Osteoporosis Awareness and Prevention Month
May is recognized as National Osteoporosis Awareness and Prevention Month, and Dr. Annabel Fountain, Medical Director at Fountain Health, aims to raise awareness and spread the importance of bone health.
A spokesperson said, “Bone is living tissue made of cells within a matrix of calcium, magnesium, phosphate and other minerals. These cells constantly repair and replace old or damaged bone. Osteoporosis occurs when the creation of new bone doesn’t keep up with the loss of old bone and the bone mineral density drops significantly below the average value for a young healthy person. This makes the bone more fragile and more likely to break. Typical osteoporotic fractures occur in the wrist, spine or hip. Osteopenia is the level between normal and osteoporosis.
“The risk of developing osteoporosis increases as people grow older, but age isn’t the only risk factor for low bone density. Peak bone density is attained in the twenties when people are finished growing. Childhood and adolescent illnesses, gut diseases that reduce absorption of nutrients [e.g., coeliac disease, Crohn’s disease], and other disorders such as anorexia nervosa can impact this. If an individual does not reach their potential bone density, they’re more likely to have osteoporosis in the future.”
Dr. Fountain says: “As a physician who treats people with osteoporosis, I want my community to understand more about their bone health so that we see less people living with osteoporosis in the future. The lifestyle choices we make can affect our bone health – it’s not just a disease that older people need to worry about. Being active, not smoking, eating food that supports bone health, and limiting alcohol consumption are all things you can do now to prevent osteoporosis.”
The spokesperson said, “Estrogen deficiency is a significant risk factor for osteoporosis. Women whose periods stop [outside of pregnancy] for a long time [e.g., due to the progesterone only contraception shot], are likely to have low peak bone density. Then, as their estrogen levels start dropping in perimenopause, they start to lose bone mass. Hormone replacement therapy in women who are at low risk for breast cancer is one way to support bone health after menopause [365 days after their final menstrual period] and this may have other benefits too.”
“Osteoporosis is much less common in men because they don’t go through menopause and continue to make testosterone throughout their lives. It affects about one in five women over age 50, but only one in 20 men. However, “men can have testosterone deficiency for a variety of reasons [pituitary tumours, testicular injury, childhood mumps] so I see quite a few men with this disorder”, says Dr. Fountain.
The spokesperson said, “Many people don’t know they have osteoporosis until they break a bone. According to the International Osteoporosis Foundation [IOF], osteoporosis causes more than 8.9 million fractures worldwide annually, meaning an osteoporotic fracture happens every three seconds. One in three women over age 50 will have an osteoporotic fracture, as will one in five men aged over 50. However, it is estimated that the lifetime risk of fragility fracture in men is greater than that of prostate cancer.”
Dr Fountain says, “For people over the age of 50, fractures can be life-threatening. It’s not just an inconvenience to break your hip. In the first 12 months after a hip fracture the overall mortality rate is about 20%, and this is higher in men than women”. [IOF]
The spokesperson said, “During menopause, women lose bone mass more rapidly for several years. Many women will have a bone density scan soon after they enter menopause. This is a special X-ray that doctors use to assess bones and monitor the rate of bone loss over future years. If bone density is below par, good nutrition and weight bearing exercise [not swimming or cycling] can help to maintain or improve bone strength.
“On average, people of African descent have better bone density than Caucasian and Asian people. However, Vitamin D deficiency is more common in people of colour. Wearing high SPF sunscreen and hats to avoid skin cancer and ageing also prevents vitamin D production in the skin. Vitamin D is a hormone that is integral to keeping calcium and other minerals in the bones, rather than being lost via the kidneys in the urine. Other hormones are involved which is why an endocrinologist is the specialist that deals with osteoporosis.”
Dr. Fountain says, “It can be very disappointing to be diagnosed with osteoporosis, especially if one has made lifestyle choices that we think should maintain our health [maintaining a healthy weight and exercising]. Some medical conditions [chronic kidney disease, hyperthyroidism, pituitary tumours] and medications [steroids, some blood thinners] can cause damage to our bones, making some people more at risk for fractures. These people should be screened earlier.”
“The good news is that a healthy diet, weight-bearing exercise, vitamin supplements and medications can help to prevent bone loss or strengthen weak bones,” she says.
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