It is the result of bone mass loss and progressive bone structure change, which will involve a greater proportion of voids than of the tissue itself. This will lead to increased fragility and propensity to fractures frequently of the hip, spine and wrist. It is one of the most common conditions worldwide with a prevalence of about 18.3%.
Bones are in a constant state of renewal. During youth the development of new bone is faster than its degradation, so bone mass increases. But as we get older, bone mass is lost faster than it is created. Based on this, the development of osteoporosis will depend, among other factors, on the maximum bone mass reached, which is partly determined by heredity and ethnicity. In addition, there are several other categories of risk factors that may influence the likelihood of developing osteoporosis:
- Advanced age. Although it can also appear at younger ages.
- Gender. Women are much more prone, particularly when estrogen levels decrease: With early menopause or hysterectomy especially if ovaries are also removed, in both cases especially if before age 45, also by absence of menses for more than 6 months as a result of excessive exercise or excessive diet.
- Levels of certain hormones. Sex hormones, specifically estrogens in women with menopause or hormonal treatment in estrogen-dependent breast cancer, or testosterone in men in the treatment of prostate cancer. Hyperthyroidism or excess of thyroid hormone in the treatment of hypothyroidism. Hyperactivity of the parathyroid and adrenal glands.
- Asian or non-Hispanic Caucasian ethnicity.
- Small bone structure given the availability of less bone mass.
- Previous fractures due to minor injuries especially after age 50, or family history particularly if hip fractures are present.
- Eating disorders such as anorexia nervosa and bulimia that restrict food intake, as well as gastrointestinal surgery that limit the amount of surface area available to absorb nutrients.
- Smoking and excessive alcohol consumption.
- Low levels of calcium and vitamin D, provided from the diet since adolescence or inadequate absorption.
- Sedentary lifestyle or immobility such as prolonged bed rest.
Other bone diseases:
- Endocrine diseases: hyperthyroidism, hyperparathyroidism, Cushing's disease, etc.
- Inflammatory arthritis, inflammatory bowel disease, celiac disease, kidney or liver disease, neoplasms, etc.
Consumption of drugs:
Long-term glucocorticoids, heparin, anticonvulsants, immunosuppressants, antineoplastics.
There are usually no symptoms in the early stages. Once the bones are weakened, the following signs and symptoms may occur:
- Back pain, caused by a fractured or crushed vertebra.
- Loss of height over time.
- A stooped posture.
- Painful joints or stiffness.
- A bone that breaks much more easily than expected, for example, after a minor injury.
Lifestyle changes related to diet and physical exercise are the most recommended measures in the prevention of osteoporosis:
- Ensure appropriate calcium intake either through diet (dairy products, dark leafy vegetables, nuts, orange juice) or supplements if necessary. Between the ages of 18 and 50 1000 milligrams per day. This amount increases to 1200 milligrams for women from age 50 and men from age 70. It is recommended not to exceed 2000 milligrams per day for those over 50 years of age.
- Ensure the appropriate Vitamin D intake necessary to promote calcium absorption. It is obtained from exposure to sunlight, foods such as oily fish, red meat, egg yolks, liver. The recommended intake is at least 600 IUI per day and from 70 years of age, 800 IU per day. Supplements can be used if necessary.
- Stop smoking and limit alcohol consumption.
- Exercise regularly for at least 30 minutes a day, including strength training to strengthen bones and muscles and slow bone loss. Exercise that can improve balance can help prevent falls.
- Try to plan strategies to avoid falls as much as possible.
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Salari N et al. Global prevalence of osteoporosis among the world older adults: a comprehensive systematic review and meta-analysis. J Orthop Surg Res. 2021 Nov 13;16(1):669.