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Because there are typically no symptoms until the first fracture occurs, osteoporosis is considered a silent disease. Some call it a silent killer.
Osteoporosis is a bone disease characterized by decreased bone density and strength, leading to fragile, brittle bones that increase the risk of fractures, especially in the spine, hips and wrists.
The National Osteoporosis Foundation estimates that more than 10 million Americans have osteoporosis. Another 43 million have low bone mass, which is the precursor to osteoporosis. By 2030, the number of adults with osteoporosis or low bone mass is estimated to increase by more than 30%, to 71 million.
The reasons for the increase include lifestyle issues, particularly smoking, lack of physical activity and alcohol abuse. Our aging population, along with the insufficient attention paid to this disease, are also why osteoporosis is on the rise.
If you are older, it may be discouraging to read those statistics. But as orthopedic specialists who have studied this disease, we know that osteoporosis is not inevitable. The key to having healthy bones for a lifetime is to take some simple preventive measures – and the earlier, the better.
Although the symptoms are not obvious early on, certain signs will indicate your bones are becoming weaker. The most serious complications of osteoporosis are fractures, which can lead to chronic pain, hospitalization, disability, depression, reduced quality of life and increased mortality. Worldwide, osteoporosis causes nearly 9 million fractures annually. That’s one osteoporotic fracture every three seconds.
Height loss, back pain
Minor bumps or falls may lead to fractures, especially in the hip, wrist or spine. These types of fractures are often the first sign of the disease.
If you notice that you’re getting shorter, the cause could be compression fractures in the spine; this too is a common symptom of osteoporosis.
Although it’s typical for most people to lose height as they age – about 1 to 1½ inches (2.5 to 3.8 centimeters) over a lifetime – those with osteoporosis who have multiple spinal fractures could lose 2 to 3 inches or more in a relatively rapid time frame.
Curved posture, or noticeable changes in posture, may lead to a hunched back, which could be a sign that your spine is weakening and losing density.
Persistent back pain is another indicator – this too is the result of tiny fractures or compression of the spine.
Calcium and vitamin D
Osteoporosis cannot be completely cured, but certain lifestyle and dietary factors can lower your risk.
Calcium and vitamin D are essential for bone health. Calcium helps maintain strong bones, while vitamin D assists in calcium absorption. Women over age 50 and men over 70 should consume at least 1,200 milligrams of calcium daily from food and, if necessary, supplements.
The easy way to get calcium is through dairy products. Milk, yogurt and cheese are among the richest sources. One cup of milk provides about 300 milligrams of calcium, one-fourth of the daily requirement. If you are vegan, calcium is in many plant-based foods, including soy, beans, peas, lentils, oranges, almonds and dark leafy greens.
Adults should aim for two to three servings of calcium-rich foods daily. Consuming them throughout the day with meals helps improve absorption.
Vitamin D is obtained mostly from supplements and sunlight, which is the easiest way to get the recommended dose. Your body will produce enough vitamin D if you expose your arms, legs and face to direct sunlight for 10 to 30 minutes between 10 a.m. and 3 p.m., two to three times a week.
Although it’s best to wear short-sleeve shirts and shorts during this brief period, it’s okay to wear sunglasses and apply sunscreen to your face. Sunlight through a window won’t have the same effect – glass reduces absorption of the UV rays needed for vitamin D production. People with darker skin, or those living in less sunny regions, may need more sunlight to get the same effect.
If a doctor has given you a diagnosis of osteoporosis, it’s possible the calcium and vitamin D that you’re getting through food and sun exposure alone is not enough; you should ask your doctor if you need medication.
Dance, jog, lift weights and avoid alcohol
Regular exercise is an excellent activity that can help stave off osteoporosis. Weight-bearing exercises, such as brisk walking, jogging and dancing are great for increasing bone density. Strength training, such as lifting weights, helps with stability and flexibility, which reduces the risk of falling.
Aim for 30 minutes of weight-bearing exercise at least four days a week, combined with muscle-strengthening exercises at least twice a week.
Particularly for women, who lose bone density during and after menopause, regular exercise is critical. Working out prior to menopause will reduce the risk of osteoporosis in your later years.
And avoid harmful habits – smoking and heavy alcohol consumption can weaken bone density and increase the risk of fractures.
Fall prevention strategies and balance training are crucial and can help reduce the risk of fractures.
Screening and treatment
Women should start osteoporosis screening at age 65, according to the U.S. Preventive Services Task Force. Men should consider screening if they have risk factors for osteoporosis, which include smoking, alcohol use disorder, some chronic diseases such as diabetes, and age. Men over 70 are at higher risk.
