Purnika Mandal, from Kolkata, had just begun to exercise, after being told that a simple walk could help her perimenopause depression. “I was absent-minded and tripped on the pathway. My ankle twisted and the next thing I hear the doctor telling me in the hospital is that I have osteoporosis,” she says. There are many women like her in their 40s and 50s, who do not realise when osteoporosis sets in, until a seemingly small fall leads to a fracture.
“Pain can be treated, but osteoporosis needs to be detected,” says Dr Kunal Dheep, Consultant Orthopaedician at Taj Orthopaedic Research Centre, Madurai. “Osteoporosis is a major public health issue, but people tend to be careless because it is not life-threatening,” he says.
Calcium depletion in our bones is a natural process that happens with ageing. Experts explain that the body is designed in a way that bones become porous once oestrogen levels drop, especially in women past menopause. But osteoporosis can occur in men too, usually after the age of 60 when testosterone levels fall. “That is why it is essential to build a bone bank from a young age,” says Madurai-based orthopaedic surgeon, Dr Sathish Devadoss, adding that people must “achieve peak bone mass during adolescence.”
The bone is a dynamic living structure that gets formed and absorbed in the blood every day. The calcium level that needs to be maintained in the bloodstream is drawn from either the food we eat or our bones. When the hormonal protection wears off, bone loss speeds up and the imbalance created between bone creation and its usage weakens the bone density. This clinical condition is osteoporosis, which can be reversed with a proper diet and regular exercise, according to Dr Devadoss. But when neglected, it progresses silently, hampering daily movement, and putting you at risk of fractures.
The problem with a fracture for someone with the disease is the way the bone is: imagine grated coconut shells, says Dr Dheep. You cannot fix screws, frames, wires or plates to align it. All basic ortho fractures rely on natural healing, adds the good doctor.
“Spine, hip, and wrist fractures are the most common manifestations of osteoporosis, because the strong bones have weak spots in between them and are vulnerable to easy damage when you fall,” says Dr Maninder Singh, a Senior Consultant at Delhi’s Indian Spinal Injuries Centre. He says daily physical exercise, eating a calcium-rich diet and spending time outdoors are essential to keep bones strong. “Exercising results in laying down of calcium in parts of the bone that matter, thereby making the bones stronger,” he adds.
Here’s a guide against osteoporosis, if you’re well into your 40s.
Various fresh dairy products on wooden background
Change your diet
To prevent osteoporosis, the best option is to derive rich calcium from a diet of milk, paneer, cheese, curd, butter, green leafy vegetables, fish, raagi and nuts such as makhana , almonds, cashew, says Dr Singh. Say no to salt, refined sugar, carbonated drinks, canned juices and caffeine, as these are detrimental to bone density.
Exercise more
The best exercise for increasing bone-mass is strength training. “Bones are meant to be acted upon, walked and jogged. When you do resistance or weight-bearing exercises, like dancing, aerobics, stair-climbing, walking briskly or uphill and lifting small weights, you exert force on parts of your bones. The body reacts by stimulating calcium metabolism and building up stronger bones. As little as 15 to 30 minutes a day is helpful, says Dr Devadoss.
Get some sun and Vitamin D
Sunlight is an active metabolite and Vitamin D is one part of the calcium metabolism that takes place in the body, says Dr Dheep. Vitamin D helps to absorb calcium from the intestines, liver and kidney, but lack of vitamin D does not directly cause osteoporosis, he adds. When your skin is exposed to sunlight (even for 10 minutes twice a day), the body makes Vitamin D. If Vitamin D deficiency is not corrected, then calcium is pulled out from the bone, causing rickets in children and osteomalacia in adults. Osteoporosis is loss of bones, osteomalacia is decreasing bone density because the quality of new bone created is not good enough.
Get yourself checked
There are two types of screening available: the Bone Mineral Density Test, which can be done after 35. It is a simple and affordable test where you place your heels on a machine to measure bone density. The gold standard for accurate diagnosis of Osteoporosis is the DEXA (Dual-Energy X-ray Absorptiometry) Test, which should be done annually after 45, says Dr Devadoss.
Be careful with meds
Hormone Replacement Theory is no longer prescribed for osteoporosis, due to its many side effects. Once a person is diagnosed, doctors either prescribe drugs (of the bisphosphonate group) or supplements. Calcium tablets should be taken for three months and the weekly vitamin D shots should not be taken for more than six weeks. “Nothing should be consumed without prescription,” says Dr Singh.
