctor can decide whether or not to initiate osteoporosis treatment.
When detected, osteoporosis can be easily treated with a wide range of medications. Certain oral medications, intravenous infusions, and even regular injections can fight the bone loss that occurs with age. Once your doctor initiates any treatment, he or she will periodically monitor your bone density to ensure that your bones are staying healthy. Osteoporosis is a very manageable disease — the diagnosis and treatment of which will only help you live a healthier life!