Making no bones about bone health

Bone health is important for everyone at all stages of life. However, having strong bones is something people tend to take for granted, as symptoms often don’t appear until bone loss is advanced. There are many nutrition and lifestyle habits that can help build and maintain strong bones — and it’s never too early to start.

Bone health forms the structure, protects internal organs and provides attachment to muscles and stores calcium and minerals. There are many ways we can keep our bones strong and healthy. Eating foods that are rich in calcium, minerals and vitamin ‘D’ with regular exercise, along with good health and hygiene habits helps us keep our bones healthy.

If we are not eating the right and required amount of food and not doing the right kind of exercise, our bones can become weak and even break. Broken bones (called fractures) can not only be painful, but at times might require surgery to heal. They can also cause long-lasting health problems.

Symptoms and implication: If our bone health is poor, it will lead to weakening of our muscle strength. In case of prolonged poor bone health, it will lead to osteoporosis leading to structural changes like kyphosis or brittle bones leading to fractures. The joints also weaken and undergo arthritic changes. The most common bone disease is osteoporosis where our bones become weak and are more likely to break — most commonly break in the wrist, spine, and hip.

Vulnerability and trends: The most vulnerable group of people with poor bone health in India primarily belong to the lower socioeconomic strata. Inadequate nutrition or malnutrition is the main cause of high prevalence of osteopenia (52%) and osteoporosis (29%) among them. Osteoporosis is more prevalent in women than men.

Indian women from low-income groups consume diets that are low in calcium coupled with less calories, proteins and micronutrients. Hospital-based data suggest that these women have osteoporotic hip fractures at a much earlier age. Indian women between the age group of 30 to 60 years are more affected than their western counterparts.

Causes and incidences: The primary cause of poor bone health is dietary which indicates low calcium intake, eating disorders, and patients who have undergone gastrointestinal surgery. Patients who are on steroids and other medication with side effects are also prone to it. Vitamin D is a vital element of bone health and as such exposure to sunlight for a certain time during the day is important.

Further, lifestyle diseases like atherosclerosis, heart disease, stroke, obesity, diabetes and diseases like thyroid disease, rheumatoid arthritis, celiac disease also contribute to poor bone health structure. Diseases associated with smoking, alcohol and drug abuse also factors.

Diagnosis and treatment: Status of your bone health can be evaluated by X-ray, Bone Mineral Density Test which is done to diagnose early onslaught of osteoporosis, certain other blood tests like Calcium, VitD, Alkaline phosphatase, etc. based on a clinical evaluation by the doctor.

Anyone with poor bone health must see the doctor early. Secondary causes of osteoporosis like other medical diseases or use of medication causing osteoporosis also need to be diagnosed and evaluated by the doctor.

Food for your bones: The food that one intakes can affect bone health. Learning about foods that are rich in calcium, vitamin D and other nutrients that are important for bone health and overall health will help one make healthier food choices every day. A well-balanced diet with plenty of dairy, fish, fruits and vegetables should give a person enough nutrients for the day, but if one is not getting the recommended amount from food alone, he/she may need to complement his/her diet by taking multivitamins or supplements.

Precaution and prevention: Good bone health can be maintained by following a healthy lifestyle which includes regular exercise, proper diet that are rich in calcium and minerals, exposure to adequate amount of sunlight. It is always advisable to avoid use of alcohol and tobacco (in any form) to maintain a good bone health.

Medicines and drugs that are recommended for treatment of weak bones ranges from ‘antiresorptive’ which slows down bone resorption like bisphosphonates, calcitonin, estrogen, etc. to ‘anabolic steroids/agents’ that promote bone formation like parathyroid hormone (PTH) analogues.

(The writer is Consultant Orthopaedic Surgeon, Vikram Hospital, Bengaluru)