Health Tips

What You Need to Know About Osteoporosis

Ever wonder how many bones the human skeleton is made up of? Well the answer depends on your age. According to health experts, babies have 300 bones in total in which they will fuse into about 206 bones by the age of 25 upon adulthood. Our bones are further classified into 4 categories, namely the long bones, short bones, flat bones and irregular bones which are found at different parts of the body.

As we continue to age, bone health may be a concern to most of us. In conjunction with World Osteoporosis day 2022 themed Step Up to Bone Health that falls on the 20th of October every year, let us look at some interesting key facts on bones and osteoporosis that you may or may not know about:

Osteoporosis - The fundamentals & Statistics

The term ‘Osteoporosis’ comes from the Greek word osteo which translates to bone and poros which means passage or space. Just like the name suggests, osteoporosis is a condition where our bones become porous (thin and fragile) and lose their strength to provide shape and support for the body; causing pain and disability. People with osteoporosis would find their bones break easily - even from a minor fall, a slight bump, a sneeze or a sudden movement. Besides, osteoporosis is thought to be a silent disease and often goes unnoticed as most would not be aware if they have osteoporosis until they break a bone after a minor injury (also known as fragility fracture).
 

Image credit: International Osteoporosis Foundation
 

In terms of statistics, globally, 1 in 3 women and 1 in 5 men above the age of 50 will suffer an osteoporotic fracture. This staggering figure is concerning because fractures caused by osteoporosis can be life-threatening and result in long-term disability. That said, proper education and prioritization on bone health is crucial as we age.

Fact #1: Women are more prone to osteoporosis than men

Osteoporosis can happen to anyone, however its incidence is found to be more prevelant among post-menopausal women. This can be explained by the loss of oestrogen (a hormone essential for bone health) after menopause which leads to increased bone resporption and decreased bone density. Thus, elderly women are 4x more likely to develop osteoporosis than men. An estimated 50% of women will get osteoporosis as they age. However fret not as there are few ways that can prevent osteoporosis. Keep reading!

Fact #2: The spine is the most commonly fractured bone in osteoporosis

Spinal fractures, also known as vertebral compression fractures, are reported to be twice as common as other fractures such as broken hips and wrists that are typically linked to osteoporosis. With spinal fractures, the usual first red flag is intense back pain that is made worse with motion (ie: shifting positions, coughing & sneezing) and can be relieved by rest or lying down. If the fractures are bad enough, it may also cause nerve pain that will radiate into the legs. Great news is, spinal fractures are preventable by reducing the likelihood of an individual to have osteoporosis; through proper nutrition and weight-bearing exercises.
 

When to suspect osteoporosis?
While we know osteoporosis often goes undetected for a long time and there are no apparent symptoms, someone with the following symptoms is likely to suffer from osteoporosis: 

• Low back pain or neck pain 

• Loss of height (4cm or more)

• A stooped (bent) posture 

• Easily fractured bones from minor falls

Thus, to detect osteoporosis at the early stage, a routine Bone Mineral Density test through DEXA scanning should also be scheduled if you’re of a higher risk. This is to allow appropriate care to be taken to manage your condition. To check your osteoporosis risk, kindly refer to our previous article here or visit Risk Check Osteoporosis Foundation.

Ways to Preventing or Slowing Progression of Osteoporosis

The general osteoporosis preventive measures are mainly on adequate nutrition, physical exercises, alcohol & smoking cessation as well as by incorporating preventive measures with elderly people in the house. 

Nutrition - A bone-healthy diet essentially consists of an adequate intake of calcium, protein, vitamin D, vitamin K and other nutrients. However, the nutritional demands for these minerals varies with age. For instance, growing children and post-menopausal women may require a much higher calcium intake than the others as their bones are considered to be vulnerable to fractures.

Calcium rich foods: milk, natural yoghurt, almonds, tofu, cheese

Protein: Milk and dairy products

Vitamin D rich food: salmon, canned tuna, shiitake mushrooms, egg yolks
PS: Alternatively, you may also get vitamin D from direct sun exposure by standing under the sun for about 10-20 minutes daily during peak sunlight hours; before 10am and after 2pm without any sunscreen or sun protection.

