Eat right, stay fit, keep osteoporosis out

Doctors say that though its onset in women may occur soon after menopause and in men after 50, one can manage it with a wellplanned diet, enriched with calcium and adequate Vitamin D throughout childhood and adulthood.

It is common to hear about hip or arm fractures among the elderly. While it is brushed aside as an age-related problem, it’s due to poor bone health that worsens with age. Bones undergo change right from the time of birth and the major factors influencing their health, or triggering osteoporosis, are diet and exercise. 

The peak bone mass, which signifies the health of the bones, is reached by the time one is 30. After that, there is a gradual loss that cannot be replaced. Rapid bone loss leads to osteoporosis.

While the condition has received greater exposure in the media due to its increasing  prevalence among women, there is little data available on its  actual incidence, say doctors.

Dr PV Vijayaraghavan, Professor of Orthopaedics, Sri Ramachandra University, says, “In India, it is an extremely common condition,” but in the absence of India-specific studies, he categorises them broadly into two types. “Among women, after menopause, there is a rapid drop in oestrogen levels, which leads to a decline in bone health. This is also called post-menopausal osteoporosis. The other category is called senile osteoporosis or type II osteoporosis, which occurs in men over 60, and some women too,” he says.

Women are more prone to osteoporosis than men since they have thinner and narrower bones, says Dr Ravikiran Muthuswamy, endocrinologist. He adds, “Calcium absorption is improved with Vitamin D, but storage of calcium may be affected by a number of factors like hormones.” 

Younger women in the age group of 25-30 years may have osteoporosis, but this is not common. It may occur due to exposure to radiation or in those living in high altitude areas.

A DEXA (Dual energy X-ray absorptiometry) scan or a DXA is a bone density scan which can measure the strength of the bones and the unit of measurement is standard deviations. According to the World Health Organisation, a T-score between +1 and −1 is considered normal or healthy. A T-score between −1 and −2.5 indicates that you have low bone mass, although not low enough to be diagnosed with osteoporosis. A T-score of −2.5 or lower indicates that you have osteoporosis. The greater the negative number, the more severe the osteoporosis.

Dr Deen Mohammad Ismail. Professor of Orthopaedics and Director, Institute of Orthopaedics and Traumatology, Madras Medical College and Rajiv Gandhi Government General Hospital, says that one of the reasons why Indians are predisposed to the condition is the inability to produce Vitamin D. 

A recent study also revealed that 69 per cent of Indians suffer from Vitamin D deficiency and at least 15 per cent are Vitamin D-insufficient. He says, “The problem is when we don’t have enough exposure to sunlight and we deprive our body of the essential component which produces Vitamin D. We can make up for it by exposing our hands, feet and face to the sun between 1pm and 3 pm for 45 minutes.”

A calcium tablet may come in handy for women after menopause. However, that alone is not sufficient to improve bone health, points out M. Sowmya Binu, senior nutritionist. “We have to eat food that is high in calcium throughout adulthood. Milk and milk products, soya, spinach and broccoli, nuts like sesame, flax and almonds, fish like mackerel, salmon and tuna go a long way in ensuring bone health,” she says. She adds that avoiding alcohol, caffeine, aerated drinks and high salt intake also help in the process.