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Osteoporosis a silent danger

Today osteoporosis is a condition that affects people the world over, with numbers continuing to rise, due to the growing number of elderly in super-aged societies. Osteoporosis is considered a “silent danger” because its symptoms are not evident in the early stages; diagnosis is only made after a fall and a resultant fracture.

Osteoporosis causes bones to become brittle and weak due calcium and vitamin deficiencies.   This makes it harder for bones to withstand pressure (weight), and some individuals may experience a loss of height of up to 3 cm, others may experience back pain from falls or lifting heavy objects.

People with osteoporosis will find that their bones are extremely brittle and may fracture from minimal impact or sharp twist movements, including sneezing. Spine fractures can occur easily which may and can lead to paralysis and a poorer quality of life.

Did you know?

  • Thailand has over 1 million people living with osteoporosis
  • 25% or 1 in 4 Thais are unaware that osteoporosis can lead to paralysis and death

Are you at risk of fracture as a result of Osteoporosis?

A fracture that occurs for the first time as a result of Osteoporosis, will often lead to a 2nd and 3rd fracture.

Especially in individuals aged 50 and above

  • Men are at higher risk of fracture from osteoporosis than prostate cancer
  • Women are at higher risk of fracture from osteoporosis than breast,cervical, and ovarian cancer combined

Statistics about Hip Fracture due to Osteoporosis

  • 20% of victims will die within a year
  • 30% will become permanently paralyzed
  • 40% will need assistance to walk (walking stick, crane)
  • 80% will be unable to perform daily tasks

“Fractures as a result of osteoporosis are highly dangerous, therefore prevention and prompt treatment of osteoporosis are vital”

FAQ: Osteoporosis

Q: Is it true that only women get osteoporosis, and men and children don’t?
A: This is not entirely true. Although osteoporosis is most commonly found in females, it is also prevalent in men, especially those who are older in age. In terms of hip fracture specifically, it has been observed that the mortality rate
for is higher for men. As for children and adolescents, whilst osteoporosis is rare, it can develop as a result of other underlying conditions, or the medications used to treat those conditions (secondary osteoporosis) or occasionally, idiopathic osteoporosis can arise which has no identifiable cause.

Q: Can drinking milk and exercising prevent osteoporosis?
A: There are a number of other factors that can contribute to the development of osteoporosis, some of which cannot be controlled, such as one’s family genetic history, and one’s age. Research studies have not conclusively proved that drinking milk reduces the chances of osteoporosis.

Q: Is it true that most people won’t require vitamin D supplements as the body is capable of creating its own?
A: This is a common misunderstanding, because it is so sunny in Thailand. Thai people often believe that the vitamin D obtained from sunlight will be sufficient. However, statistics indicate that more than 50% of post- menopausal women in Thailand suffer osteoporosis due to vitamin D deficiency. Sun block lotions can prevent Vitamin D from being absorbed into the body properly, or sufficiently. Thus, people who do not receive sunlight,such as older citizens who spend most of their time indoors, should take calcium and vitamin D supplements.

Osteoporosis: Risk Factors

Although osteoporosis can be found in people of all ages and sex, but especially in older individuals, knowing the risk factors can help to prevent,avoid, or remedy osteoporosis. This may involve changing habits, which can delay or reduce symptom onset of osteoporosis.

Risk Factors that cannot be controlled

  • Sex: In terms of cases and onset, women develop osteoporosis faster than men. Especially post-menopause or if ovaries have been removed. Bone deterioration is heightened due to hormone deficiency, leading to approximately 40-50% of women at risk of fracture.
  • Age: Bone mass density peaks at around 30 years of age, gradually decreasing after.

o 10% of women aged more than 60 are at risk of osteoporosis
o 20% of women aged more than 70 are at risk of osteoporosis
o 40% of women aged more than 80 are at risk of osteoporosis

  • Genetics: If a family member has a history of osteoporosis and fracture,this will increase the chances of the younger generations having osteoporosis.
  • Nationality: Caucasians and Asians are at higher risk of osteoporosis
  • Medication: Certain types of medication can contribute to lower bone mass density. These include steroid medication for rheumatoid arthritis,medications for Systemic lupus erythematosus (SLE), thyroid medication,and medication to prevent seizures.
  • History of fracture: Individuals with fracture have 2.5 times higher chance of another fracture occurring

