How to Prevent Osteoporosis - 5 Ways by Decode Age

Osteoporosis to fracture is what hypertension is to a stroke. While there is no cure for it, osteoporosis can be prevented by curating a perfect regime to protect your bones. 

What is Osteoporosis?

Osteoporosis is a condition in which your bones become weaker, thinner and brittle. The term was coined from the Greek terms ‘Osteo’ meaning Bones + ‘Poros’ meaning Porous or passage - in simple words, porous bones. 

The inside of a bone resembles a honeycomb, filled with small hollow spaces. Osteoporosis causes these spaces to be enlarged causing your bones to lose mineral density and strength. Loss of inner strength can ultimately lead to changes in bone shape, structure or even fractures.  The International Osteoporosis Foundation claims that it globally affects 21.2 % of women and 6.3% of men over the age of 50.  

Who is at Risk of Developing Osteoporosis?

This bone disease affects both men and women, although is more commonly seen in women. Osteoporosis can affect anyone, at any age but is more common in older people. Due to fluctuations in the hormonal levels, women are likely to develop the disease a year or two before the menopause. People taking medicines such as glucocorticoids, Antiepileptic drugs, heparin, and Progestins are more prone to osteoporosis. Some children may develop a rare form of idiopathic juvenile osteoporosis. 

Importance of Preventing Osteoporosis to Improve Bone Health

It is said that bones are stronger than steel but they are living tissues, subjected to wear and tear. The tissue is constantly broken down and rebuilt. When you are young, your body can manufacture new bones faster than it can break down old tissue. This process gets slowed down as you age, causing the bones to become brittle, resulting in osteoporosis. People with osteoporosis are at a higher risk of fractures, and broken bones of the hip, vertebrae or wrist, These bone breaks can occur while doing daily activities such as standing, walking, running or even lifting not-so-heavy things. 

Osteoporosis doesn’t directly affect lifespan but surely affects the quality of life. Bone breaks in the hip or the spine are serious complications of this disease, and can permanently lead to disability or an increased risk of death in the first year of injury. The only way to mitigate the disease is to prevent it from happening in the first place.

Causes of Osteoporosis

Not all people develop osteoporosis, certain causative factors are involved with the progression of this disease. Certain factors contributing to osteoporosis risk can be managed, while others are beyond one's control. By understanding the risk factors, one can always prevent them.  Some of the risk factors are as follows:

1.  Age: Age-related decline in the replenishment of lost bone tissue is a major factor in osteoporosis.  
2.  Sex: The disparity in hormones between males and females affects bone size and quality. Testosterone, found in high levels in men increases bone size and strength. Whereas estrogen- found in women reduces further growth while increasing the mineral content of the bone. 
3.  Ethnicity: Non-Hispanic Asian adults and Hispanic adults are at a higher risk of osteoporosis followed by non-Hispanic white adults and non-Hispanic Black adults.
4. Genetics and familial history: You are at a higher risk of developing the disease if you have a family history of the same. Some genes such as BMP2, VDR, ESR1 and ESR2, COL1A1 and STAT1 are related to osteoporosis. (Styrkarsdottir et al., 2003; Morris et al., 2019; Johnson et al., 2009)
5.  Hormonal changes: Low levels of estrogen and testosterone in women and men affect bone formation. Menopausal women have a very low level of estrogen increasing their susceptibility to reduced bone mineral density.
6.  Diet: Excessive dieting, low levels of protein intake, and insufficient levels of Calcium and Vitamin D increase the risk of osteoporosis.
7.  Lifestyle: A sedentary lifestyle alters your metabolism, resulting in poor physical condition. This increases your chances of breaking a bone. Alcohol abuse and smoking is a significant factor.

Osteoporosis Symptoms 

Osteoporosis is also known as the ‘Silent Disease” as there are no signs until the person experiences a fracture.  The minor signs that may point towards early-stage osteoporosis include:

• Receding gums: Loss of bone in the jaw leads to your gums being pulled away from the teeth. If you notice this, contact your dentist.
• Loss of grip strength: Muscle strength plays an important role in maintaining bone density. The loss of grip strength can be a direct indicator of loss of bone density. 
• Weak and brittle nails: Bone strength can be correlated with the strength of your nails. However, brittle nails can also be a result of other factors such as weather and deficiencies

Initial-stage osteoporosis doesn’t present itself with a lot of symptoms, which is why it is recommended to consult a health consultant if you have a familial history of osteoporosis and/or are over the age of 40.

 

Once the bone quality has started to decline, you can see more obvious signs such as

• Stooped posture: The loss of bone can cause a compression in the vertebral column which can be seen as a Kyphosis or hunched back.  This change in posture adds pressure to the airway and limits lung expansion, causing breathing problems.
• Frequent fractures: Osteoporosis makes the bones brittle and prone to fractures and breaks. These can be triggered by minor pressures like walking, coughing or even sneezing.
• Height loss: The loss of bone causes vertebral compression. This can be visualised as a height loss. 
• Pain in the neck and back: Compressed vertebrae add pressure to the spinal cord resulting in chronic or bursts of pain in the neck and the back.

