The International Osteoporosis Foundation has revealed how it is receiving more and more worrying reports of under-diagnosis and inappropriate care for sufferers of the devastating brittle bone disease.
We’ve covered numerous e-Alerts in the past on this debilitating condition, whereby the bones become brittle and porous and more prone to breakage. According to the National Osteoporosis Society one in three women and one in twelve men in the UK will develop osteoporosis during their lifetime. Worryingly, the condition is increasing in prevalence by around 10 per cent each year, which is mainly attributed to poor dietary and lifestyle choices.
The latest damning report by The International Osteoporosis Foundation came to light at the World Congress on Osteoporosis that was recently held in Toronto, Canada. Delegates in Toronto heard the results of three surveys designed to assess preventative measures, diagnosis of osteoporosis, and treatment, which were conducted in Belgium, Canada, and Germany.
The Canadian study showed that 61 per cent of 125 patients who suffered a low-trauma fracture of wrist, hip, spine or shoulder in 2003 did not receive a bone density scan to test for osteoporosis. The majority were also not told to increase calcium or vitamin D intake, or to undertake exercises to maintain bone strength. In Germany the rates were even lower: Out of 761
postmenopausal women who suffered a wrist fracture questioned, less than four per cent were offered a scan and less than 10 per cent received supplement advice.
In Belgium, two thirds of post-menopausal female outpatients were offered supplements or drugs regardless of whether or not they had been diagnosed with osteoporosis. This may, perhaps, be good news for prevention, but Florent Richy of the University of Liege was condemnatory of the overall public health approach:
The findings show that while we have the weapons to diagnose and treat osteoporosis, we are not yet able to direct them where they are needed most.
Osteoporosis: What to do if you think you may be at risk
Risk factors for the disease include low body weight (thin small-framed women have less bone mass which puts them at greater risk), certain medicines such as steroids, the menopause (due to declining levels of oestrogen, a hormone which stimulates osteoblast cells that can rebuild bone), and a sedentary lifestyle (made worse by smoking and consuming alcohol and caffeine).
A reliance on processed convenience foods also puts you at risk, as these meals are severely depleted of many essential nutrients such as calcium, magnesium and vitamin D that are needed for good bone health.
You should be aware that osteoporosis rarely produces any symptoms, as bone loss normally occurs very gradually. However, signs that indicate you should see your doctor include a sudden loss of height, chronic back pain and a change in posture. You should also make your doctor aware if you have a family history of the disease, as it can run in families.
Osteoporosis is diagnosed using a Bone Mineral Density (BMD) test, which usually involves X-rays of the spine and hip area. An ultrasound test may also be conducted (normally performed on your wrist or heel), which also measures bone density.
Osteoporosis: Its never too early to start taking preventative measures
Prevention also came under the spotlight at the conference in Toronto, with the presentation of study data that indicates the important role of vitamin D consumption for children, as poor skeletal growth in infancy was seen to increase the risk of future fractures.
Vitamin D is present in oily fish, eggs, liver, and fortified cereals.
Nicholas Harvey of the MRC Epidemiological Resource Centre in Southampton, UK and colleagues looked at vitamin D levels taken during late pregnancy, infant bone density in 556 babies soon after the birth, and levels of calcium transporter in the placenta.
They found that baby girls born to women with low vitamin D levels tended to have bones of lower density. Higher levels of calcium transporter were also linked to higher infant bone density.
What we hypothesise is that the mother’s vitamin D levels somehow influence the amount of calcium transporter in circulation, said Harvey.
In parallel with this, Dr Kassim Javaid, also from the Southampton centre, compared the weight and length data from 13,345 children born in Helsinki, Finland, between 1934 and 1944, at birth and during childhood with later hip fracture incidence. They found that those with a lower weight in infancy and early childhood tended to have more hip fractures in later life.
Now we have evidence that the bone mass you have at the age of 80 reflects what you started with very early in life, said Dr Javaid.
Osteoporosis: Take these steps to help strengthen your bones
While you can’t turn back the clock, there are steps you can start taking right now to lower your risk of osteoporosis.
Maintain a healthy lifestyle Don’t smoke and limit your intake of alcohol and caffeine, as they reduce your body’s ability to absorb vital bone-building nutrients.
Avoid sugar and refined carbohydrates from your diet, as studies have shown that they acidify the blood and cause calcium to leach from your bones thereby lowering overall bone mass (Biosci.
Biotechnol. Biochem. 1995; 26(3):395-400; American Journal of Clinical Nutrition 1989;50(5):955-61)).
Exercise should be incorporated into your lifestyle too. Weight-bearing exercises are best as they help to increase the strength and thickness of your bones as well as your muscles (Endocrinol Metab Clin N Am 1998, 27 (2) 369-387). However, check with your doctor first before starting on a strenuous exercise regime.
Calcium, Vitamin D and Magnesium can help prevent the loss of calcium from your bones, especially after the menopause (Endocrinol Metab Clin N Am 1998, 27(2) 389-398). Increase your dietary intake of calcium to keep your bones strong, by eating more cheese, sardines, broccoli and dark leafy vegetables. Supplementing with this essential mineral is also advisable: take 1,000mg of calcium a day; women over 50 (especially post-menopausal women) and men over 65 should take a higher dose of 1,500mg.
Vitamin D3 is also important for maintaining healthy bones and protecting against fractures. Take 400IU of Vitamin D3 a day. Magnesium also helps your body absorb calcium take between 400 and 600mg each day. Dietary sources include, chickpeas, dried figs, prunes, pumpkin seeds and peanuts.
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