Risk Factors that can be controlled

  • Alcohol liquor, beer, or wine consumption that exceeds 3 glasses/day can contribute to osteoporosis
  • Cigarettes Toxins from cigarettes destroys cells that contribute to healthy bone mass density. Smoking more than 20 cigarettes per day increases the risk of hip fracture by more than 1.5 times compared t o a non-smoker
  • Excessively skinniness: Individuals who are excessively skinny (including those who suffer from Anorexia Nervoas) are at higher risk of osteoporosis and are twice as likely to suffer fractures.
  • Malnutrition: A diet that does not include the 5 food groups will lead to nutritional imbalance, and malnutrition for example of calcium, vitamin D,and protein.
  • Lack of Exercise: Individuals who do not exercise are at higher risk of developing osteoporosis. Office workers who sit for more than 9 hours a day are 50% more likely to have osteoporosis than people who sit 6 hours a day
  • Diet: Consumption of more than 1 teaspoon of salt, 3 glasses of tea or coffee, and 4 or more cans of soda per day, as well as intake of protein 10-15% in each meal, can lead to osteoporosis. Too much protein can prevent efficient calcium absorption by the body

The Relationship between Osteoporosis and Menopause Women have a higher chance of osteoporosis than men because on average they have approximately 10-30% less bone mass than men. Furthermore,after menopause, women will experience bone deterioration at a rate of 3.5% per year. The average age for menopause in women is 50 years and during,this period, the body produces less estrogen, causing bones to become brittle and contributing to fracture.

Common Symptoms

Osteoporosis is considered a silent killer as early symptoms are not noticeable. Diagnosis is usually made following a fall or fracture. Common symptoms include back pain, which will worsen as the condition progresses. It can cause detrimental effects in the spine, hips, and wrists.

Prevention in Women

Women who are at the menopause stage of their lives should take extra care with their health. They should attempt to reduce stress and eat healthy foods that are high in calcium such as dried shrimp, red beans, and various vegetables. This can attribute to a higher bone mineral density. For postmenopausal women calcium will not make bones stronger, but it will prevent deterioration.

It is recommended to get regular exercise 2-3 times a week for at least an hour each time; this can help to preserve calcium within the bones. Quitting,or at least reducing smoking and alcohol consumption, as well as taking
preventative measures against falls will all help to prevent osteoporosis.

Prevention of Osteoporosis

Prevention of Osteoporosis is not only for older people, measures can be taken from an early age to prevent this condition developing in the future.

Foods that provide a high amount of calcium include leafy greens such as broccoli, milk, sardines (with bone), small fishes (with bone), dried shrimp,tofu, and black sesame. Vitamin D Helps the body to absorb calcium. It is recommended that the body consumes 400-800 units of vitamin D per day. 1 glass of milk =100 units of vitamin d and 300 milligrams of calcium

Daily Exercise for Osteoporosis Prevention

  • Children 
    Research has shown that children in Thailand experience a lack of exercise during their early stages of development.
  • Adults 
    Adults, especially office workers who sit for more than 9 hours a day as they are 50% more likely to have osteoporosis than people who sit 6 hours a day.
  • Elderly 
    Exercise activities for the elderly should put weight on bones: dancing and brisk walks, either indoors or outdoors. Exercise that help improve balance can also help prevent falls and fractures from accidents.

Measuring Bone Mineral Density (BMD)

Measuring Bone Mineral Density (BMD) is a safe, painless, process that is able to give information about all important bone structures. Diagnosis can then be made according to WHO standards, with regards to, for example, the state of the lumbar spine and hip, and will be expressed as numbers of standard deviation.

X-rays can also be effective in identifying areas that may be affected by osteoporosis, such as bone thickness and signs of cracks. In some cases fractures and spinal stenosis will be evident.

When should you measure Bone Mineral Density (BMD)? 

  • Individuals without risk factors:  Should start BMD check-ups aged 60 and above
  • Individuals with high risk factors: Those with a family history of fractures as a result of osteoporosis, or individuals who consume steroid medication should actively seek regular BMD check-ups.

A Safe home for Fall Prevention

Simple steps you can take at home to prevent indoor accidents, prevent fractures from falling, or any impacts that can cause imbalance, especially in older family members

  • Floor: Remove objects that can cause falls or tripping such as electrical wires, telephone cords, ropes. If your house has a rug or rugs, make sure that the edges are tucked in and they are heavy enough to prevent slipping. The same applies for doormats etc.
  • Bathroom: Install handles along the walls and a rubber mat to prevent slipping in and around the bathtub or shower.
  • Brightness: Make sure there is enough light in your home, especially in stair and hallway areas around. If you are moving around at night, always make sure to turn the lights on.
  • Kitchen: Ensure that there are no slippery areas; and clean up any spills immediately to prevent risk of accidents.
  • Stairs: The stairs should not be slippery and should ideally be wide, not steep, have handles or banisters to grip onto; stairs should be well lit.
  • Shoes: Wear shoes that are not slippery (do not wear only socks when walking around the house)
  • Medication or other items that may cause intoxication: Some medication may cause dizziness that can lead to falls; similarly one should limit alcohol consumption or quit drinking altogether, to reduce the risk of accidents.