OSTEOPOROSIS

Osteoporosis is typically defined as reduction in bone mineral mass that results in decreased bone strength & increased susceptibility to fracture with only mild or moderate trauma.It is a major health problem through out the world owing to the morbidity, mortality & cost of care which are consequence of the fractures.Osteoporosis is classified as Primary & Secondary Osteoporosis.

Primary Osteoporosis is further classified as Post menopausal & Age Related Osteoporosis.

Secondary Osteoporosis is caused due to long term Glucocorticoid treatment. Glucocorticoids are a class of drugs used to treat a range of chronic inflammatory diseases such as Inflammatory Bowel Disease, Asthma , other respiratory disorders & to suppress the rejection of transplanted organs. Adverse effects associated with the use of Glucocorticoids are decreased intestinal absorption & increased urinary excretion of Calcium, inhibition of Osteoblast function and increased bone resorption.Each of these mechanism result in accelerated bone loss & increase risk of fracture.Osteoporosis occurs in more than half of patients who receive long term Glucocoricoid treatment. Secondary Osteoporosis is also caused by elevated levels of thyroid hormone whether due to thyrotoxicosis or excess replacement therapy in Hypothyroidism.The thyroid hormone acts on Osteoclasts indirectly through the Osteoblasts therefore bone resorption exceeds bone formation thus resulting in Bone loss.

Age related Osteoporosis is seen in both males & females. Bone density decreases with age due to decline in physical activity & decreased Calcium intake. Evidence suggests that initiating exercise in older people who were initially sedentary individuals has increased their bone density & slowed bone loss.

Till now it is clear to you that not only Post menopausal women suffers from Osteoporosis but also men & women who have received Glucocorticoid treatment for a very long time or have elevated levels of Thyroid hormone or are not exercising suffer from Osteoporosis. Alcoholics are also at a risk of developing Osteoporosis. Since Ethanol damages the liver thereby the synthesis of 25(OH) Colicalciferol ( a form of Vitamin D) is reduced.Vitamin D is necessary for absorption of Calcium. Also excess of Ethanol causes low Testosterone levels & decreased Testosterone levels leads to Osteoporosis.

Thus the belief of many people that only elderly women are victims of Osteoporosis is in correct.

NON-MEDICAL TREATMENT OF OSTEOPOROSIS

Osteoporosis is a condition in which the bone mass reduces. As a result of which fracture of bone occurs even with mild trauma. Here are some non medical measures to prevent reduction in bone mass .

A ) CALCIUM INTAKE :
Osteoporosis can be prevented by achieving maximum bone mass during growth & maintaining proper calcium intake throughout life.

Rich Food Sources Of Calcium

FOOD ITEM & CALCIUM CONTENT

Ragi( Nachni ) - 344 mg/100 gms

Channa - 202

Matki - 202

Rajmah - 260

Soya bean - 240

Amaranth Leafy Veg -530

Arbi Ke patte - 460
( black variety )

Lotus stem dry - Veg. 405

Apricot dry - 110

Dates dried - 120

Milk buffalo's- 210

Curds cow's milk - 149

Cheese - 790

Paneer -cow's milk - 208

Paneer-buffalo's milk 480

Mutton muscles - 150

All fishes & dry fruits are rich sources of calcium



B ) SODIUM INTAKE :
In order to prevent resorption of bone one should not take Sodium in excess amounts. Sodium causes an increase in renal Calcium excretion. For each 500 mg increase in Sodium excretion there is approximately a 10 mg increase in the amount of Calcium lost in urine.The major source of Sodium in our diet is the Common salt. Also preserved food items like jam, pickles papads , canned fruits contain high amounts of Sodium.Therefore elderly people who may not be suffering from Hypertension should still consume less Sodium.

C ) INTAKE OF CAFFEINE :
Caffeine ingestion causes a short term increase in urinary calcium loss.Such a temporary increase may have a minor effect on net calcium balance.However older individuals with low calcium intake will be affected greatly.Therefore intake of Coffee should be reduced .

D ) PROTEIN INTAKE :
Elderly people should avoid taking excess of protein because excess of protein is not stored in body .It is metabolized & excreted therefore with increase in urinary loss of protein there is increase in urinary Calcium loss.

E ) ALCOHOL INTAKE :
Restrict the intake of alcohol. Since ethanol damages the liver as a result synthesis of Vitamin D is affected. Vitamin D is required for the absorption of Calcium from the intestine .