Weak and brittle bones are caused by osteoporosis, with mild stresses such as bending over or coughing or a fall potentially causing a fracture, stated American not-for-profit health care company Mayo Clinic. Fractures associated with osteoporosis occur in the hips, wrist, or spine. As a living tissue, bone is continuously being broken down and replaced. Osteoporosis happens when new bone fails to keep up with the loss of old bone.
This condition affects men and women, regardless of their race. However, white and Asian women—especially older post-menopausal women—are at the highest risk of having osteoporosis. A healthy diet, weight-bearing exercise, and medications can prevent bone loss or strengthen weak bones.
Challenges In Osteoporosis Awareness and Management (2019)
Published in biomedical and life sciences journal PMC, The Harris Poll in 2017 conducted an online survey, gathering 1,012 postmenopausal women over 50-years-old, explained E. Michael Lewiecki and colleagues. The survey included eight screening questions and 35 mandatory questions on lifestyle, general health, bone fracture, awareness, osteoporosis, and demographics, including follow-up questions where applicable. The study had an oversample of 102 women with osteoporosis and a fragility fracture, totaling 280 subjects with osteoporosis and a fracture.
Of 1,012 participants, 49.5% self-reported a diagnosis of osteoporosis and 50.5% had no known osteoporosis diagnosis. Among those with osteoporosis diagnosis, 69% were 65 years and above and 355 had a prior fracture. The most common self-reported comorbidities were hypertension among 38% of women with an osteoporosis diagnosis and 32% among women without, followed by thyroid disease (25% versus 16%), type 2 diabetes (13% versus 12%), and respiratory disease (19% versus 6%). From the self-reported risk factors, Lewiecki and colleagues found that 64% of those who had no osteoporosis diagnosis were at risk of osteoporosis.
115 postmenopausal women osteoporosis and a fracture who were informed by their healthcare provider (HCP) that their fracture could be associated osteoporosis were asked what they thought caused their fracture before consulting their HCP. 35% said they had no idea that osteoporosis was to blame not until their HCP told them. 34% were unsure that fracture might be due to osteoporosis and 31% of those with osteoporosis felt sure their fracture was caused by osteoporosis.
13% of women with osteoporosis and 2% without osteoporosis recognized that poor bone health might have caused their most recent fall-related fracture. Rather than poor bone health, the participants also blamed their most recent fracture on clumsiness (43% with osteoporosis versus 44% without). They also associated their fracture to balance problems caused by medical conditions or other issues (6% with osteoporosis diagnosis versus 13% without). Only 29% of women with an osteoporosis diagnosis and 25% of women without osteoporosis diagnosis associated fractures involving the hip and back with osteoporosis.
The study found that most undiagnosed women with, or at risk for, osteoporosis did not know its risk factors. Among the participants, the most recognized risk factors were a positive family history (76% not at risk versus 78% at risk), smoking (56% for both groups), premature menopause (28% versus 33%), having a small body frame (20% versus 29%), consuming three or more alcoholic beverages a day (27% and 26%), use of glucocorticoid agents (19% and 25%), and decreased strength (27% and 22%).
The survey showed that postmenopausal women could benefit from being more informed about osteoporosis. Increased awareness is needed as a fracture is considered as a “sentinel event” requiring evaluation and early intervention to minimize a woman’s risk for fracture.
To reduce fracture risk, patients may also benefit from non-pharmacologic and pharmacologic therapy. Fostering heightened disease awareness may allow patients to self-advocate and to ensure they are assessed for osteoporosis.
What Are the Risk Factors?
Women are more likely to develop osteoporosis than men. As you age, the more women are at risk of osteoporosis. You are also at risk of developing this condition when you have a parent or sibling with osteoporosis, especially if one of your parents fractured a hip. If you have small body frames, you may be at risk of osteoporosis as you have less bone mass to draw from as you age.
Low calcium intake, especially a lifelong lack of calcium, enables the development of osteoporosis. Low calcium intake leads to diminished bone density, early bone loss, and heightened risk of fractures. If you suffer from anorexia nervosa, it increases your risk of osteoporosis as it weakens your bones, said Mayo Clinic and the National Institutes of Health, on online resource for health-related information. Smoking is also a risk factor, which is also bad for your heart and lungs. Likewise, excessive consumption of alcoholic drinks increases your risk of bone loss and fractures.
What Are the Signs of Osteoporosis?
Bone loss does not show any symptoms, making osteoporosis a silent disease among individuals. You may not know that you have this condition until your bones become extremely brittle to the point that a strain, bump, or fall causes a vertebra to collapse or hip fracture. Collapsed vertebrae may be felt or seen in the form of loss of height, severe back pain, or spinal deformities. One example of which is kyphosis or having a “severely stopped posture.”
Is There Any Way to Prevent Osteoporosis or Reduce My Risk of Having One?
1. Increase Your Calcium Intake
Start consuming food sources rich in calcium such as low-fat dairy products (e.g. milk) and dark green, leafy vegetables such as bok choy and broccoli. Almonds, orange juice, and tofu are also good sources of calcium. Calcium demand is greater during childhood and adolescence, when the skeleton is growing rapidly, and during pregnancy and breastfeeding. Postmenopausal women and older men need to increase their calcium intake. Bear in mind that your body becomes less efficient at absorbing calcium and other nutrients as you get older.
2. Consume Vitamin D
Vitamin D improves your body’s ability to absorb calcium, thereby improving bone health. You can get vitamin D from egg yolks, saltwater fish, and liver. Sunlight is also a source of vitamin D but this is not the most appropriate source if you live in high latitude areas, if you are housebound, or if you regularly use sunblock or avoid the sun to minimize your risk of skin cancer. A supplement is a wonderful alternative if you have limited sun exposure or if you don’t have any other sources of vitamin D.
Your bones respond to exercise, helping them become stronger. You can try doing weight-bearing and resistance exercises. Weight-bearing exercises include walking, jogging, dancing, climbing stairs, and playing tennis. Resistance exercises include using weight training machines and lifting weights. These should help promote balance and good posture.
Osteoporosis affects people regardless of their background; however, white and Asian women are more at risk of developing this condition. Family history also plays a role in the development of osteoporosis. It is best for individuals to introduce lifestyle changes and consult their physicians for early intervention and diagnosis.