The prevention of osteoporosis

The prevention of osteoporosis

 Adequate calcium

The calcium (contained in the skeleton and teeth) is the absolute mineral present in greater amounts in our bodies and is the first 0.5 to 2% of the total weight of an adult. But football is also dissolved in the blood (1%) and provides vital functions as muscle contraction (including heart), blood clotting, the conduction of nerve impulses, etc.. The prevention of osteoporosis begins from the moment of conception. The pregnant woman, for example, should increase the amount of calcium daily from 1000 to 1200-1500 milligrams. During adolescence, then, the intake of calcium should not be less than 1200 mg a day. This level is increasing over the years. It 'important to continue taking calcium into adulthood to help compensate for the loss of bone mass. The products that are naturally contain more milk and dairy products. A liter of milk, just as an example, provides 1120 mg of calcium. However, we must consider that the calcium in these foods is absorbed in adults than in quantity because the metabolism of bone is reduced compared to age youth. In addition, milk and dairy products also contain a considerable amount of fat. It is therefore necessary to move towards low-fat cheese and yogurt and prefer foods such as cabbage, broccoli, radishes, artichokes, walnuts, almonds, octopus, squid, etc.. One more duty. The calcium is not in solution in fats but only in the water, so that the skimmed milk or skimmed contains more calcium than whole. It is always good in taking no longer than the 2500 mg of calcium a day.

Maintaining a good level of vitamin D

The function of vitamin D is to ensure the absorption of calcium and proper bone mineralization. Its lack, therefore, favors the development of osteoporosis - and, in more severe forms of osteomalacia - by reducing intestinal absorption of calcium resulting in secondary hyperparathyroidism. In the Italian elderly population there is still a noticeable lack of vitamin D. As is known, that vitamin can be synthesized in the skin by exposure to the sun or to be introduced with the feed, although it is not widely available in food. One finds, for example, in fatty fish such as mackerel, sardines, and the "famous" cod liver oil.

Regular physical activity

Adequate exercise in young people can develop a good bone quality. Especially if the work is challenging, as the weight training. In the elderly, physical activity, such as brisk walking (less effective in this regard are the "non-load" such as swimming or cycling) can slow bone loss and have beneficial effects on general health and functional capacity. In addition, regular exercise, improving muscle strength, agility and balance, can prevent falls.

Quitting smoking

As for adults, smoking has many adverse effects on bone: it increases the degradation of sex hormones, menopause accelerates, and represents a risk factor, as we have seen, for osteoporotic fractures. The pregnant woman should not smoke because nicotine damages the cells that produce new bone.

Prevention of falls

It 'very important, especially after age 50, prevent falls and to do this, we need interventions that increase physical strength and improve balance and gait. Check the weight. Correct vision, for example, where you have problems of reduced vision, and ensure adequate illumination in the house and during the night. Avoid drugs with sedative effects.

Reducing the impact of falls

The majority of fractures of the femur depends on a lateral fall. To avoid the impact of this type of fall should be used if the situation requires it, or provide support for walking hip padding (hip protectors) for the elderly, who, unfortunately, often refuse - for psychological reasons - to use such media.

Pharmacological measures

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Drug therapy of osteoporosis must be able to protect the quality of the bone, trying to preserve the structural properties and materials, by adjusting properly the bone turnover. Of course, the drugs that we describe below should be changed only by prescription.

Taking calcium and vitamin D

The administration of salts of calcium and vitamin D (for example, calcifediolo or calcitriol) significantly reduces the risk of non-vertebral fractures of the femur and in the elderly. The therapy has also confirmed safe, even if the cost / benefit analysis is undoubtedly favorable.

Hormone replacement therapy (HRT)

Because, as we have seen, the reduction of bone mass is mainly due to falling estrogen in women after menopause, the most common treatments are based on hormones. Therapy of this type prevents the loss of bone mass, so that epidemiological data confirm that the therapy reduces by 50% the incidence of vertebral fractures, and about 30% of hip fractures. Recently, the market is a parathyroid hormone (PTH) which, in combination therapy with

bisphosphonates, it would seem to guarantee a certain increase in bone density, although not yet proven. An alternative to this therapy are tamoxifen or tibolone, which exert an action similar to that of hormones, but only on certain tissues such as bone and cardiovascular system. SERMs (Selective Estrogen Receptor Modulators). The only compound of this class that is commercially available is raloxifene, indicated for the prevention of postmenopausal bone loss.

