Chinese
骨質疏鬆尋因與預防
(by 林發雄､蘇曉醫師; Translation: PhilCheung.com)
Osteoporosis is a bone disease characterized by reduction in bone density and quality due to metabolic problems. Onset of the disease is slow and commonly seen in the elderly, especially in postmenopausal women. Nowadays, however, more and more young people have joined the "club."
With normal metabolism in youth, bone synthesis is greater than consumption. At age 30 to 35 people peak at their bone mass. Every year thereafter the bone mass declines slowly and steadily. The bone loss rate for men after middle-age is about 1 percent, while the rate for postmenopausal women is 2 to 4% in 5 to 10 years due to sex hormones deficiency. The calcium absorption rate is inverse with age. On average, the calcium absorption rate reduces 5 to10% every 10 years. People at age 80 and older, the calcium absorption rate is extremely poor.
The most common symptoms of osteoporosis
Osteoporosis, a.k.a. "the invisible killer" , has no early symptoms. The onset of symptoms is gradual, only after the disease has developd to a certain stage. The most common symptoms of osteoporosis are:
1. Back pain, ankle pain, and heel pain when waking up to walk early in the morning.
2. Conscious fatigue, malaise, prone to fatigue during light housework, often insomnia, night dreams, waking up easily, loosen teeth, night cramps, lower extremities, depression, poor memory, speed aging and the like.
3. Growing shorter, i.e., height is shorter compared to that at a younger age, ranging from shorter by 1 - 2 cm up to 5 - 6 cm or more.
4. Hunchback appearance, shape like a turtle shell. Humpback indicates occurance of spinal vertebral compression.
5. Fracture is the most severe problem in osteoporosis. The reason being the mechanical properties of bones has depleted. Fracture in the spinal vertebrate, lower limb, neck and wrist are most common. Severe vertebral fracture can occur when bending, lifting heavy objects, going downstairs and even coughing. Congestion on public transportation can also cause fracture to occur. Slipping or falling to the ground can easily lead to fracture of hip, neck, or wrist.
Osteoporosis categorization
Osteoporosis can be divided into primary, secondary and idiopathic. Primary osteoporosis also includes type I - postmenopausal osteoporosis and type II - senile osteoporosis.
Secondary osteoporosis is osteoporosis that exists after other diseases (e.g. Cushing's disease, diabetes, etc.)
Idiopathic osteoporosis is quite rare. It occurs mainly in adolescents. The cause is not clear, it may be a primary metabolic bone diseases.
Osteoporosis Causation
Dietary factors
Calcium is the most abundant and important mineral, most of which exist in the bone. The study found that bone becomes loose in long-term heavy drinkers. This is because alcohol causes liver damage, resulting in abnormal metabolism of nutrients.
In addition, high intake of excessive fatty food can also cause nutritional and metabolic imbalance in calcium. Not only that it affects the absorption of calcium, it also makes a lot of calcium "migration" and a significant increase in calcium outpour through urination, thus causing severe bone calcium deficiency, and ultimately osteoporosis.
Lack of sunshine
Vitamin D is an essential nutrient that helps calcium absorption. Sources of vitamin D are limited. When exposed to sunlight, the body can absorb raw material for manufacturing and conversion of calcium. However, with modern lifestyle changes, people have reduced their opportunity to accept sunlight, causing vitamin D deficiency. This affects calcium absorption and eventually causes osteoporosis.
Insufficient Exercise
The skeletal system is supported by the muscle system. More muscles helps more calcium absorption in bones. Therefore, exercise is very important in maintaining healthy bone density. Studies have pointed out an inverse relationship between osteoporosis incidence and exercise, but proportional for exercising in early age and in older age.
Drug factors
Perennial medication is also a predisposing factor for osteoporosis. This is especially true when medication consists of synthetic adrenal glucocorticoid, such as strong prednisolone, adrenocorticotropic hormone, heparin (anticoagulant) , and thyroid gland hormones. Antiepileptic drugs such as phenytoin, phenobarbital, etc., can promote the degradation of vitamin D to cause osteoporosis. Certain diuretics, anti-cancer drugs and isonicotinoyl may also affect bone metabolism.
Genetic Factors
Genetic factors and osteoporosis are closely related. There are two types of bone genes stablized through the vitamin D receptor to regulate calcium absorption, playing a lead role in bone metabolism. However, as people grow older, their genetic factors will gradually weaken, and the environmental factors will affect more.
Prevention of Osteoporosis
1. Reasonable balanced diet
Include foods with adequate protein, calcium, phosphorus and vitamin C as they are necessary for bone formation. Examples are eggs, fish (including freshwater fish), shellfish, soy products, etc.
2. Increase physical exercise
Young adults should exercise more to peak the bone mass in order to prevent or slow down osteoporosis in old age. The elderly should also exercise within his/her capacity. Exercise can increase the muscle's ability to assist bone tissue, maintain calcium steadiness, and increase bone mass. Continuous physical activities can prevent further loss of calcium and have a positive effect on bone tissue reconstruction.
3. Outdoor Activities
Outdoor activities give us more chances to expose to sunlight. Through the 7-dehydrocholesterol in skin, sunlight enables generation of vitamin D, which when converted to vitamin D3 can promote intestinal absorption of calcium.
4. Consume less foods that hinder calcium and phosphorus absorption
Limit the consumption of food that contains large amounts of phytic acid and oxalic acid. Cut down the amount of food that contains excessive cellulose, such as spinach, bamboo shoots. Calcium compound is not readily absorbed by the intestine phytic acid or oxalic acid, rather it is easily discharged. Consume less carbonated drinks, strong caffinated drinks, and food that contains preservatives. Avoid taking unnecessary drugs such as corticosteroids and anticonvulsants. They either prevent calcium absorption or speed up excretion of calcium.
5. Change to healthy habits
Develop a reasonably balanced diet; don't be a picky eater. Avoid smoking and drinking alcohol. Excessive smoking and drinking will affect dietary intake and influence calcium intake as well as absorption.
6. Reasonable calcium supplement
Calcium is an important element, lacking which can cause a variety of diseases. Calcium deficiency in the elderly can cause osteoporosis. Having adequate calcium supplement is the key to prevention of osteoporosis. For the elderly and postmenopausal women, adequate calcium supplement is essential in prevention of osteoporosis. Having reasonable supplement is also a way to improve health and quality of life for the elderly.
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