Osteoporosis

Osteoporosis
Osteoporosis is a chronic disease in which bone density decreases and the risk of fractures increases. In cases of severe reduction in bone density, spinal deformities, a sharp decrease in height, or the development of low-trauma fractures may occur.
The frequency of osteoporosis increases with age. Among women over 60, its frequency is approximately 25%, while among men over 70, it is 10%.

Risk Factors for Osteoporosis

• Gender: The risk of developing osteoporosis is higher in women.

• Age: The risk increases with age.

• Low body weight

• Family history of osteoporosis or fractures

• Low levels of sex hormones: Menopause, hypogonadism (low testosterone levels in men or low estrogen in women), late puberty.

• Sedentary lifestyle

• Poor diet lacking calcium, vitamin D, proteins

• Excessive use of tobacco, alcohol, and caffeine

Other Causes of Osteoporosis

• Medications: Corticosteroids, blood thinners, and others

• Chronic diseases: Endocrine, liver, or kidney diseases, gastrointestinal diseases, etc.

• Bariatric surgery

Symptoms
Osteoporosis often does not present with symptoms. It is a silent, chronic process, but may present with back pain, loss of height, curvature, or spinal deformities.

Diagnosis
The gold standard for diagnosing the disease is densitometry (DXA – dual-energy X-ray absorptiometry). This method allows determining the amount of calcium and other minerals in a specific bone segment. The higher the bone density, the stronger the bone structure, and the lower the risk of fractures. Densitometry provides information about the risk of osteoporosis or the development of bone fractures.

Treatment
Effective management of osteoporosis and reduction of fracture risk is possible. Treatments include oral medications, subcutaneous or intravenous extended-release medications, such as bisphosphonates, denosumab (Prolia), estrogen receptor modulators, teriparatide (Forteo), abaloparatide (Tymlos), romosozumab (Evenity), and others. Medication selection is made by a doctor based on the evaluation of potential benefits and risks.

Prevention of Low Bone Mass 
You can help build and maintain healthy bones and prevent osteoporosis with:

• Exercise: 30-60 minutes most days of the week.
  Exercise strengthens bones, reduces bone density loss, and improves physical capabilities. Some recommended exercises include:

  • Weight-bearing exercises: Walking, dancing, jumping rope, running, stair climbing, weight training, and skiing.

  • Strength training exercises: Free weights, resistance bands, exercise machines, and water activities.

  • Core strengthening exercises: Targeting the abdominal and back muscles.

Maintain a Healthy Diet
A balanced diet helps maintain a healthy weight and strong bones. Calcium and vitamin D are especially important for bone health.
Calcium and Vitamin D for Healthy Adults

• Calcium

  • Women under 50: 1,000 mg

  • Women over 50: 1,200 mg

  • Men under 70: 1,000 mg

  • Men over 70: 1,200 mg

• Vitamin D

  • Women and men under 50: 400-800 IU

  • Women and men over 50: 800-1,000 IU

Calcium and vitamin D recommendations may vary for adolescents under 18, pregnant women, breastfeeding mothers, or those experiencing bone density loss.

Sources of Calcium
It's best to get calcium from food sources. Calcium-rich foods include:

• Dairy products (e.g., low-fat milk, cheese, or yogurt), green vegetables (e.g., broccoli, spinach, or cabbage varieties), and calcium-fortified foods (e.g., cereals, bread, pasta, rice, pancake or waffle mixes, fruit juices, and soy products).
  Vitamin D helps the absorption of calcium and is produced by the skin when exposed to sunlight. Other significant sources of vitamin D include: fortified milk, cereals, egg whites, fatty fish, liver, multivitamins, and calcium supplements.

Limit Tobacco, Alcohol, and Caffeine
Excessive use of tobacco, alcohol, or caffeine reduces bone density.

• Do not use tobacco or its products.

• Limit alcohol use: Women should not exceed 1 drink per day; men should not exceed 2 drinks (1 drink = 45 ml of hard liquor, 150 ml of wine, or 350 ml of beer).

• Limit caffeine use to less than 3 cups per day.

Maintain a Healthy Body Posture
To maintain proper posture:

• Keep your head up and chest forward, slightly tuck your chin, relax your shoulders, and pull them back, align your spine and neck, and create a small curve in your lower back.

• While sitting or driving, you can place a rolled-up towel at your lower back.

• When reading, working on a computer, or performing other tasks, keep your body straight and the book, keyboard, or other items at a height that allows you to maintain a good posture.

• When lifting objects, bend your knees and use your legs to lift, ensuring your upper body remains straight.

Fall Prevention
Falls increase the risk of fractures. Wear low-heeled, sturdy shoes, avoid long electrical cords, rugs, or slippery surfaces that could cause tripping. If you struggle with balance, consider using a cane or other assistive devices.