Osteoporosis is a somewhat symptomless bone disease characterized by increasingly fragile bones that ultimately break under the pressure of everyday movements, as a result of falls or even spontaneously. Osteoporosis occurs both in men and women, but tends to be predominant in women over reproductive age as a result of decreasing estrogen levels. Certain medication, lack of physical exercise and, most important, nutrient deficiencies as a result of bad dietary habits are all risk factors for osteoporosis.
Because the disease is characterized by loss of bone mass, its most worrisome aspect is bone fractures. Generally, fractures occur at the level of the hips, spine and forearm and cause a significant reduction in mobility following the incident. In the majority of cases, osteoporosis is diagnosed only after a more serious fracture has occurred.
What is osteoporosis? Also known as thinning bones, osteoporosis is a disease characterized by low bone density. Low bone density is a result of an imbalance between two otherwise perfectly normal processes: bone formation and bone resorption. We basically do not have the same bones throughout our life. Just like our skin cells are renewed regularly, so is old bone reabsorbed and new bone is created, mostly from minerals from the foods we eat.
Osteoclasts, a type of bone cells, are responsible for remodeling or repairing bones through a process called bone resorption. Osteoblasts, another type of bone cells, get together and create new bone in a process called bone formation. In certain situations, imbalances occur within our body which leads to bone resorption exceeding bone formation. In other words, osteoclasts demineralize bones at a faster rate than osteoblasts can create bone. This results in low bone mineral density and represents a serious risk factor for osteoporosis.
The three main processes that favor the development of osteoporosis are:
1) Insufficient peak bone mass (the maximum density and strength of one’s bones at the end of the growth process).
2) High bone resorption rate (bones are absorbed faster than they are created).
3) Low bone formation rate.
Osteoporosis is basically a disease in which our bones become more fragile, more porous or less dense. It is this characteristics that makes them less resistant, more brittle so any fall or stress put on them can lead to a fracture. However, the disease does not develop all of a sudden because bones do not become brittle in an instant.
It takes time for this to occur so, naturally, osteoporosis itself develops gradually as one’s bone density becomes sufficiently low to allow for the bones to fracture easily. Low bone density that is not low enough to be labelled as osteoporosis is classified as osteopenia. This is basically a condition preceding osteoporosis.
Causes and risk factors
Osteoporosis is a disease brought on by an accumulation of factors. Generally, the medical community distinguishes between unmodifiable risk factors one has no control over and risk factors that one can control in view of preventing the disease from developing.
The categories of people believed to be at higher risk of osteoporosis include:
1) Women (due to hormonal factors).
2) People over of 50-65 years of age.
3) Anyone with a family history of osteoporosis.
4) People with a thin frame.
5) Underweight individuals.
6) Anyone with bone fractures.
7) Caucasian and Asian populations.
Why are these people more at risk for osteoporosis? Women are believed to be more at risk of osteoporosis following the end of their reproductive age. This is because estrogen levels drop considerably at this point in a woman’s life. Estrogen is a hormone directly involved in the process of bone resorption and low levels have been linked to a faster rate of bone resorption. Hormonal imbalances causing an estrogen deficit, removal of the ovaries, endocrine conditions, smoking can all increase bone resorption and osteoporosis risks.
Old age is correlated with a higher risk of osteoporosis because aging itself results in bone mineral loss, increasing the risk of fractures. People with a thin, narrow frame or underweight individuals also pose a risk because both this type of body frame and low body weight in general are highly indicative of potential nutrient deficiencies that have lead to poor bone development and low bone mineral density.
Children and young adults need to correctly nourish themselves to ensure their bones get the necessary amounts of nutrients required to grow strong and dense. Adults also need to maintain a healthy body weight because their bone frame needs sufficient amounts of nutrients to maintain a balance between bone resorption and bone formation. Last but not least, anyone who has already experienced bone fractures is more likely to develop or suffer from osteoporosis because an existing fracture is generally indicative of low bone mineral density or bones that are already brittle.
Although the mechanisms are not fully understood yet, it would appear that Caucasian and Asian females tend to have a lower bone mass and are thus more prone to bone fractures due to osteoporosis. African American women, on the other hand, tend to have a higher bone mass and are thus less likely to develop osteoporosis.
People without a predisposition to osteoporosis can develop it if they do not take proper care of themselves. The second set of risk factors includes:
1) Calcium deficiency.
2) Vitamin D deficiency.
3) High alcohol intake.
5) Low body weight.
7) Excess coffee or soft drinks intake.
8) Disease and invalidity.
Our bones are mostly made of collagen, a protein that keeps them flexible and able to remain intact under stress, and strengthened by calcium. Eating foods rich in calcium such as dairy or green leafy vegetables prevents bones from fracturing easily. But our body also requires generous amounts of vitamin D to help us better absorb calcium.
Vitamin D deficiency has been found to promote bone resorption and prevent bone loss. Most of the vitamin D we need is produced as a result of moderate sun exposure, but consuming foods rich in vitamin D such as liver, mushrooms, etc. contributes to better prevention against osteoporosis as well and better health in general.
Taking dietary supplements is also a good idea, provided we choose good brands that offer quality formulas and no GMO compounds (such as starch). Magnesium and phosphorus also promote bone health. Smoking is problematic because cigarette smoke has been shown to alter estrogen metabolism. Chronic alcohol consumption (alcoholism) has also been associated with a higher risk of bone fractures, presumably because high amounts of alcohol reduce nutrient absorption. The principle is similar for coffee consumption.
Being underweight is believed to increase osteoporosis and bone fractures risks because a low body weight is associated with poor nutrition. In other words, underweight people do not eat right so they generally do not have a sufficient intake of nutrients to help strengthen their bone frame and keep it strong. Research has also linked lack of physical exercise to increased osteoporosis risks. This is because physical exercise can help strengthen bones and make them more resistant to physical stress.
Some illnesses may increase one’s osteoporosis risks. These include a variety of conditions and illnesses that limit the production of reproductive hormones: anorexia, amenorrhea, diseases that require the surgical removal of the ovaries, andropause, Turner syndrome, Kallmann syndrome, Klinefelter syndrome, endocrine problems such as hyperthyroidism, diabetes type 1 and 2, adrenal gland problems etc.
Osteoporosis risks are higher in people with malabsorption problems brought on by conditions such as colitis, Chron’s disease, celiac disease, lactose intolerance, surgery that removes part of the intestinal tract (bypass surgery or gastrectomy) as well as in people with inflammatory diseases such as rheumatoid arthritis. Invalidity caused by disease or accidents that leads to immobilization increases osteoporosis risks (the same principle as sedentarism applies).
Lastly, certain medication can lead to low bone mineral density over time and thus increase osteoporosis risks. Examples include: anticoagulant medication, corticoids (glucocorticoids in particular), some epilepsy medication, antacid medication, particularly aluminium antacids but also proton pump inhibitors such as esomeprazol, omeprazol and so on, certain diabetes medication etc.