What is it about ?
Osteoporosis is bone decalcification, an attack that weakens the bones. Bones lose their strength due to a decrease in the quantity (density) and quality of the bones. Inside our bones, new bone tissue is being made all the time, while old bone tissue is being broken down. This is a normal process. Bone tissue experiences increased production during the growing period, and then further degradation as we age. With age, our bones therefore become more fragile. They can fracture more easily and the vertebrae can collapse.
The condition is more common in women because of the hormonal changes they undergo during menopause, which results in faster bone destruction. Lack of physical exercise, insufficient intake of calcium in the diet, vitamin D deficiency (which promotes absorption of calcium from the intestines), excessive alcohol consumption (≥ 3 units / day) and smoking contributes to the development of osteoporosis.
The risk of osteoporosis increases in the presence of certain diseases, such as rheumatoid arthritis, the diabetes, the COPD, the chronic kidney disease and the chronic inflammatory bowel disease. The use of certain medicines (eg prolonged use of cortisone) may also stimulate the development of osteoporosis.
What is its frequency?
Osteoporosis affects about 3% of men and 19% of women over 65. Each year, 2% of women aged 85 to 89 and 2.5% of women over the age of 90 have a hip fracture. The trend is similar for men, but with a lag of 6 to 7 years.
How to recognize it?
Osteoporosis as such does not cause symptoms. This disease therefore often goes unnoticed until the bone is weakened to the point of fracturing.
How is the diagnosis made?
Early diagnosis of osteoporosis, i.e. before a fracture occurs, is only possible by measuring bone density. So if you are at increased risk for osteoporosis, your doctor will order a bone density measurement (or bone densitometry), a test also known as DXA. This test measures the amount of calcium in your bones using x-rays. The dose of the rays is much lower than for a normal x-ray.
To date, there is no laboratory test that can diagnose osteoporosis. However, certain laboratory tests can be used to identify the underlying cause (eg thyroid disease).
What can you do ?
Eat a healthy diet, get enough physical activity every day and spend a lot of time outdoors: this is the basis for strong bones.
Calcium and vitamin D play an important role in the formation and maintenance of bone tissue. The optimal contribution in the management of osteoporosis is not clearly established. Most recommendations are for a minimum of 1 g of calcium and 800 IU of vitamin D per day. According to some recommendations, a daily supplement of 500 mg of calcium is sufficient for people who consume 1 to 3 dairy products per day and no calcium supplement is necessary for those who consume 4 or more dairy products per day.
Calcium
Adequate intake of calcium in the diet is crucial: first during childhood for building maximum bone strength, then for maintaining bone mass, and finally for minimizing loss of bone mass. Sufficient calcium intake is necessary throughout life.
Dairy products and soy products fortified with calcium cover about 50% of calcium requirements. In adults, the recommended daily allowance is 950 mg of calcium. Young people, between the ages of 11 and 18, and the elderly have greater needs. In young people, the bones are indeed developing and growing; and in the elderly, calcium is less well absorbed into the blood. An intake of 1150 mg per day is recommended in their case.
For dairy products: 1 glass of milk or calcium-fortified soy beverage (200 ml) contains approximately 250 mg of calcium, a small slice of cheese (5 g) contains approximately 50 mg, while a jar of yogurt of 125 g, 35 g of cheese spread, 1 serving of fromage blanc (100 g), 1 glass of buttermilk, 1 glass of drinkable yogurt, 1 pot of calcium-enriched soy yogurt contain approximately 180 mg of calcium. As our food is generally too fatty and too sweet, we prefer to opt for low-fat products (except for children under 6) and products with less added sugars. Skim milk and calcium-fortified soy drinks contain as much calcium as whole milk, but less fat.
About 300 to 400 mg of calcium per day comes from foods other than dairy products. Bread, sardines, vegetables in general (broccoli, Brussels sprouts, cauliflower, endive, collard greens, kale, Chinese cabbage, kohlrabi and purslane) and, above all, legumes contain a lot of calcium. Nuts (almonds, hazelnuts, pistachios), dried apricots and dried figs are excellent sources of calcium, as are certain types of mineral or spring water (more than 150 mg of calcium / liter) or tap water rich in lime (“hard” water).
Finally, other foods of plant origin are also very good for their calcium intake when consumed in sufficient quantity and fortified with calcium.
Vitamin D
Vitamin D is needed to absorb calcium from food. The main sources of vitamin D are sunlight, fish and dairy products fortified with vitamin D. The recommended daily allowance is 10 to 15 g. For pregnant women, breastfeeding women, and people over the age of 75, the recommendation is 20 g of vitamin D per day.
Sunlight is the most important stimulating factor for vitamin D production. Indeed, vitamin D is produced in the skin under the influence of ultraviolet (UV) rays. In most cases, it is sufficient to expose yourself to sunlight for 15 minutes a day with your hands and face uncovered to maintain sufficient reserves of vitamin D in the body. However, certain groups of the population are at greater risk of vitamin D deficiency for a variety of reasons. Thus, obesity inhibits the formation of vitamin D, while “older” skin has a reduced ability to manufacture vitamin D.
If sun exposure is not enough, proper intake through food is especially important. Vitamin D is a fat soluble (fat soluble) vitamin, which is present in varying amounts in foods of animal origin that are high in fat (fish, meat, liver, sometimes in cheese and whole milk). The greatest amounts are found in fatty fish (eg sardines, herring, salmon, mackerel). In Belgium, where sunlight is sometimes scarce, the weekly consumption of oily fish is also an important source of vitamin D. Foods of plant origin can be fortified with vitamin D, as provided by law for minarines and vegetable margarines enriched with vitamin D.
Once in the body, vitamin D must undergo an initial reaction in the liver, then in the kidneys, before it is fully active. It is therefore essential that the liver and kidneys function properly.
Physical activity
Physical activity is an effective measure to prevent osteoporosis. Exercise stimulates the storage of calcium in the bones. Lack of exercise results in decreased absorption of calcium.
A sufficient level of daily physical activity during childhood stimulates bone formation and is also crucial for maximum bone mass. Indeed, the body tries to adapt the structure and the mass of the bone to the demands placed on the skeleton.
Physical activity also improves flexibility and coordination of movement, as well as muscle strength, which reduces the risk of fall. Bed rest (immobilization) accelerates the loss of minerals in the bones.
It is recommended that adults do at least 30 minutes of physical exercise (moderate intensity) per day, with the minimum duration of one hour for children.
Smoking cessation
Stop smoking. In addition to all the other negative effects, smoking also promotes bone decalcification.
What can your doctor do?
For the prevention of osteoporosis, the doctor will advise all people over the age of 75 to take vitamin D supplements during the time of year when the sun is less present. People who don’t go out often should even take it throughout the year. Vitamin D also decreases falls in seniors.
Patients on prolonged corticosteroid therapy are also advised to take calcium and vitamin D supplements. All this in conjunction with sufficient physical activity and smoking cessation in all age groups.
In addition to this basic treatment, drug therapy for osteoporosis is started if the patient has had an osteoporotic fracture in the past or if for other reasons they are at high risk for a fracture. This treatment can be hormonal or non-hormonal. Your doctor will work with you to decide which one is best for you.
Want to know more?
http://www.mongeneraliste.be/nos-dossiers/losteoporose