Medical imaging such as a bone density scan and spinal X-rays can help confirm osteoporosis and detect compression fractures. These basic tests, combined with age and medical history, are enough to make a clear diagnosis.
Managing osteoporosis is a long-term process that requires ongoing commitment to lifestyle changes. Recognizing the early warning signs and making these proactive lifestyle changes is the first step to prevent the disease and keep your bones healthy.
Ting Zhang is a research scholar of Orthopedics, University of Pittsburgh. Jianying Zhang is a research professor of Orthopedic Surgery, University of Pittsburgh.
The Conversation is an independent and nonprofit source of news, analysis and commentary from academic experts.
© The Conversation
24 Comments
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falseflagsteve
Keep this issue and others at bay with a healthy lifestyle and eat sensibly. Get off the couch, stop snaking on junk and eat proper food, learn about nutrition and making meals from scratch. In the richer people are far too inactive and eat far too much food with low nuttional value.
It’s making society sick in health and financially. Meds can help people live longer but not with a high quality of life
virusrex
Meds can help people live longer and more productive lives without any problem, some are extremely useful helping people maintaining a much healthier lifestyle as well, the best advice is the personalized one that a medical professional gives to each patient according to their specific situation, for some lifestyle changes (at an opportune time) will be enough, for others drugs can greatly improve the time and quality of the remaining life.
falseflagsteve
Virusrex
Not always they don’t. Most people that need them meds need because they are in a bad state mostly due to lifestyle choices.
Pharma don’t want healthy people, those they can have on multiple daily meds for decades are their favourites.
wallace
DNA is a factor. My 70+ Japanese partner has 20% bone loss. My stepdad had osteoporosis. When he fell over he would break a bone.
virusrex
The same as lifestyle changes, they don't always help, specially when failure is the most common result by much. That is of course a completely irrelevant argument to contradict the fact that both can and frequently are very beneficial.
And using them allows for a better quality of life than if they are not used, and for many they even allow for better lifestyle choices.
Still a failed argument, pharmaceutical companies profit the most by keeping people healthy enough to get as old as possible so they can buy many kinds of medication. Precisely because profiting from a decade of a patient with bad quality of life makes no sense when they can profit from many decades by giving that patient a much better life to enjoy.
And of course pharmaceutical companies are NOT the ones that decide a patient benefit the most with a drug, that is the job of doctors that have the welfare of their patients as the priority, the excuse where doctors are all in a global conspiracy to profit from keeping patients unhealthy is impossible to believe, at least for rational people that would never do that even if they had the chance.
virusrex
As with most diseases the prognosis is very heavily reliant on two things, genetics and money. People that are born with good genes and with plenty of resources get troubles later in life and in less dangerous ways, lifestyle is not the almighty factor some people believe it to be.
For patients with advanced osteoporosis it can become impossible to find out if a fall caused a fracture of if a spontaneous fracture caused a fall.
Raw Beer
Vitamin K is also beneficial, but no need to supplement if you eat right, especially if you occasionally eat natto.
Most (all?) meds come with a range of side effects, so I would only take them for osteoporosis if the natural approaches described in the article fail.
Ideally yes, but in reality doctors (or their employers) generally have strong financial incentives to encourage certain products (and discourage other approaches), even at the detriment of their patients.
virusrex
Doctors recommend pharmaceutical treatments when their benefits surpass their risks and negative effects, if someone would have half of the benefits without drugs than with them and the negative aspects can be managed, there is no real point in denying treatment, the difference in benefits can mean having or not a fracture that would develop into postration and a quick degradation of the overall health of the patient.
You keep making this claim yet never prove it, this supposedly global conspiracy where doctors put the welfare of their patients aside for economic profit as a general rule is impossible to believe. Except of course for people that would do that in a heartbeat, for those people it is natural to think all doctors in general would act the same, but fortunately the vast majority of the people consider this realistically impossible.
iron man
I have spent years working and living in hot climates, I was mentored very early to ensure eating many veggie every meal. heavy sweating leaches many minerals out of the body, not just salt. I attended a safety course some years ago about sweat and mineral loss, potassium is also essential to regulate sweat (calcium + sunshine sure) but certain bone formation (teeth, cartilage etc requires magnesium), once retired I got involved in mentoring young athletes regarding the consumption of mineral water in preference to tap water. I believe osteoporosis is a major reason for hip joint replacements (but never researched it), V.R... I have never worked for any water supplier. what do you make of this objective
Zaphod
Do animals in the wild get osteoporosis? Afaik, only animals kept as pets under unhealthy conditions have that problem. What does that tell us?
virusrex
That animals in the wild tend to die before reaching advanced age?
