Strong bones vital to good health

Bone health for everyone is important at all stages of life. Though, 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 to 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.

If our bone health is poor, it will lead to weakening of our muscles 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, also the joints weaken and undergo arthritic changes. The most common bone disease is osteoporosis and with osteoporosis, our bones become weak and are more likely to break. People with osteoporosis most commonly break their bones in the wrist, spine, and hip.

The most vulnerable group of people with poor bone health in India primarily belongs to the lower socioeconomic strata. Inadequate nutrition or malnutrition is the main cause of high prevalence of osteopenia (52%) and osteoporosis (29%) among this group of population.

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 within the age group of 30 to 60 years are more affected than their western counterparts.

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 poor bone health.

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 contributes to poor bone health structure. Diseases associated with smoking, alcohol and drug abuse also leads to poor bone health.

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 needs to be diagnosed and evaluated by the doctor.

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

Good bone health can be maintained by following a healthy lifestyle which includes regular exercise, proper diet 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 slow 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)