Osteoporosis is NOT only a disease of old people. Although it is commonly seen in the elderly, studies have shown that bone loss can occur at a relatively younger age (30 – 40 years), especially in the Indian population[1]. This could be attributed to a sedentary lifestyle, poor dietary habits, and smoking. Osteoporosis, in simple terms, is a condition that makes your bones weak and puts you at risk of fractures. With around 200 million adults suffering from osteoporosis worldwide, this bone disease can be prevented to a certain extent if the risk factors are known.
What are the risk factors of osteoporosis?
While it is not possible to know if you will develop osteoporosis or not, there are certain factors that increase your risk. So knowing about these risk factors and making few lifestyle modifications can help you to maintain healthy bones and prevent osteoporosis. Dr. Dhananjay Gupta, Director, Orthopaedics and Joint Reconstruction and Replacement Surgeon, Fortis Hospital, Delhi explain about the modifiable and nonmodifiable risk factors of osteoporosis.
Modifiable risk factors of osteoporosis are:
1. Poor diet
A diet that lacks essential nutrients to keep the bones healthy and strong can predispose you to develop osteoporosis. If your diet lacks sufficient amounts of calcium and Vitamin D it can lead to weak bones. This is because calcium helps build bones and Vitamin D aids in the absorption of calcium and maintains bone strength.
For adults between 20 to 50 years of age, the daily recommended dose of calcium and Vitamin D is 1000 mg and 600 units respectively. This can be obtained through a diet rich in natural food sources of calcium such as green leafy vegetables and fish and for Vitamin D foods such as fortified milk and sunlight.
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2. Sedentary lifestyle
It is a known fact that leading a sedentary lifestyle can up your risk of numerous health problems including osteoporosis. Being physically active is the key to keep your bones healthy and strong. Hence, ensure you exercise every day as it not only helps to build and maintain bone mass but also keeps your weight in check, which in turn can help avoid pressure on the bones. It is wise to try exercises such as walking, running, and weight training for strong bones.
3. Certain medications
Certain medications can put you at risk of osteoporosis which includes gastric acid-suppressing drugs such as proton pump inhibitors and other drugs like steroids. Long-term use of these medications is reported to cause weakening of the bones. Also, certain antidepressants and anti-seizure medications have also been associated with osteoporosis. Hence, if you are taking any of these medications, then do talk to your doctor about the side effects on the bones and overall health. Also, ask your doctor how you can reduce the negative effects of these drugs to lower your risk of the condition.
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4. Smoking
According to a 2012 study published in the journal Osteoporosis International[2], cigarette smoking is associated with reduced bone mineral density (BMD) and increased risk of fractures. In smokers, the relative risk for bone fractures is 1.25 higher as compared with non-smokers. The effects could be more severe if the person has low body weight (body mass index [BMI] <20 kg/m²) or leads a sedentary lifestyle. Moreover, smoking also causes numerous hormonal changes in the body which impact the function of the bone cells and overall bone health.
But the good news is that cigarette smoking is a reversible risk factor for osteoporosis, which means the risk of osteoporosis is reduced if you quit smoking. The increased risk of hip fractures in smokers compared with non-smokers decreases significantly after 10 years of abstinence from tobacco.
5. Alcohol intake
Excessive alcohol consumption can cause leaching of calcium from the bones, which in turn can put you at risk of fractures and osteoporosis. Moreover, it also decreases bone density at a faster rate. Excessive drinking can not only impact the bones but also affect other major organs of the body including the liver, kidneys, and heart. Hence, it is advised to limit the intake of drinks to not more than two per week for both the sexes to lower the risk of osteoporosis[5].
6. Hormonal problems
Certain medical conditions, especially hormonal and autoimmune diseases, can increase the risk of osteoporosis. This is because an imbalance in the hormones can affect the bone metabolism and in turn make it weak and prone to injury and fractures. Conditions such as hyperthyroidism (high levels of thyroid hormones) can lead to weakened bones. Moreover, there is a deficiency of hormones such as estrogen and testosterone post 50 and 70 in women and men respectively which can up the risk of osteoporosis.
Non-modifiable risk factors of osteoporosis are:
7. Age
As you might be aware of, the risk of osteoporosis increases with age. This is because there is a gradual decrease in the bone mineral density from the age of 30-40 years in both men and women. Hence, by the time you reach 60, there is a significant bone loss, which causes the bones to become weak and fragile and predispose you to osteoporosis.
8. Gender
It is estimated that worldwide one in three women above the age of 50 will experience osteoporotic fractures, as compared to one in five men[1]. The reason women are at greater risk of developing osteoporosis is that they have less bone tissue (peak bone mass) than men. Moreover, during menopause, there are numerous hormonal changes that occur in the body, which have a significant impact on the bones. Also in women, menopause is followed by an immediate decrease in bone mass and density within a year, which further increases the risk of osteoporosis.
9. Thin body frame
Obesity is known to put pressure on bones and make your more prone to joint pain and fractures. However, what most people are unaware of is the fact that people with thin body frame are at a higher risk of suffering from osteoporosis. This is because thin people and people with a small body frame have less bone mass which ups the risk. Moreover, the risk increases with age. Hence, if you are underweight (body mass index [BMI] <20 kg/m²), then the risk is high[3].
10. History of osteoporosis or broken bones
Osteoporosis does run in families, so it goes without saying that genetics play a strong role in predisposing you to the condition. So if you have a family history of osteoporosis, then you carry a risk and if you have osteoporosis, the risk is carried onto your children. Moreover, if you suffered a fracture when young, then the chances of getting osteoporosis is high. This is because, a fractured bone not only weakens the bone but also causes the bone to become stiff, which is a risk for osteoporotic fracture.
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Bottom line: By 30 years of age, most people reach their peak bone mass. Hence, it is important to start taking care of the bones in the early years itself through a healthy diet, regular exercise and a disciplined lifestyle to prevent the risk of osteoporosis at a later stage. So let’s pledge to keep our bones healthy.
20th of October is World Osteoporosis Day. The campaign for 2018 is for raising awareness about the prevention, diagnosis, and treatment of osteoporosis.
(The article is reviewed by Dr. Lalit Kanodia, General Physician)
Recommended Reads:
Prevent Osteoporosis: Avoid these Calcium Robber Foods
Fight Osteoporosis: 6 Ways To Strengthen Your Bones
References:
1. Kadam NS, Chiplonkar SA, Khadilkar AV, Khadilkar VV. Prevalence of Osteoporosis in Apparently Healthy Adults above 40 Years of Age in Pune City, India. Indian J Endocrinol Metab. 2018 Jan-Feb;22(1):67-73.
2. Yoon V, Maalouf NM, Sakhaee K. The effects of smoking on bone metabolism. Osteoporos Int. 2012 Aug;23(8):2081-92.
3. Schürer C, Wallaschofski H, Nauck M, Völzke H, Schober HC, Hannemann A. Fracture Risk and Risk Factors for Osteoporosis. Dtsch Arztebl Int. 2015 May 25;112(21-22):365-71.
4. Ramalingaiah A., et al. “Burden of Osteoporosis in the Urban Indian Population”. EC Orthopaedics 7.2 (2017): 74-81.
5. Jang HD, Hong JY, Han K, et al. Relationship between bone mineral density and alcohol intake: A nationwide health survey analysis of postmenopausal women. PLoS One. 2017 Jun
29;12(6):e0180132.