Osteoporosis

Causes and Prevention

Osteoporosis is a condition characterized by weak bones and low bone mass, making fractures more likely to happen. This occurs more frequently in older people, especially if they don’t follow the necessary guidance and advice to maintain bone health and increase bone density at young age. The main factor of osteoporosis is the process of regeneration of bone tissue, i.e. the imbalance between bone tissue loss and the creation of new bone.

Osteoporosis affects women and men, but women who are past menopause are more susceptible. This is due to the absence of female hormones that served as a protection from this condition.

This disease is characterized by the presence of pores in the bones that result in loss of bone density and strength. Bone consists of collagen fibers and noncollagenous proteins, on which mineral salts deposit to give the bone its rigidity. Bone is a constantly renewed living tissue characterized by its rigidity and hardness and is the structure that supports the whole body. The structure and composition of bone tissue are subject to constant changes over the years. Different physical and hormonal factors that activate or inhibit bone cells lead to changes in bone density and structure.

Osteoporosis is often called a silent disease because people may not be aware they have it until they break a bone due to its fragility. Attention should be paid to symptoms such as weakness, joint pain, and motor system. These symptoms are severe and sudden and appear with age where people tend to fall more often and break a bone. Most fractures happen in the pelvis, spine, and thigh.

The likelihood of osteoporosis depends on the amount of bone mass people attain in their youth. The more a person is able to follow the correct practices to strengthen bone mass, the more this contributes to the avoidance of osteoporosis with age.

Hence, it is necessary to adopt a healthy lifestyle in the 20s and 30s, such as exercising, eating healthy foods, avoiding smoking and soft drinks, and not taking too much salt, because these are risk factors for osteoporosis.

The most important element for bone protection is sports or any kind of physical activity.

The gravity of the disease is related to the speed at which a person loses bone tissue beyond the age of forty and to the amount of bone tissue accumulated in the body between 25 and 35 years old. In this phase, the amount of bone tissue reaches its peak. The larger the size of the bone mass, the greater the stock of bone mass and the lower the risk of osteoporosis.

The Most Important Vitamins for Strong Bones

As is well known, vitamin D and calcium are important for strong bones and any deficiency in them makes people more likely to get osteoporosis and have weak bones. Things get worse over the years and if a healthy lifestyle is not adopted.

What are the vitamins that affect human bones?

Vitamin D

It is the most important vitamin for bones and it is necessary for calcium absorption and bone growth. Exposure to sunlight helps the body to produce vitamin D. It is enough to put the hands and feet for 20 minutes in the sun in the morning twice a week to get the body’s need for this vitamin.

Supplements are required if a person has severe vitamin D deficiency.

Osteoporosis will lead to fractures in the bones in older people who don’t get enough vitamin D.

The normal percentage of vitamin D in the human body ranges from 20 to 50 ng/ml. A level less than 20 ng/ml indicates vitamin D deficiency. It is also dangerous to have a level higher than 50 ng/ml. In case of deficiency, the patient should take a dose of vitamin D to prevent its increase by taking 600 IU per day for adults and 800 IU for older people.

Calcium

Calcium is very important to build bones and reduce the loss of its density. It is one of the most important substances the human body needs to maintain bone health, apart from its many other benefits.

A low-calcium diet leads to a reduction in bone mass and an increased chance of fractures. Calcium-rich foods include dairy products, eggs, and vegetables such as spinach, jute mallow, cauliflower, cabbage, broccoli, and turnip. Nuts also contain a good percentage of calcium, most notably almonds, hazelnuts, walnuts, and cashews.

Vitamin A

It is one of the vitamins necessary for bone health. Beta-carotene is converted in the body to vitamin A, which maintains bone health and reduces bone problems. It should be noted that a high amount of vitamin A can lead to congenital defects, and over the long term can cause serious damage to the liver where this vitamin is stored. However, this cannot happen when vitamin A is obtained from beta-carotene. It is also essential for overall body health especially for the immune system, growth, and vision.

Animal sources, food, supplements, beta-carotene, and other carotenoids found in vegetables and fruits are rich in vitamin A.

Vitamin K

Vitamin K helps build bones and make them grow healthily by activating 3 proteins essential for bone health. One of these proteins, matrix Gla protein, promotes bone growth while healthily storing cartilaginous tissue, and another protein, osteocalcin, helps bind calcium and incorporate it into new bone tissue. In addition, vitamin K also activates 1/3 of the proteins in bone cells known as protein-S. Hence, this vitamin enhances bone health and maintains its density.

Vitamin C

Vitamin C helps promote the synthesis of collagen, which is essential for keeping bones healthy and strong, as well as teeth health. It is a component of collagen-rich connective tissues that help in bone formation.

