Prevent osteoporosis by increasing physical activity

By Injil Abu Bakar

BOSTON, Massachusetts (JP): The mention of osteoporosis is increasingly familiar to us due to increasing news promoting awareness of the condition. But few people may realize that regular physical activity can help prevent our bones from degenerating as we age.

Osteoporosis, a condition in which the bones become fragile and weakened, affects one-third to one-half of all older American women and an increasing number of older American men.

There is no precise data on osteoporosis patients in Indonesia, but doctors estimate that the prevalence is quite high given the increased life expectancy of Indonesian women.

Losing bone density often occurs with aging. However, many factors can speed up bone density loss. As bones become thinner and more brittle, the chances of breaking a wrist or hip, or developing a curvature of the spine, known as "dowager's hump", increase.

In order to slow the process of osteoporosis down, regular physical activity must be accompanied by eating a well-balanced diet with the recommended amount of calcium.

In some cases, hormone or drug therapy may be necessary. If you have been diagnosed with osteoporosis, you must also take special precaution to avoid falls.

Risk

Osteoporosis has been called a "silent" disease because there are no early warning signs. A broken bone is often the first signal that there has been serious bone loss.

There are several safe, painless methods of measuring bone density. People with bone density well below the level of others their age have osteoporosis.

Some women are more at risk of osteoporosis than others. They include women who are: * Caucasian or Asian * thin * postmenopausal

... and women who: * do not eat enough calcium-rich foods * are not physically active * smoke cigarettes * drink alcohol excessively * drink more than 2-3 cups of caffeine beverages per day (coffee, tea and colas) * have lost ovarian function before menopause * have a family history of osteoporosis * have a mother or father who lost height or broke bones with age * have or had other conditions, such as bulimia, anorexia, rheumatoid arthritis, some endocrine disorders, or * take certain forms of medication such as steroids or cortisone-like drugs, or drugs which lower estrogen levels

Physical activity

Physical activity can slow the progress of osteoporosis and will improve your strength and balance, decreasing your risk of falling. If you have been inactive, it is important to begin any kind of physical activity program slowly and gradually increase your activity.

Thirty minutes of moderate physical activity each day could include walking or using a manual wheelchair, dancing, working in the garden, exercise classes and swimming.

Regular strength-training exercises, which cause muscles to work against gravity, can help build bone density. Activities such as climbing stairs, lifting weights, tennis, cycling and rowing are examples of strengthening activities.

Physical activity improves your all-round health by strengthening your heart, controlling your weight and reducing stress. And, when done with friends or family, physical activity can be fun!

Getting enough calcium in your diet throughout life may help protect you against osteoporosis. Women who have gone through menopause may require up to 1,500 mg of calcium each day.

The following foods each contain about 300 mg of calcium per serving: * 1 cup of low-fat or fat-free milk. * 1 cup of low-fat yogurt. * 3 cups of cooked broccoli. * 8 oz. lasagna. * 1 cup of cooked collard greens. * 1 bean and cheese taco. * 1 cup of calcium-fortified orange juice. * 4 oz. tofu processed with calcium sulfate.

Low-fat and free-fat milk, yogurt and cheese contain as much calcium as whole milk products and are better choices for your overall health.

But many women may not get enough calcium through diet alone.

Consult with a doctor about whether you should take calcium supplements. Calcium supplements have been linked to kidney stones and may make some illnesses worse, so it is best to check with your doctor before using them.

To use calcium, your body needs vitamin D. You can get the vitamin from brief exposure to sunlight, totaling 30 minutes per week. Whenever the climate does not allow you to get natural vitamin D, you need dietary sources from vitamin D-fortified milk, fish liver oil and multivitamins.

Many dietary factors affect the amount of calcium your body absorbs. A diet rich in fruits, vegetables and whole grains is your healthiest choice.

Preventing Falls

If you already have osteoporosis, you are more prone to breaking a bone or hip due to a fall. Look around home and see if you can make it safer.

These are general tips: * Avoid the use of throw rugs. * Secure carpet with double-faced carpet tape to avoid slipping. * Remove all loose wires and cords. * Make sure stairs have sturdy railings on both sides. * Make sure halls, stairways and entrances are well lit. * Have a light within easy reach when the entering room.

Don't forget that your personal safety habits can help you avoid falling down suddenly. * Wear comfortable, low-heeled shoes with good grip, such as those provided by rubber soled shoes. * Get up slowly from a sitting or lying position to avoid dizziness. * Avoid excessive use of alcohol. * Avoid sedatives. * Review your medication with your doctor to find out if side effects include dizziness. * Have your vision and hearing tested regularly and properly corrected.

Therapy

Some women who are at high risk of contracting osteoporosis, or those who have had their ovaries removed before age 50, may take hormone therapy in the form of estrogen, which has been shown to slow the loss of bone density. Progesterone is added for women with uteruses.

Hormone therapy may increase bone mass and have other health benefits but is not without risks. Non-hormonal drugs to reduce bone density loss or increase bone mass are also available. Review your family history and risk factors for the disease with your doctor before deciding on any form of treatment.

The writer is an Indonesian obstetrician currently living in the United States.