Osteoporosis is a condition where the amount of bone in the skeleton decreases to the extent that bones become porous and brittle. This decrease in bone mass undermines the structure of the bones, making people vulnerable to fractures.

Such fractures, for example of the hip, leg, arm and neck bones, can cause a great deal of suffering, necessitate expensive surgery, and can even be fatal. Osteoporosis, therefore, can sharply decrease the quality of life of older men and women.

Who gets osteoporosis?

The two most important factors that determine if someone is going to develop osteoporosis are 'peak bone mass' and the rate at which this maximum amount of bone is lost over time.

Peak bone mass is in turn influenced by:

    • Genetic factors: some individuals have a lighter and more brittle skeleton from birth.

    • How the skeleton is used: people who do plenty of load-bearing exercise all their lives have a higher peak bone mass than those who lead sedentary lives.

    • Nutritional intake, particularly shortages of calcium, vitamin D, vitamin K, magnesium and protein.

    • Gender: women have a lower peak bone mass than men.

    • Race: Africans tend to have a higher peak bone mass than Caucasians and Asians, which is why osteoporosis is relatively unknown in Africa generally.

    • Cigarette smoking decreases peak bone mass and should be avoided.

    • Excessive alcohol intake also has a negative impact and drinking should always be kept at a moderate level.

    • Self-imposed starvation (anorexia) can have a disastrous effect on peak bone mass and cause osteoporosis at a much earlier age than normal.

Bone loss is influenced by the following:

    • Because women start out with a lower peak bone mass than men, they also tend to lose more bone and at a faster rate than men as they age.

    • Menopause: lack of oestrogen speeds up bone loss.

    • Lack of exercise is also linked to increased bone loss.

    • Low calcium intake accelerates bone loss.

    • Smoking and alcohol abuse.

    • Increasing age: bone loss increases with age.

    • Nulliparity: not ever having given birth to a baby.

Can osteoporosis be prevented?

We can't influence our genetic makeup, our gender, race, or age, but it is possible to take precautions which can help prevent osteoporosis.

5 steps to help prevent osteoporosis:

    • Be active, do regular exercise, especially so-called 'load-bearing' exercises (weight and resistance training), all your life.

    • Don't smoke or abuse alcohol.

    • For women, talk to your doctor about whether you are a candidate for hormone replacement therapy (HRT) once you reach menopause.

    • Ensure you get adequate direct sunshine. This boost your vitamin D levels - vitamin D is critical for helping your body absorb calcium. If you work in an office and don't get much direct sunshine during winter months, consider taking a vitamin D supplement to ensure strong bones and muscles.

    • Eat a balanced diet rich in calcium, but particularly during the early years (childhood to young adulthood) when your body is depositing calcium in the bones to ensure an adequate peak bone mass for the rest of your life. If you struggle to get the recommended 1000-1300mg of calcium a day from diet, or are simply worried about bone health, you may benefit from a calcium supplement. Many of these already contain vitamin D.

Bone density determinations

It is a good idea to have bone density determinations done if you fall into any of the above mentioned risk categories, e.g. white females who smoke, drink alcohol, do not exercise and have a low calcium intake, or any woman over the age of 40.

Image via Thinkstock

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