‘Osteoporosis can be life-threatening and a major cause of long-term disability’

What are the major reasons behind osteoporosis?

Throughout our lifespan, our bodies undergo many physiological changes. Our bones grow till the age of 20, but our muscles keep growing and we continue to gain body mass. This disproportionate growth between bones and muscles is a major reason behind osteoporosis. Besides this, around the age of 50, the body starts getting affected by many chronic diseases such as diabetes and cardiac problems. These affect the internal tissues and lead to the reduction of bone density, thus resulting in osteoporosis.

Osteoporosis is a worldwide problem and, in most countries, up to one in three women and one in five men aged 50 years or over suffer osteoporotic fracture. Osteoporosis causes bones to become weak and fragile, making them vulnerable to minor falls, bumps, sudden movement or even a sneeze. Fractures caused by osteoporosis can be life-threatening and a major cause of pain and long-term disability.

Which age groups of people are most likely to be affected and why? How are women affected in particular?

Women aged above 45 and men aged above 50 are more likely to get affected by osteoporosis. However, women are more likely to suffer from the disease due to causes such as hormonal changes, post-menopausal issues, and the stress women endure during pregnancy and motherhood. Besides, women also undergo a lot of physical and mental stress compared to men.

Societies in South Asian countries like Bangladesh are mainly male-dominated. In such a scenario, the consumption of nutritious food in larger quantities is more prevalent among men compared to women. Thus, women, regardless of whether they are employed or not, usually remain deprived of a nutritious diet. They do not have the opportunity to take care of themselves as they remain too preoccupied fulfilling responsibilities towards family and work. Back pain and knee pain are some of the common problems that arise among women due to osteoporosis. Moreover, post-menopausal women, and those who have had their ovaries removed or who have experienced early menopause before the age of 45 years, must be particularly concerned about their bone health. Rapid bone loss begins after menopause when the protective effect of estrogen is reduced. Intake of improper medication, mainly painkillers, also leads to loss of bone density, resulting in osteoporosis. For some women, hormone replacement therapy may help slow down the loss of bone density, when applied before the age of 60 years or within 10 years after menopause.

What are some good lifestyle habits for maintaining healthy bones?

The first step, regardless of age or the state of bone health, is to ensure a healthy lifestyle. This includes doing regular exercises, maintaining a balanced diet rich in calcium, protein, vitamin D along with other important nutrients, and avoiding unhealthy habits such as smoking or excessive intake of alcohol.

Access to fresh air and sunlight is also necessary for maintaining healthy bones. Vitamin D, a crucial component for maintaining healthy bones, is made in our skin through exposure to the sun’s ultraviolet rays. Vitamin D helps the body absorb calcium. However, Vitamin D deficiency is common, particularly in the elderly and in those who do not go outdoors frequently. Moreover, since most South Asian people, like those from Bangladesh, tend to have darker complexion, the absorption of Vitamin D through sunlight tends to be difficult. Physical exercise is very important to prevent obesity—a major cause of osteoporosis. Disorders such as anorexia and bulimia which can result in extreme weight loss are also dangerous for bone health. In young women, this can lead to estrogen deficiency (much like menopause) and dramatically reduce calcium retention. The result is rapid loss of bone minerals.

How should people who are already suffering from osteoporosis take care of themselves?

Individuals who are suffering from osteoporosis should do regular check-ups. Besides maintaining proper diet and medication, individuals should do exercises to reduce obesity and take care of other chronic diseases such as diabetes. Their diet should comprise of enough fruits and vegetables along with provision of sufficient amounts of calcium and Vitamin D. Patients at high risk will need proper drug therapy to effectively protect themselves against fractures. Today, there is a wider variety of treatment options than before. The type of treatment recommended will depend on one’s individual risk profile.

What needs to be done to create mass awareness about bone health?

In Bangladesh, individuals are more concerned about chronic illnesses like cardiac and renal diseases. They are not much concerned about the causes and effects of osteoporosis. Mass media can play an important role to raise awareness about osteoporosis.

Special programmes, focusing on women in particular, should be arranged. If we can raise awareness among the homemakers, they can in turn take care of themselves as well as their families.

The government should also try and carry out awareness programmes to reach the mass population. The health sector can play a major role as well but the channel needs to be created via the health ministry to provide treatment facilities to the general population. For example, reducing the cost of Bone Mineral Density (BMD) test will help increase awareness and interest among different socio-economic groups.

The interview was taken by Kazi Nafisa Hasan of The Daily Star.