Osteoporosis is something that can affect many women, but it can be successfully combated, says Mai Samih Osteoporosis is a skeletal disease characterised by low bone density and general deterioration of bone tissue, commonly known as bone fragility, according to the World Health Organisation (WHO) definition. While there are various theories about the causes of osteoporosis, some blaming it on genetic factors and others on a poor intake of calcium during pregnancy, the good news is that it is a disease that can be successfully combated. Ashraf Nassif, a consultant orthopedic surgeon, divides the WHO definition into two forms. Rickets, he says, another bone disease, occurs in children and before maturity, whereas osteoporosis only appears after the age of 18. "In the latter category, we should differentiate between osteopenic bones, which are when the bones become weakened, and osteomalacia, which is when the bone material itself is affected." According to Ehab Abul- Yazid, an endocrinologist, osteoporosis is a "silent disease" that rarely affects males. "Ninety-five per cent of the time, osteoporosis only affects women, especially after the menopause because of the decline in estrogen levels, which are important for the formation of bones." Nassif agrees and adds that women can suffer from post-menopausal changes in the bone metabolism in addition to decreases in estrogen levels during menopause. Simple tests can be carried out to determine how liable an individual's bones are to osteoporosis using x-rays, densitometry and chemical analysis. There is no definite age range during which osteoporosis occurs, Nassif says. "In the past, it was usually thought to occur only in older women, but now one sees osteoporosis in younger people too." This may be attributable to reduced calcium intake, or reduced formation of Vitamin D. Osteoporosis can be avoided, Abul-Yazid says, who advises women to change their lifestyles, avoid fizzy drinks and smoking, and get enough calcium and Vitamin D -- especially important for girls. "Excessive intake of caffeine also decreases bone minerals and may help cause osteoporosis," he adds. It is better to start prevention efforts before rather than after menopause. "Young women should be especially careful to take care of themselves at puberty when the bones reach maturity, and they should take in large amounts of calcium and have a degree of exposure to the sun." Exposing the skin to the sun's rays helps in the formation of Vitamin D, essential for healthy bones. Lifestyle changes recommended to patients with osteoporosis include increased intake of dairy products, which are very rich in calcium, as well as taking calcium tablets. Calcium intake recommended by the WHO is at least 800-1,500 milligrammes per day in children and adults. Eggs, carrots, apples and apricots are rich in vitamin D. Calcium + Vitamin D + a new life style = bones of rock, Nassif says. Not only can osteoporosis be prevented, but the age at which it is often developed can also be postponed. Nassif cites a study conducted on girls in Canada in 2004 that concluded that when girls aged 15 started eating yoghurt and drinking milk, osteoporosis could be postponed for 16 years after the age of 35. As a result, instead of worrying about the possible onset of osteoporosis at the age of 50, a woman could be 65 before she has to worry about any symptoms. Osteoporosis weakens the bones, making them more at risk of fracturing or breaking. A recent press release issued by the WHO revealed that the number of hip fractures worldwide due to osteoporosis is expected to rise threefold from 1.7 million in 1990 to 6.3 million by 2050. Seventy-five per cent of these fractures will occur in developing countries. However, Abul-Yazid says that most women do not need to be alarmed. "Osteoporosis is non-symptomatic unless complications occur. We worry particularly about the complications of osteoporosis because they take the form of spontaneous fractures without trauma," he says. The most common fractures are those to the backbone, he adds. "Once one occurs, the patient complains of back pain and loses height." Other fractures, such as those in the upper part of the thigh, can require surgery. There are also hip, vertebrae and distal radius fractures, more common in short people than in those of heavy stature. Finally, the key to managing osteoporosis is making changes to your lifestyle in order to prevent bone loss, and this may involve changing your diet, getting enough exercise, and considering whether the available medication is right for you. Remember that the earlier these measures are begun, the more effective are the results.