Low vitamin C levels negatively affect bone and dental health.

What Factors Affect Bone Health?

Bones are affected by lifestyle in general and some bad daily practices, whether in the diet or physical activity, especially after the age of forty where the bone mass begins to decrease and the risk of fractures and osteoporosis increases.

Factors affecting bone health include:

Lack of vitamin D and calcium

Vitamin D and calcium are among the most important vitamins to build strong bones. Any deficiency in them will inevitably lead to osteoporosis and fractures. Vitamin D helps the body to properly absorb calcium. In case of vitamin D deficiency, the body cannot absorb the amount of calcium needed even if the person is eating calcium-rich foods. 

Daily exposure to sunlight for at least 15 minutes in the early morning provides the body with vitamin D, in addition to eating certain foods such as fish, salmon, tuna, and other foods. Calcium can be obtained from dairy products, spinach, cabbage, jute mallow, nuts such as almonds, walnuts, and cashews, and legumes such as cowpea, beans, chickpeas, lentils, and other foods.

Too much salt intake

Excessive daily salt intake contributes over time to the development of osteoporosis because it increases the loss of calcium through the urine, and therefore the body does not get the necessary amount of calcium that benefits the bones. Therefore, nutritionists and orthopedists recommend limiting salt intake.

Smoking

Smoking is one of the bad habits that destroy bones because it prevents blood from reaching them. The large amount of nicotine inhaled absorbs calcium from the body, making the bones less dense and more prone to problems and injuries.

Lack of exercise

Lack of physical activity increases the risk of osteoporosis. Sports are essential to maintain health in general and bone health in particular because they increase joint flexibility and bone density and maintain optimal physical fitness and weight, thereby reducing the risk of osteoporosis.

Drinking a lot of soft drinks

Soft drinks have many negative effects on the body in general and on bones in particular. Studies have shown a strong relation between the excessive intake of soft drinks and weak bones and osteoporosis, because these drinks prevent the absorption of calcium in the body.

Lack of sleep

Especially in childhood because the body grows during sleep and sleep helps to support the strength of the bone marrow, which is the fundamental material that helps in the formation of bones. Therefore, the number of hours of sleep should not be less than 6-8 hours a day.

Unhealthy daily habits

Some daily bad practices and habits negatively affect bone health. Repeating them for a long time with the presence of negative factors make it worse. These habits include standing for long periods, wrong sitting position, wrong sleeping position, carrying heavy weights, etc.

Taking some medications

Taking medications for cancer, pneumonia, and depression for example also affects bones. If the patient has to take this type of medications, supplements containing vitamins such as calcium, vitamin D, and others should be taken to make up for their lack in the body due to the effects of these medications.

How is bone density measured?

Bone density is measured by doing a Dual-energy X-ray absorptiometry (DEXA) scan. This name describes the mechanism of work of the device. Two X-ray beams, with different energy levels, are aimed at the patient’s bones.

This test helps detect osteoporosis and see if the person is susceptible to it. Bone density is measured through the scan by calculating the number of grams of calcium and other minerals in the bone. This test measures bone mineral density, bone hardness, fracture potential, and the progress in treating osteoporosis. It can be performed to scan the body completely and sometimes to diagnose bone pain without any cause or for cancer patients after chemotherapy. It can also measure the bone density of the lower spine bones (lumbar vertebrae), narrow neck of the thighbone (femur), and bones in the forearm.

The higher the rates of these minerals are, the higher the bone density, and the higher the bone density is, the stronger the bones and the less the risk of fractures. This test provides very accurate results and is the best to detect osteoporosis.

As for how to perform it, the patient lies on the exam table. The technician will place an imaging device above them and an X-ray generator below them. Very small doses of X-rays are emitted which is nothing the patient should be worried about. The generator produces two X-ray beams with different energy levels, one low and one high. The contrast between the two enables us to differentiate between bones and other tissues.

The results of a DEXA scan use a system called T-score. A T-score of -2.5 or lower means a diagnosis of osteoporosis. A T-score of -1.1 to -2.4 indicates osteopenia, or low bone density.

Prevention Steps

Prevention of osteoporosis consists of eating healthy food and exercising during the period of bone remodeling which is a continuous process of bone resorption and formation that takes about 3 months. 

Before the age of forty, the body makes new bone faster than it breaks down old bone. The bone mass is constantly increasing in young people and reaches its peak in the middle of the third decade of life. At the age of forty, this process stops and begins to decrease at the age of fifty, especially in women who are past menopause due to the absence of female hormones. Building a strong bone mass in youth reduces the risk of osteoporosis with age. Good nutrition and regular exercise are essential to maintain bone health throughout life.