Balanced diet essential to evade osteoporosis

What is osteoporosis?

Osteoporosis is a disease of the bone. It is a condition where in the bones become brittle from loss of tissue due to hormonal changes or calcium or vitamin D deficiency. Secondly, it is often called a silent disease because it has few symptoms.  Osteoporosis means porous bones.

World Health Organisation defines osteoporosis as Bone Mineral Density (BMD) and the standardized score or the T-score, comparing BMD to average values for young women is used to define the categories.

These include

·  Normal (T-score -1.0 and above)

· Low bone mass, referred to as osteopenia (T-score between -1.0 and -2.5)

· Osteoporosis (T-score -2.5 and below)

· Severe osteoporosis (T-score -2.5 and below with history of a fracture

Symptoms

Osteoporosis is mostly asymptomatic unless complications -like fracture happens.  Most common fracture is the vertebral compression.

A slight loss of height and increased Kyphosis due to compression of the anterior part of the vertebral bodies has also been observed in most cases of. Wrist & hip fractures are also found among such patients.

Causes

· Senility (common cause in men)

· Post-immobilisation e.g. a bed ridden patient

· Post –menopausal (in women)

· Protein deficiency – malnutrition, mal-absorption, excess protein loss

· Hormones

· Drug induced – long term steroid therapy, phenobarbitone therapy

Human beings reach peak bone mass by the age of 30-35 years and gradually loose it with age. After menopause reduced level of estrogen accelerate bone density loss in females.

Men are affected by osteoporosis at a later age than women.

What next?

Osteoporosis screening is recommended for older people, women who have already had a previous fracture or who have other risk factors such as rheumatoid arthritis, history of smoking, heavy drinking, or long term steroid use should talk to their doctor about having a bone density test.

Two types of bone density test are available – ultrasound based and x-ray based. DEXA scan (dual energy xray absorptiometry) is the gold standard in the quantification of bone mass.

Prevention

We must ensure a balanced diet right from early childhood and exercise regularly so that a good bone mass is created till the age of 30-35 years.

Osteoporotics must prevent falls as it could lead to fractures.

Tips to avoid fall in elderly people:-

· Use assistive devices like cane or walker

· Wear rubber sole shoes to prevent falls

· Always use handrails while climbing up or coming down the stairs

· Install grab bars in bathrooms

· Exercise regularly

· Live in rooms that have enough light

· Ensure you have anti skid tiles in bathrooms

· Ensure there are two-way switches on both sides of stairs

Treatment

Principle objective of treatment are alleviation of pain and prevention of fractures.

The treatment can be divided into medical and orthopaedic medical treatment

· Have high protein diet

· Increase calcium supplementation

· Make sure you are not low on vitamin D

· Undergo hormonal therapy

Orthopoaedic treatment

· Exercises – Weight bearing exercises is a major stimulus to bone formation. Increased guarded activities hence, benefit the patient.

· Bracing -Prophylactic bracing of spine by using Ash brace or Taylor’s brace may prevent pathological fractures in a spine.

· Vertebroplasty – This alleviates the pain

(Dr Atul Varshney is aProfessor of Orthopaedics working with People’s Hospital, Bhopal)