4 Types of Osteoporosis:

Osteoporosis may appear as weakened and brittle bones, but as per the study, it's important to note that there are four different types of this condition:

Primary Osteoporosis: 

Primary osteoporosis is an age-related condition defined by decreasing bone mass and increased fracture risk in the absence of other identifiable sources of bone loss. There are also two types of it:

Type 1 Osteoporosis:

Occurs in women post-menopause. Lack of estrogen increases the release of chemicals called cytokines which stimulate the osteoclats- cells responsible for bone degradation. (Damjanov, 2008)

Type 2 Osteoporosis:

Occurs in both men and women. It is also known as senile osteoporosis. The exact cause is unknown, unrelated to increased osteoclastic activity and is attributed to age.  (Damjanov, 2008)

Secondary Osteoporosis:(Ganesan et al., 2023)

This condition is caused because of any underlying process or medical problems. The decreased bone density can be caused by to:

Endocrine problems:

Hyperthyroidism, Premature Ovarian Insufficiency, Cushing's syndrome and Diabetes mellitus type 1

Chronic Inflammatory conditions:

Rheumatoid Arthritis, Cystic fibrosis, and chronic obstructive pulmonary disorders can cause bones to become frail, increasing the risk of fractures. 

Neuromuscular diseases:

Progressive muscle disorders like Cerebral Palsy, Spina Bifida, Duechenne’s Muscular dystrophy, Multiple sclerosis, and Parkinson’s can cause bone frailty due to factors such as malnutrition, Vitamin D deficiency, and use of medications- steroids and anticoagulants. 

Nutritional Conditions:

Eating disorders such as Anorexia nervosa, and bulimia can cause vitamin and mineral deficiency leading to loss of Bone Mineral Density. 

Others:

Gastrointestinal disorders, Kidney diseases, Idiopathic Calcinuria- calcium-containing kidney stones are also prominent causes of low BMD

Osteogenesis Imperfecta(OI):

OI is a genetic disorder which causes brittle bones. This is due to defects in the gene coding for Type 1 collagen, a building block of the bone. The defect causes the collagen to be made incorrectly or in insufficient amounts making the bones weak and prone to breakage. (Osteogenesis Imperfecta, 2017)

Idiopathic Juvenile Osteoporosis:

It is a spontaneous condition of children that manifests as pain in bones, fractures, and deformity of the axial and appendicular as part of the clinical examination skeleton after minor traumas between the ages of 2 and 14 years.  This specific classification occurs when bone loss is present without a discernible cause and there is no family history of osteoporosis. (Imerci et al., 2014)

How to keep your Bones Healthy and Osteoporosis at Bay

Fortunately, there are many steps one can take to enhance the strength and overall health of their bones.  Here are a few tips for you: 

Infuse your diet with an abundance of calcium:

Strive to get the daily Recommended Dietary Allowance (RDA) dosage of calcium:

• 1000mg for women 50 and below
• 1200mg for women 50+
• 1000mg for men 19-70
• 1200mg for men 71+

Sources of calcium encompass a variety of foods, such as dairy products, almonds, broccoli, kale, canned salmon (complete with bones), sardines, and soy-based products like tofu. If you think you aren’t getting enough from your diet you can get the required calcium from supplements.

Calcium and Vitamin D go hand-in-hand:

Vitamin D is required for the absorption of Calcium. Your body can make vitamin D when exposed to sunlight, but not everyone can rely on the sun. The RDA for adults is:

• 600 IU for adults aged 19-70
• 800 IU for adults aged 70+

Sources of  Vitamin D   include oily fish, such as salmon, trout, whitefish and tuna,  mushrooms, eggs and fortified foods, such as milk and cereals. If you think you aren’t getting enough from your diet you can get the required vitamins from supplements such as SeneVit and SportVit.

Don’t forget the Protein:

Protein is required to build every cell of your body, including the osteocytes and bone cells. Proteins make up ~50% of bone volume and ~1/3rd of its weight. It is essential for the structural framework of the bone. (Tsagari, 2020)

Increase your Physical Activity:

Working out is good for the muscles and even better for the bones. It stimulates the cells responsible for building bones. Exercises such as strength training, walking, hiking, jogging, climbing stairs, tennis, and dancing are suggested.