Bisphosphonates

Among the bisphosphonates, which include alendronate is effective in the prevention and treatment of osteoporosis, preventing bone loss and increasing bone mineral density by 5-10%. In full-blown osteoporosis, alendronate reduced by 40-50% the incidence of vertebral and nonvertebral fractures (femur, radio). There is also Risedronate increases bone density at the hip and spine of 3-6% and 40-50% reduces the incidence of fractures. Risedronate specifically acts on the deterioration of trabecular microarchitecture that occurs under conditions of high bone turnover, maintaining mineral properties and structure of collagen.

Calcitonin, fluoride, etc..

These drugs have modest effects in the laboratory and still lack convincing documentation on their usefulness




Bibliography - National Institutes of Health. Consensus Development Conference Statement: Osteoporosis prevention, diagnosis, and therapy. NIH Consens Statement 2000, 17 (1) :1-36 - Consensus Development Conference. Osteoporosis: prevention, diagnosis, and therapy. JAMA 2001; 285:785-95

Calcium and osteoporosis

OSTEOPOROSIS

 Definition of disease

Osteoporosis is a disease which affects the skeleton and is characterized by several factors such as the reduced bone mass, microarchitectural deterioration of bone tissue, as well as skeletal disorders that contribute to compromising its resistance. These factors favor the affected individual increased bone fragility and a higher susceptibility to fractures.

People most at risk are elderly because aging per se leads to higher bone deterioration, but the disease can also affect women in a relatively early age, especially those who have reached menopause, because it is precisely in this period that is not the action taken by estrogen - the female sex hormones - in order to counteract the progression of this disease.

Osteoporosis, therefore, also in relation to the continued aging of the population is steadily increasing and, for serious consequences, is considered a social disease.

Symptoms and consequences of osteoporosis

 Osteoporosis is asymptomatic, unfortunately - that does not provide specific symptoms, apart from some feeling of pain in bone, which, therefore, should never be underestimated - it is progressive and potentially disabling. It manifests itself with that which is its most common and most serious complication, ie, a fracture, spontaneous or following a fall. The most frequent sites of fracture are the spine in the back-back (over 46%), femur and wrist. The female is significantly more affected than men (one in three women above 50 years of age) and hip fractures are more common in women over 75 years. The fracture of the femur is associated with important medical consequences, which go beyond mere injury to bone. Such damage is accompanied, in fact, pain, loss of functional autonomy, and may result in admission to institutions of rehabilitation and long-term hospitalization. Remember that people who have suffered a fracture of the femur showed an increase in mortality from 2 to 4 times higher compared to subjects who had no fractures.

Risk factors for osteoporosis

The loss of bone mass, than the peak achieved by a healthy person, can be determined, up to 70%, by genetic factors. It has been noted, in fact, a structural resemblance between mother / daughter and mother / grandmother, with regard to the femur and spine were examined by X-rays.

The presence nell'anamnesi of a patient suffering from osteoporosis, a family who have suffered the same disease is also confirmed by further investigations by means of densitometry examinations. If the peak bone mass attained in youth is high if the loss is slow and do not worry. If capital is not high and the initial bone loss is rapid (or worse both at once) to be put in place adequate measures.

We must, however, consider that there are other factors that can influence the level of bone mass of a person, such as nutritional, hormonal, related to physical activity, etc..

Here are two tables that highlight the most important risk factors regarding the likelihood of the occurrence of the disease of osteoporosis:

Risk factors likely

 - Early menopause (before age 45)

 - High consumption of alcohol

 - Postmenopausal women with a family history of osteoporotic fractures probably from

 - Inadequate intake of calcium

 - Low weight / height in postmenopausal women

 - smoke

 - Oophorectomy premenopausal

 - High ratio of protein / phosphate feeding

 - Premenopausal amenorrhea

 - High consumption of coffee

 - Prolonged immobilization

 - Use of corticosteroids


Read more The prevention of osteoporosis

Benefits of Calcium

Most people know that calcium is an essential component of bones and teeth strong, and that as we age, we usually need to supplement your diet with more calcium to keep our body healthy and of strong  bones. Calcium deficiency can lead to osteoporosis, a disease that leads to Osteoporosis, weaker bones and susceptibility to fractures, and there are many other health that benefits offered by calcium, as well.

For example, studies indicate that intake of calcium helps to prevent kidney stones, and some studies of another point timidly to the prevention of calcium is the formation of colon polyps, which often can lead to colon cancer if not treated . Other studies indicate that calcium can help reduce blood pressure, too. Calcium deficiency can lead to rickets and other diseases, for which calcium is essential for good health for any number of valid reasons.