No matter their age, it’s important for women to pay attention to bone health

Osteoporosis is a disease characterised by low bone mass and deterioration of bone tissue. This leads to increased bone fragility and risk of fracture (broken bones) particularly of the hip, spine, wrist and shoulder. The disease makes the bones brittle; it can lead to a hunched posture and can be acutely painful. The condition affects both men and women and should be taken seriously. However, women have more chance of developing osteoporosis as their bones are generally thinner than men and bone density declines rapidly after menopause, when enough hormones are not generated. In men, senile osteoporosis is a major cause. Osteoporosis is sometimes confused with osteoarthritis. While osteoporosis is a bone disease, osteoarthritis is a disease of the joints and the surrounding tissue.

Women and osteoporosis

“Women of all ages should pay attention to bone health because after menopause the lack of oestrogen makes them vulnerable to osteoporosis. Approximately 20 per cent of women above age 50 may develop osteoporosis. But, it may also affect those in their late thirties or early forties. Mostly such persons are either malnourished, or are on medications that cause bone loss,” says Dr. Anurag Awasthi, orthopaedic specialist, Fortis Hospital, New Delhi and director, Centre for Orthopaedic Treatment and Rehabilitation, Gurgaon. If your skeletal frame is thin and frail, or you have a family history of osteoporosis, it puts you at high risk of developing it. Bone is a living, growing tissue that’s constantly broken down and renewed. The best bone-building years are the tweens and teens. By the time you hit age 30, your bones are at their strongest. They remain more or less strong throughout middle age. After that, achieving a balance between bone formation and bone loss becomes difficult. If you lose too much bone, you can develop painful osteoporosis.

Mothers are more vulnerable because their calcium reserves are used to help infants build strong bones. But women usually don’t undergo bone density testing until after menopause, when the bone protecting properties of oestrogen drop significantly and the bones become fragile. “Younger women rarely undergo bone testing in India because of lack of facilities and the high cost,” says Dr. Nozer K.Sheriar, obstetrician and gynaecologist, and a consultant at Breach Candy Hospital and Holy Family Hospital, Mumbai. A bone density test is a good way of screening for osteoporosis and is commonly done by a scan. Any person with values less than 2.0 is classified as having osteoporosis, as per WHO standards.

Of course, you don’t need a scan to tell you that your bones are worth protecting. “It is important for women to be aware of osteoporosis and the risks involved. They should frequently ask their doctor about the lifestyle changes they have to make to ensure bone health,” says Dr. Sheriar. “Regular physical activity is the best way to prevent or delay osteoporosis. Women should take 1000mg of calcium and 400IU of vitamin D daily. They should also drink plenty of water to minimise the risk of kidney stones,” says Dr. Awasthi. One of the best lines of defence is eating foods that maximise bone mass and boost bone density at any age.

Don’t skip calcium While collagen makes up the soft framework of bones, calcium strengthens them. Since calcium is continuously deposited in the bones and teeth, all women should take the required amount of calcium and minerals everyday. Unfortunately, most of us fall short of this. Nursing mothers are the most affected. Dairy products such as milk, yoghurt and cheese are the best sources of calcium but it is also found in broccoli, soya bean, apricot, grapes, orange juice, nuts and seeds, salmon and other fatty fish. Caffeine intake should be minimised as it can affect the body’s ability to absorb calcium. Excessive alcohol can also lead to bone loss. Calcium supplements help close the gap, but it is always good to derive nutrients from food because the body absorbs and uses them better.

Your Daily D The skin makes vitamin D from sunlight, but it’s hard to produce enough of it if we remain indoors throughout the day. Without vitamin D, our body cannot properly absorb calcium from our food. As the best source of vitamin D is sunlight, we should go outdoors for a walk or other leisure activities everyday to get enough of it.

Go slow on sodium Salt is a major culprit that deprives the body of calcium. The more salt we eat, the more calcium gets excreted in the urine. Sticking to a low-salt diet helps retain calcium necessary to strengthen our bones. Avoid processed foods and opt instead for low-salt versions of soup and salad dressings.

Build strong bones To get the most out of a diet that boosts bone health, one needs to practise regular weight-bearing exercises. Brisk walking, cycling, tennis, dancing and yoga have all been shown to benefit our bones.

Contraceptive pills Birth control pills contain low doses of oestrogen that help maintain bone mass. In women with post-menopausal osteoporosis, oestrogen is an important component of therapy. There are different doses of birth control pills. “For instance, 30 mg benefits the bones and protects against osteoporosis,” says Dr. Sheriar. Talk to your doctor about the birth control methods that are advisable, and know more about those that could protect against osteoporosis, she advises