Physical activity - Generally, weight-bearing exercises are recommended for osteoporosis patients or as a way of preventing osteoporosis. Weight-bearing exercises are exercises where your feet and legs support your weight. Some examples include walking, dancing, low impact aerobics, stair climbing and gardening. These exercises are seen to be beneficial as it may not only improve the patient's strength and enhance flexibility, stamina and balance, but also helps strengthen the bones which will prevent or reduce the risk of developing osteoporosis.

Alcohol & smoking cessation - Just like any condition, the prime way to prevent osteoporosis is to avoid or limit both alcohol intake and smoking. Studies have shown that the tobacco found in cigarettes allows one to be more susceptible to osteoporosis and impedes healing from musculoskeletal injuries. Besides, heavy, chronic alcohol consumption would also compromise bone health and hence increase the risk of osteoporosis.If needed, the recommended alcohol intake is not more than 14 units per week (6 pints of average-strength beer or 10 small glasses of lower-strength wine).

Prioritizing falls prevention - As mentioned, any falls is risky for osteoporosis patients and this is why a safe falls-proofed home environment is crucial. This can include removing tripping hazards (ensure floor is not slippery, wet and messily occupied), installing handrails and placing rubber matts in the bathroom, good lighting along the stairways and wearing slip-proof soles, especially for the elderly population.

Treatment 

To date, osteoporosis remains irreversible and is not considered curable. However, there are some medications indicated to protect and strengthen the bones such as: 

• Bisphosphonates (ie: Alendronate/Alendronic Acid, Ibandronate/Ibandronic Acid)

• Calcitriol

• Vitamin D analogs (ie: Alfacalcidol)/supplements

• Oestrogen Replacement Therapy

• Raloxifene

• Strontium ranelate

For a more detailed explanation of the existing osteoporosis treatment, you may refer to our previous article here.

The takeaway

While osteoporosis is rarely fatal and deemed not serious by some, broken bones from osteoporosis may decrease one’s quality of life and affect their ability to be independent. Hence it is important to be more informed on the risk factors and be aware of some healthy practices in your daily life that can help to minimize your risk of developing osteoporosis. It is never too late to start adopting healthy measures to preserve and enhance your bone health. Healthy bones, healthy life!
 

Written by Janelle Leong, Bpharm(Hons)
Reviewed by Ashwini Nair, MB BCh BAO

References 

1. Serve up Bone Strength Throughout Life - International Osteoporosis Foundation. Available at: https://www.osteoporosis.foundation/sites/iofbonehealth/files/2022-03/2015_ServeUpBoneStrengthThroughoutLife_Brochure_English.pdf Accessed on: 19th October 2022

2. World Osteoporosis Day 2022 Toolkit - IOF. Available at: https://www.osteoporosis.foundation/sites/iofbonehealth/files/2022-05/WOD%20Toolkit_Final.pdf Accessed on: 19th October 2022

3. Top 10 Facts on Osteoporosis. Available at: https://www.medindia.net/health_statistics/health_facts/top-10-facts-on-osteoporosis.htm Accessed on: 19th October 2022

4. Exercising with osteoporosis: Stay active the safe way - Mayo Clinic. Available at: https://www.mayoclinic.org/diseases-conditions/osteoporosis/in-depth/osteoporosis/art-20044989#:~:text=Weight%2Dbearing%20aerobic%20activities%20involve,machines%2C%20stair%20climbing%20and%20gardening. Accessed on: 19th October 2022

5. Osteoporosis Prevention - NHS. Available at:  https://www.nhs.uk/conditions/osteoporosis/prevention/#:~:text=High%2Dimpact%20weight%2Dbearing%20exercise,as%20trainers%20or%20walking%20boots. Accessed on: 19th October 2022

Written by

Janelle Leong, Bpharm(Hons)