Early detection and care is the only way to combat osteoporosis.

A test conducted last year by a team of doctors on 150 police personnel on active duty in Pune revealed something alarming. Nearly 50 of them, both men and women, tested positive for osteopenia — an earlier stage of osteoporosis, a condition characterised by extremely weakened bones. Referred to as a silent killer, like diabetes, osteoporosis has taken on the proportions of an epidemic with nearly 50 per cent of the Indian
population, especially women, suffering from it.

“I get upto 10 cases every week,” says Dr Abhijit Joshi, a city-based orthopedic surgeon.

Osteoporosis involves the weakening of bones to the extent that the patient suffers from fractures even due to trivial falls, especially in the wrists, hip joint and vertebrae. While the condition can’t be prevented, it can be considerably delayed if detected at the osteopenia stage.

“It’s caused by hormonal imbalances, especially in menopausal women, though a large number of men suffer from it too. The onset of the condition can be kept at bay or at least delayed if a person exercises regularly and ensures sufficient intake of vitamin D and calcium from direct sources rather than in the form of supplements,” says Dr Murtaza Adeeb, a joint replacement and sports medicine surgeon based out of Pune.

What’s more, specifically in the urban population, osteoporosis tends to occur at a younger age to Indians compared to their western counterparts, and is manifest from the age of 50 upwards. With October 20 being marked as World Osteoporosis Day, there couldn’t be a better time to equip oneself against this silent killer.

Know the signs
While osteopenia, unfortunately, doesn’t manifest itself in symptoms, osteoporosis does have a few defining markers. “A general symptom is body aches and pains, especially in the shin bones, arms and the back,” says Adeeb.

The second sign — which is when your orthopedic asks you to take the DEXA scan or ultrasound bone density tests that detect osteoporosis — is a series of fractures within a short time or low-intensity fractures, caused by trivial falls that wouldn’t normally result in fractures.

Fight the enemy
Detecting the disease at an early stage, i.e. osteopenia, is very beneficial. “One should start testing for osteopenia from the age of 45. The earlier the detection, the better the chances of the condition being stalled,” says Joshi.

Regular exercise is an absolute must, say the doctors. Walking for at least 150 minutes a week along with weight training would help to strengthen bones. Obesity is a strict no-no.

“Combine strength-training exercises (weights/yoga) with weight-bearing exercises. Strength training helps strengthen muscles and bones in your arms and upper spine, and weight-bearing exercises — such as walking, jogging, stair climbing, skipping, and impact-producing sports — mainly affect the bones in your legs, hips
and lower spine,” advises nutritionist and food writer Rita Date.

Regulation of one’s diet is also very important. Vitamin D and calcium deficiency play a significant role in augmenting the condition. “There should be an intake of 500 mg to 1 g calcium every day. Many people take a supplement of 250 g under the misconception that it’s enough,” says Joshi. Vitamin D3 supplements are now available in the form of drops (for children) and granules — incidentally, it also helps to keep diabetes under control.

Stay away from steroids. “In India prescription of steroids is not regulated. A side effect of steroids is osteoporosis,” warns Adeeb.

BUILD ‘EM UP

Rita Date suggests the perfect diet to build strong bones
1. Get enough calcium. Pre-menopausal women need at least 1,000mg of calcium a day and post-menopausal women need 1,200 mg. The best sources of calcium are dairy products such as milk, dahi, buttermilk, paneer, and cheese. They should be the low fat variety (the malai should be taken off after boiling).

Quantity of calcium got from:
1 cup dahi – 450 mg
1 glass milk – 300 mg
1 glass buttermilk – 280 mg
100 g paneer – 200 mg
100 g cheese – 500 mg (app)
Also, 100 g of canned sardines or salmon has 325 mg calcium

Some vegan sources:
Sesame seeds – 50 g contains 500 mg
Rajgira (amaranth): 1 cup contains 275 mg
Tofu – 1/2 cup has 250 mg
Liquid gud (molasses) – 1 tbs has 170 mg
Almonds – 50 almonds contains 130 mg
Soybeans – 1 cup has 175 mg
Broccoli – 1 cup has 95 mg
Black currant – 1 cup has 60 mg
Fig – 1/2 cup has 120 mg
Green leafy vegetables – amount varies

2.  Vitamin D is required for your body to absorb calcium. Sunlight is the major source of Vitamin D. Although we have plenty of sunlight in India, we are still not getting enough since we tend to avoid the sun.Scientists are still researching the optimal daily dose of vitamin D. A good starting point for adults is 600 to 800 international units (IU) a day, through food or supplements. Teens and adults can safely take up to 4,000 international units (IU) a day. Oily fish such as mackerel, sardines and salmon are good sources of vitamin D.

3. Take calcium and vitamin D supplements if you are deficient. A doctor or dietician will recommend the right one.

Published in Pune Mirror October 19, 2014

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