Calcium intake, exercise help reduce risk of osteoporosis

Calcium intake, exercise help reduce risk of osteoporosis

Maria Endah Hulupi, The Jakarta Post, Jakarta

While strolling along the dairy aisle at supermarkets, people
will easily spot high-calcium milk for adults to prevent
osteoporosis. You may ask why more people are so concerned of
late about osteoporosis. Everybody will eventually get older, and
naturally, the bones will become weaker.

It is true, but one would do well to listen to the experts'
opinions prior to the World Osteoporosis Day which will fall on
Oct. 20.

"Osteoporosis is a common problem for middle-aged people but
it is better to prevent it from an early age," said Johanna
Rumawas, a nutritionist from the University of Indonesia, in a
recent seminar jointly held by the Indonesian Osteoporosis
Association (PEROSI) and New Zealand Milk, producer of the high
calcium milk Anlene.

People with strong bones can reduce the thinning process of
natural bones as they get older but those with thinner bones are
more prone to fracture due to falls or the carrying of heavy
objects.

Taking an adequate amount of calcium from calcium-rich sources
-- particularly dairy products, tofu and anchovies -- since the
early phase of growth is important for strong bones and high bone
mineral density (BMD).

Vitamin D -- available in egg yolk, saltwater fish, liver and
sunshine -- is also needed for the body to absorb calcium.

So far, there is no available data on the number of
Indonesians suffering from this silent illness. However, doctors
believe the figure is relatively high as the average calcium
intake among Indonesians is only 254 milligrams per day. Compare
that figure to the international recommended intake at 1000
milligrams for adults and 1500 milligrams for pregnant and post
menopausal women, and the difference is astounding!

Rumawas said people with low calcium diets needed to fulfill
the daily requirement by taking calcium supplements.

Other sources said it is important to ensure adequate intake
of calcium for healthy teeth, proper function of the heart,
muscles and nerves. Otherwise, the body will extract the mineral
from bones.

A balanced diet alone is not enough and must be assisted with
an active lifestyle or at least 30 minutes of daily exercise to
help stimulate bone formation and also reduce the bone resorption
process, said a rheumatologist from the Cipto Mangunkusumo
General Hospital (RSCM) Bambang Setiyohadi.

Human bone, Bambang explained, is a dynamic organ that
undergoes constant formation. This process is carried out by
bone-forming cells osteoblast, which rebuild the bones corroded
by the bone-eating cell osteoclast.

Due to poor calcium intake and inactive lifestyles, the bone
forming process can not cope with the activities of osteoclast
and in turn leads to decreased bone density and enlargement of
bone spaces, making them susceptible to fracture.

And as osteoporosis has no outward symptoms, a person will
only suffer pain after microfractures occur.

Bambang identified bones that are prone to fracture include
the wrists, hip and spine. The latter can become unnaturally
curved, also known as Dowager's Hump.

People at high risk of osteoporosis are Caucasians, people
with small figures, smokers, alcoholics, people under prolonged
immobilization due to illness, underweight people, those who are
on a drastic weight loss program, people taking steroids (and
other medications, including for epilepsy) and women.

Bambang explained that women are particularly prone to
osteoporosis because they naturally have thin bones, while a
significant decrease in estrogen during menopause can aggravate
the problem. However, it can be controlled by hormone replacement
therapy.

"Estrogen helps control the activities of osteoclast," he
explained, adding that rapid resorption process continues 10
years after menopause.

As for men, a drop in testosterone levels also increases their
risk as the hormone also helps control the activities of
osteoclast.

The best exercises for strong bones are walking, jogging and
aerobics (including dancing) as they stimulate bone formation.

It is also important to avoid alcohol, reduce coffee intake
and high salt food as these items have roles in affecting the
bone formation, hampering the calcium absorption or encouraging
calcium excretion from the body.

RSCM rehabilitation center's Siti Annisa Nuhonni warned that
prevention must be prioritized.

She explained that people with normal bones needed to prevent
osteoporosis, those with osteoporosis needed to be extra careful
to prevent bone fracture due to falling or other accidents, while
those with fractured bones needed to prevent crippling effects
due to prolonged immobilization.

"It can be aggravated by psychological problems because at
this stage, the elderlies, weakened by bone fractures, may feel
that they are nothing but a burden for the other family members,"
she said.

Nuhonni also stressed the importance of maintaining proper
posture by standing and sitting straight and by bending knees
when carrying objects from the floor because it was not only more
comfortable, but such a position was also less stressful to
bones.

As for fall prevention, it is advisable to rearrange things
that may hamper movement, such as cables, toys and rugs, to make
sure that all rooms are well illuminated, to install hand rails,
to put anti-slip mats in the bathroom and other wet areas, to
keep floors clean and dry.