Improve your Habits:

Choices can make or break you- can be taken quite literally in the context of osteoporosis. The lifestyle choices you make in your early years can affect your bone health. Incorporate the following changes to your lifestyle:

• Quit Smoking
• Limit Alcohol Intake
• Maintain Healthy Weight
• Take a bone density scan or DXA (dual-energy X-ray absorptiometry)

Conclusion

Osteoporosis is a condition which causes your bones to develop pores within, making them brittle and prone to fracture. There is no cure for it but can be prevented by incorporating certain changes to your routine. By keeping a check on your calcium, Vitamin D and protein intake along with an active lifestyle you can keep osteoporosis at a distance.  Understand how DecodeAge keeps your bones healthy and strong.

References:

• Styrkarsdottir, U., Cazier, J. B., Kong, A., Rolfsson, O., Larsen, H., Bjarnadottir, E., Johannsdottir, V. D., Sigurdardottir, M. S., Bagger, Y., Christiansen, C., Reynisdottir, I., Grant, S. F., Jonasson, K., Frigge, M. L., Gulcher, J. R., Sigurdsson, G., & Stefansson, K. (2003). Linkage of osteoporosis to chromosome 20p12 and association to BMP2. PLoS biology, 1(3), E69. https://doi.org/10.1371/journal.pbio.0000069
• Johnson, M.L., Lara, N. & Kamel, M.A. How genomics has informed our understanding of the pathogenesis of osteoporosis. Genome Med 1, 84 (2009). https://doi.org/10.1186/gm84 
• Morris, J. A., Kemp, J. P., Youlten, S. E., Laurent, L., Logan, J. G., Chai, R. C., Vulpescu, N. A., Forgetta, V., Kleinman, A., Mohanty, S. T., Sergio, C. M., Quinn, J., Luco, A., Vijay, J., Simon, M., Pramatarova, A., Trajanoska, K., Ghirardello, E. J., Butterfield, N. C., . . . Richards, J. B. (2019). An atlas of genetic influences on osteoporosis in humans and mice. Nature Genetics, 51(2), 258-266. https://doi.org/10.1038/s41588-018-0302-x 
• Damjanov, I. (2008). Bones and Joints. Pathology Secrets (Third Edition), 409-433. https://doi.org/10.1016/B978-0-323-05594-9.00020-9 
• Ganesan, K., Jandu, J. S., Anastasopoulou, C., Ahsun, S., & Roane, D. (2023, March 2). Secondary Osteoporosis - StatPearls - NCBI Bookshelf. Secondary Osteoporosis - StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK470166/#:~:text=Secondary%20osteoporosis%20describes%20a%20finding,secondary%20causes%20for%20bone%20loss. 
• Osteogenesis Imperfecta. (2017, April 10). National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.niams.nih.gov/health-topics/osteogenesis-imperfecta 
• Imerci, A., Canbek, U., Haghari, S., Sürer, L., & Kocak, M. (2014). Idiopathic juvenile osteoporosis: A case report and review of the literature. International Journal of Surgery Case Reports, 9, 127-129. https://doi.org/10.1016/j.ijscr.2015.02.043 
• Tsagari, A. (2020). Dietary protein intake and bone health. Journal of Frailty, Sarcopenia and Falls, 5(1), 1-5. https://doi.org/10.22540/JFSF-05-001 
• Osteoporosis. (2017, April 7). National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.niams.nih.gov/health-topics/osteoporosis 

 

FAQ:

 

Q: What is the best way to prevent osteoporosis?

A:  The best way to prevent osteoporosis is through a combination of a balanced diet rich in calcium and vitamin D, regular weight-bearing exercise, and lifestyle choices such as avoiding smoking and excessive alcohol consumption.

Q: When can you prevent osteoporosis?

A: You can take steps to prevent osteoporosis throughout your life, with a focus on building and maintaining strong bones starting in childhood and continuing into adulthood. However, the most effective prevention strategies are typically implemented during early adulthood and continue into later life, including a balanced diet rich in calcium and vitamin D, regular weight-bearing exercise, and avoiding risk factors like smoking and excessive alcohol consumption.

Q: What foods prevent osteoporosis?

A: Foods that can help prevent osteoporosis include those rich in calcium, such as dairy products, leafy green vegetables, and fortified foods like orange juice. Additionally, foods high in vitamin D, like fatty fish and egg yolks, aid in calcium absorption. Protein from sources like lean meats, beans, and tofu supports bone health, while foods containing magnesium, such as nuts and seeds, contribute to bone density.

Q: Do supplements help prevent osteoporosis?

A: Supplements can be beneficial in preventing osteoporosis, especially when dietary intake of essential nutrients is insufficient. Calcium and vitamin D supplements are commonly recommended to support bone health. A balanced diet and lifestyle, along with appropriate supplements when necessary, are key factors in preventing osteoporosis. Regular exercise, especially weight-bearing and resistance exercises, also play a crucial role in maintaining strong bones.

Q: What supplements can prevent osteoporosis?

A: Vitamin D and calcium are the main supplements required. Other helpful supplements include vitamins K and A, zinc, and magnesium.