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Deep Dive
What is osteoporosis?
Osteoporosis is a common bone disorder characterized by reduced bone density, disrupted bone microarchitecture, and an increased risk of fractures, particularly in the hip, spine, and wrist.
Why might our bones become more fragile as we age?
As we age, the rate of bone turnover slows down, and the cells that form new bone become less active, while the cells that resorb bone continue to be active, leading to a net loss of bone density and strength.
Does menopause cause osteoporosis?
Menopause doesn't cause osteoporosis but it accelerates bone density loss due to the decline in estrogen levels, which are crucial for maintaining bone health.
What are the symptoms of osteoporosis and at what age should you get checked?
Osteoporosis often has no noticeable symptoms, but common fractures can occur in the hip, spine, and wrist. It's recommended to get checked around age 70 to 80, especially if you have risk factors like a family history of osteoporosis or previous fractures.
Why are common myths about calcium and vitamin D supplementation wrong?
While calcium and vitamin D are important for bone health, most people get enough from a balanced diet. Supplementation, especially at high doses, has not been shown to reduce fracture risk and may even be harmful. Trials have shown that excess calcium can increase the risk of cardiovascular disease, and vitamin D supplementation has had mixed or negative results in reducing fractures.
Why is exercise important in preventing osteoporosis?
Exercise, especially weight-bearing activities like walking, skipping, and heel raises, stimulates bone-forming cells and can improve bone density and reduce the risk of fractures. Regular exercise also enhances muscle function and balance, which helps prevent falls.
What are the top three actions to improve bone health according to the experts?
1. Maintain a healthy lifestyle with a balanced diet rich in vegetables and low in ultra-processed foods. 2. Engage in appropriate levels of weight-bearing exercise. 3. Assess your risk and consider medical treatments if necessary, such as bisphosphonates or HRT.
What are the treatment options for osteoporosis?
First-line treatments include bisphosphonates like alendronate and risedronate, which reduce fracture risk by 50% when taken weekly. Intravenous bisphosphonates and denosumab injections are also effective. Hormone replacement therapy (HRT) can help reduce bone density loss in women, especially around menopause.
What are the potential side effects of osteoporosis treatments?
Oral bisphosphonates can cause esophagitis, a condition that may lead to inflammation of the esophagus. Long-term use of bisphosphonates and denosumab can also lead to rare but serious side effects like osteonecrosis of the jaw and atypical fractures, which is why drug holidays are sometimes recommended.
Why should diet quality be a focus in osteoporosis prevention?
A high-quality diet rich in vegetables and low in processed foods has been shown to significantly reduce the risk of fractures. While specific nutrients like calcium and vitamin D are important, the overall quality and diversity of the diet are more crucial for bone health.
- Osteoporosis is the commonest bone disorder worldwide.
- It's associated with reduced bone density and increased fracture risk.
- Fractures typically occur in the hip, spine, and wrist.
- Low trauma or no trauma can lead to fractures in older adults.
- Reduced collagen and mineral content weaken bones.
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