Osteoporosis leads to bone fragility and increased susceptibility to fractures. Prevention can play a decisive role.
There are, in Portugal, more than half a million people, mainly women, diagnosed with osteoporosisso it is worth getting to know this disease better and knowing how we can prevent it.
Osteoporosis is a disease characterized by a decrease in bone mass and by a change in the microstructural quality of the bone. Its consequences are a decrease in bone strength and an increased risk of fracture, especially in dorsal and lumbar vertebraeat the distal end of the radius and at the proximal femur.
We can distinguish primary osteoporosis from secondary osteoporosis:
a) Primary osteoporosis: when there is no underlying pathology that justifies its occurrence. It commonly results from a decrease in estrogen after menopause or from insufficient bone mass acquisition during the growth phase;
b) Secondary osteoporosis: when bone loss is secondary to an illness, an eating disorder, or taking a certain medication.
In our country there are about 9500 fractures per year, which are related to bone fragility and can occur anywhere in the body, although, as we have seen, they are mostly located in the spine, hip and also in the wrist. Fractures caused by osteoporosis more often affect postmenopausal women and the elderly. It is, therefore, a very prevalent disease in our countrywhich has serious consequences in terms of health and significantly reduces the quality of life and well-being of those who suffer from it.
Risk factors for the disease
You most relevant risk factors in the onset of osteoporosis are:
- Age over 65 years;
- Previous vertebral fracture;
- Fragility fracture after age 40;
- History of hip fracture in one of the parents;
- Systemic corticosteroid therapy lasting more than 3 months;
- Early menopause (<40 years);
- Primary hyperparathyroidism;
- Increased propensity for falls.
In addition to these risk factors, in the case of osteoporosis there are other conditions that must also be taken into accountnamely:
- rheumatoid arthritis;
- hx of clinical hyperthyroidism;
- chronic therapy with anti-epileptics;
- low intake of calcium in the diet;
- excessive caffeine consumption (>2 cups per day);
- excessive consumption of alcoholic beverages;
- body mass index less than 19 kg/m2;
- weight loss greater than 10% relative to the individual’s weight at age 25;
- chronic heparin therapy;
- prolonged immobilization.
Diagnosis and treatment of osteoporosis
For the proper treatment to be implemented, it is important, first of all, to establish the correct diagnosis. However, bearing in mind that osteoporosis by itself does not cause symptoms, the diagnosis (goes through the determination of bone mineral density, through one of the several existing methods) and treatment tend to start lateafter the occurrence of a fracture.
Ideally, the diagnosis should happen in a timely manner, by performing a bone densitometry. Moreover, special attention should always be paid to all people who have some of the risk factors for the disease described above.
Subsequently, it is important to start the treatment that will aim to prevent the occurrence of osteoporotic fractures?? Pharmacological treatment, which is indicated for some patients and must always be prescribed by the doctor, can reduce the speed of bone loss or even stimulate bone formation.
How to prevent osteoporosis? Does lifestyle have any influence?
Once the risk factors are known, the discussion about the prevention of osteoporosis has gained greater prominence, as seems to be the only way to stop the advance of this disease?? Studies indicate that lifestyle can have a great influence on the onset of the disease, which is why it is important to reduce and correct these risk factors, that is, it is necessary to abandon some bad habits, replacing them with a healthier lifestyle??
1) Practice physical activity on a regular basis: physical exercise seems to contribute to increase bone strength, improving bone density and quality;
2) Adopt an adequate and balanced diet: it is important to avoid excessive consumption of caffeine and adjust the protein content of the diet according to each person’s needs. Furthermore, the diet must ensure a sufficient supply of calcium and vitamin D;
3) Avoid falls: the risk of falling tends to increase especially during the aging process. It is also at this stage of life that the consequences of falls tend to be more serious;
4) Avoid excessive alcohol consumption: chronic alcohol consumption has negative repercussions on the bone;
5) Avoid tobacco consumption: tobacco consumption also has an impact on bone metabolism, accentuating the loss of bone mass, as well as the risk of fracture, possibly due to the toxic effect of the substances that compose it.
In short, it’s better to be safe!
This disease, characterized by a decrease in bone mass and deterioration of bone architecture, is highly prevalent in western countries, including Portugal. Being a disease that is often silent, it is important to focus on its prevention, in order to obtain good levels of bone mass. As we have seen, tobacco and alcohol must be avoided, caffeine must be consumed in moderation, the diet must be balanced and physical exercise must be an integral part of everyday life.