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Osteo Awareness Osteoporosis is called the “silent” disease because it often shows no symptoms, even for decades, until suddenly a bone breaks. It is a very common disease affecting millions of women (and men). In osteoporosis, bone mineral density (BMD) is reduced, bone microarchitecture is disrupted, and the amount and variety of proteins in bone is altered. Until approximately age 30, bones go through a continuous process whereby old bone is replaced by new bone. This process is similar to the way our skin sheds cells every day, resulting in new “fresh” skin. For bones in the” shedding” process, cells called osteolasts dissolve the surface, creating small pits and tunnels. Fresh bone is then built up by cells called osteoblasts. These cells fill in the pits and tunnels with new bone, and restore a solid surface. The strength of this solid surface depends upon a number of factors including, age, weight, diet, exercise habits and genetic heritage. The strength of your bones depends upon the amount of calcium they contain. Vitamin D is a necessary factor because without it the body cannot absorb dietary calcium. Calcium and Vitamin D in food and supplement form can help keep bones strong. Bone loss intensifies during and after menopause because estrogen decreases significantly. Osteoporosis can be prevented with lifestyle changes and sometimes medication. In people with osteoporosis, treatment may involve both. Lifestyle change includes exercise and preventing falls; medication includes calcium, vitamin D, bisphosphonates and several others. Once you are diagnosed with osteoporosis or osteopenia (a mild thinning of the bone mass but not as severe as osteoporosis), treatment is a must. Your doctor may suggest several things, including dietary changes, sunshine and exercise. A diet rich in calcium and vitamin D is necessary. After menopause, most women require 1,500 mg of calcium. This can be obtained from different foods including: dairy products (milk, yogurt and cheese), sardines, greens, leafy vegetables and foods fortified with calcium including oatmeal and orange juice. The vitamin D that is necessary to absorb calcium comes from foods and the sun. The sun’s ultraviolet rays trigger vitamin D production in the skin, allowing it to manufacture the vitamin D you need. One should spend about 15 minutes in the sun several times a week. Physical fitness helps reduce fracture risk by improving balance, flexibility, and muscle strength which all make falls less likely. Recommendations vary from person to person but everyone needs at least 30 minutes of moderate physical activity every day. Especially important are weight bearing exercises because they work against gravity by putting pressure on your bones and muscles. The body responds to this pressure by increasing bone density and adding new cells that strengthen bones. Always consult your doctor before starting any exercise program.
Rosen, Hillel N. Calcium and vitamin D supplementation in osteoporosis. In: UpToDate, Basow, DS (Ed),
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