Primates and other mammals do get osteopenic towards old age
https://pmc.ncbi.nlm.nih.gov/articles/PMC3014087/
https://pubmed.ncbi.nlm.nih.gov/11472893/
iron man
I will add an interesting addition. A few years ago another westerner whom I have known since he was a grad, (also an outdoor prof.) and w/e marathon guy met up for a lunch. He had just done his annual med thing that revealed a reduction of bone density. I was surprised to hear that doc had warned him about tea. He is a Brit so cannot survive w/o, he reckons he does 10- 12cups per day off brit tea (ceylon+ kenya ?), but his asian mrs does not allow alcohol during the week. I enjoy a decent local gentle tea with a meal here, enjoy a macha in jpn. has anybody who is not a 'GP' expert heard anything similar, my older sis never drank coffee she always had the kettle on to keep the pot warm, she had a double hip job in her early 60's.
Zaphod
virusrex
Your first find is about baboons. Conclusion:
"No females or males were osteoporotic."
Your second find compares moose in Northern Norway (low pollution) to Southern Norway (led pollution). Conclusion:
In conclusion, the animals from the southern part of Norway had lower bone mass, decreased mechanical strength, and an increased bone concentration of lead.
Maybe you should re-consult with your experts and world-wide respected instituations?
Zaphod
iron man
No idea, but this guy suggests that the Tannin content in tea might be an issue. Just saying, not makig any claims based on experts and respected institutions...
https://www.youtube.com/watch?v=GrEs0ZKper0
iron man
Zaphod: northern norway has lower pollution but south has lead pollution? Surely , it is the north sea oil /gas to blame for differing bone density? No 'GP' expert needed for that one
virusrex
And it also says "The absence of osteoporotic animals may be due to colony maintenance resulting in truncation of the aged population and selection for healthier animals in the oldest ranges."
You know, exactly as I said about not reaching old age
That is why my comment is literally "Primates and other mammals do get osteopenic towards old age"
Do you have any argument that refutes the actual comment? or just about something nobody wrote?
Your claim was that animals in the wild did not experience ossification problems, the animals of the second study do, and they are living in the wild, so they demonstrate your claim was wrong.
Which institutions can you bring that say there are no bone density decrease on wild animals, only on domestic ones? Claiming someone agrees with your claim is not the same as proving it.
wallace
My stepdad had osteoporosis. When he fell over he would break a bone.
My stepdad would get fractures in his arms after a fall.
virusrex
That is much more clearly fractures as a consequence, when the fractures are in the legs (or hips) is when it can get difficult to know.
Raw Beer
The only valid reason is that wild animals consume safe and effective medicines approved by all the scientific institutes of the world.... Or perhaps it's because they consume their proper species-specific diet, and remain active...
virusrex
Nonsensical, nobody but you is making this obviously irrational argument, the real one is that something that requires reaching a very old age is very difficult to observe in a population that does not reach that old age, osteopenia (what would be expected before that old age) is well observed.
to die from the pressures of life in the wild long before they reach the necessary age to naturally develop osteoporosis. Wild mammals are not exactly being feed their "proper species specific diet" when they weaken from old age. It is like saying that is the food that makes house cats blind because you never see a blind lion or tiger in the wild... a much more obvious reason is there to explain the difference.
falseflagsteve
I prefer to get my info from experts nor some faceless guy online.
As i stated diet and exercise are the main ways to prevent this
https://www.nhs.uk/conditions/osteoporosis/prevention/#:~:text=Get%20some%20sun,body%20to%20make%20vitamin%20D.
virusrex
Are you genuinely surprised doctors do not consider useful to recommend to patients to be born with good genes in a rich family?
One thing is to giver recommendations about things the patient can actually do something about, another completely different is to pretend genetic and socioeconomic factors do not act as a powerful indicator of the predisposition.
https://pubmed.ncbi.nlm.nih.gov/31309515/
We conclude that the polymorphism of the WNT16 gene seems highly relevant in the pathogenesis of osteoporosis
https://pmc.ncbi.nlm.nih.gov/articles/PMC9932766/
Socioeconomic status (SES) is an important social determinant of health inequities that has been linked to chronic conditions, including osteoporosis
Higher levels of childhood and adult SES link to lower odds of osteoporosis diagnosis.
Raw Beer
Exactly! Very well put. That is exactly how many of us feel when certain others make similar claims.
Zaphod
Raw Beer
Must be former, clearly. Since all the worldwide experts and respected institutions agree on this. I hope you are not denying science.