Step up for bone health

Dr M K Mam
Osteoporosis is a disorder of bones where bones lose their strength. They become so weak and fragile that they break easily even as a result of a minor fall, bump, sneeze or sudden movement. It goes unnoticed for years because most of the people do not know that they are suffering from it until they sustain a fracture with minimal trauma. Common sites of these fractures are spine, hips and wrist. These fractures especially of the hip are difficult to manage and are associated with lot of morbidity and mortality. These fractures also cause a lot of psychological and social problems thus affecting performance of the person. These fractures reduce not only quality of life but also quantity of life. Management of such fractures involves lot of cost, puts enormous financial burden on the affected person, family and the society as a whole. India being second most populous country in the world is home of a very large population of osteoporosis patients and the number is increasing every year. Considering the risk of fractures and subsequent complications- morbidity and mortality following such fractures, and then a very high cost involved in treatment, it is all the more imperative to take care of bone health. Bone health can very well be taken care of by adopting bone healthy habits and avoiding bone-damaging habits.
Bone healthy habits:
a) Regular physical activity is essential for overall wellbeing of the body and mind. The physical stimuli of pressure, loading, push and pull movements stimulate the bone cell to form new bone, increase bone mass. Weight bearing exercises that one performs while on the feet when bones and muscles work against gravity increase bone mass, strengthen the bones and muscles. Simple walking (30 minutes a session- 150 minutes a week ), pushing, lifting, going up stairs, running, jogging, jumping, dancing, weight lifting, playing volleyball, basketball are some of the weight-bearing exercises which one can do depending on one’s age, physical, and medical status etc.
Yoga strengthens muscles, bones and the body as a whole. Studies have shown that yoga done every day can prevent osteoporosis and in some cases can slow down its progression. Yoga has a positive effect on the physical, mental and spiritual wellbeing of a person.
Yoga and exercise has to be a regular daily lifelong activity of a person. It just cannot be a week end activity. Research has shown that regular physical activity started in childhood and adolescence is a cheap and safe way of improving bone strength and prevention of osteoporosis. Present day lifestyle that is mostly sedentary is not good for bones and overall health of a person. This has to change to an active one. We have to be physically active as much as and as long as we can. It is good to sit less, rather we should move and move more. Again, it is good to climb stairs – use legs and not the elevator.
ii) Bone healthy diet with adequate amount of calcium and vitamin D along with proteins, vitamin C, K is essential for bone health and prevention of osteoporosis. Calcium is the most important mineral for bone health. Men aged 50-70 years need 1000 mg per day of calcium and the women age 51 and older and men age 71 and older need 1200 mg per day. Children and young people need more calcium than an adult as bones are developing and growing. Vitamin D is important for calcium absorption and mineralization of bones. An intake of 800 to 1000 international units of vitamin D per day for adults is recommended. Vitamin D is naturally synthesized in skin through exposure to sun light. A 15-minute sunbath can produce adequate quantity of vitamin D by way of the skin.
b) Bone- damaging habits:
i) Cigarette smoking and use of tobacco products are known to speed bone loss. It damages bone cells, reduces blood flow to bones, decreases the production of some of the hormones that are good for bones like estrogen in women and testosterone in men, although exact mechanism is not known. As such smoking has to be stopped at all costs.
ii) High alcohol intake has to be avoided as it is harmful for the bones. It damages bone cells directly, inhibits calcium absorption and damages the liver – the organ where activation of vitamin D occurs.
iii) Maintaining an ideal weight is important for bone health. Underweight – low body mass index (BMI) increases the chances of osteoporosis.
c) Educating the people about the importance of bone health is necessary. People need to be educated about poor bone health and its adverse effects on the individual and the society, so that they can take necessary steps to take care of bone health.
To summarize, Bone health can be taken care of by adopting bone healthy habits that include regular weight bearing and resistant exercises , bone healthy diet rich in calcium, vitamin D, proteins etc. and avoiding bone damaging habits i.e. smoking and excess intake of alcohol. All this should start in childhood and has to continue throughout life.
(The author is former Vice Principal, Prof. & Head Orthopaedics, CMC , Ludhiana, Punjab)