Osteoporosis is a disease that consists of decreasing the density of proteins and minerals in bone (DM0, Bone Mineral Density) and in particular of calcium. 
Many people think that for solid and tough bones it is necessary to eat: yogurt, cheese and dairy products, but the latest research shows that the truth is just the opposite.

Only children should drink milk, adults do not need these foods to be healthy, whereas habitual consumption can lead to osteoporosis because it increases blood ph (acidosis) and the body takes calcium from the bones to restore proper ph level .

Postural control of the level of the shoulder blades

This disease is characterized by a change in the internal structure: the trabeculae become thinner and some are completely absorbed.

If osteoporosis is severe, the bone tissue becomes more fragile and increases the predisposition to fractures that may be caused by mild trauma.
It is a chronic and degenerative disease that tends to worsen over time, but can be delayed and controlled with appropriate therapies.
Osteoporosis is a big problem today and will get worse over time due to longer life expectancy.
The social and economic cost of osteoporosis is very high because in these patients the fracture rate is very high, the management of an elderly person with a fracture consists of a lot of care and many hours of assistance.

The bones most easily fractured due to osteoporosis are the wrist , hip and spinebecause they are spongy type bones while those of compact type are less prone to injury.
The osteopenia is the first stage of osteoporosis wherein the bone calcium reduction is minimal, hence the risk of fractures in people is almost like having a good bone mass.


Classification of osteoporosis

Primary osteoporosis or high bone turnover
Primary (or primitive) osteoporosis is a senile disease that usually occurs after menopause .
Primitive type I osteoporosis is characterized by an excessive loss of trabecular bone (the area in the center of the bone).
Patients with type II osteoporosis also lose the cortical bone component (outer layer and compact), in this case is more likely a fracture of the femur and the wrist.
Reduced levels of female hormones (estrogen) are the cause of the disease.

Secondary osteoporosis or low bone turnover
Among men with osteoporosis, about 50% have secondary osteoporosis, ie caused by diseases or medications.
Prolonged intake of cortisone is the most common cause of secondary osteoporosis in men and women.
This medication is used to treat many chronic diseases, for example: rheumatoid arthritis , renal insufficiency , systemic lupus erythematosus, asthma and chronic lung diseases as a serious chronic obstructive pulmonary disease (COPD).

 

Idiopathic juvenile osteoporosis Juvenile idiopathic
oteoporosis is rare. It occurs in childhood or adolescence between 8 and 14 years of age or during periods of rapid growth.
There is no known cause for this type of osteoporosis where there is reduced bone formation or excessive bone loss.


What are the causes of osteoporosis?

The cause of osteoporosis is age, especially for women because at the age of menopause , decreased estrogen production causes a greater uptake of bone in relation to neoformation.
If you reach menopause earlier , that is before the age of 45, osteoporosis will be more severe, it often occurs after oophorectomy surgery.
In the elderly the formation of new bone tissue also decreases in men, the onset of the disease is estimated at around 50 years for women and 65/70 for men.

Feeding in young people and adolescents is vital, an adequate acquisition of peak bone mass (accumulation of bone tissue) when the person is young, suffered less and later because of osteoporosis.
Girls who have followed a strict diet to be lean and have not created a strong bone, are much more risky than others.
Other factors that predispose to the development of osteoporosis are:

  • A diet rich in calcium (milk and dairy products) does not combat osteoporosis, it actually favors it.
  • A long period of immobilization in the bed does not stimulate the activity of the osteoblasts, so the destruction of the bone prevails over its construction
  • Hormone deficiency, particularly estrogen for women, testosterone and somatotropin (growth hormone) for males
  • Gender (male or female), in fact male osteoporosis is rare
  • A diet low in vitamin C and D
  • Celiac disease (causes decreased calcium and vitamin D absorption, moreover is characterized by the presence of autoantibodies against the protein osteoprotegerin that serves to keep bones strong)
  • Crohn’s disease and ulcerative colitis (causes intestinal malabsorption)
  • A diet rich in animal proteins that increases blood ph
  • A sedentary lifestyle and the total lack of sports activity
  • The age
  • Early menopause or as a result of surgery


What are the substances and medications that affect osteoporosis?

Among the substances ingested that favor the onset of osteoporosis are:

  • Abuse of harmful substances, such as cigarette smoke and alcohol
  • Cortisone
  • Anticonvulsant medications
  • Prolonged intake of medications such as heparin, methotrexate, ethanol etc.


What are the symptoms of osteoporosis?

Osteoporosis itself is asymptomatic and silent, but it can cause a bone fracture or vertebral collapse.
In advanced stages, you may notice anatomical changes in the spine , such as loss of height and appearance of hyperkyphosis or hunchback because the vertebrae change shape (become wedge-like) or collapse.


Diagnosis and examinations appropriate for bone osteoporosis

The radiography is not the most accurate test for bone density because only after a reduction of higher mineral to 30% of normal is positive.
The examination to check the bone mineral density (BMD) of the skeleton and especially the most affected parts (femur, wrist, vertebrae) is bone densitometry.
The physician prescribes bone densitometry to individuals who have risk factors based on medical history such as:

  • fracture spontaneous or multiple fractures
  • Estrogen deficiency in postmenopausal women
  • Hormonal disorders, such as hyperthyroidism
  • Medications that act negatively on bone metabolism.

This test is done with medical devices that measure bone content and mineral density.
The equipment used is similar to an X-ray, but the emission of radiation is very low, not invasive or painful.

BMD for a 63-year-old woman who reached menopause at age 39.

The duration of the examination is approximately 10 minutes.
The patient places the part to be tested in the densitometer and the machine makes the measurement.
The tools used are based on two technologies: single photon absorptiometry (SPA) and DEXA which is similar to radiography.
In addition to BMD, laboratory tests are helpful in finding out if there is susceptibility to osteoporosis and in checking whether the body responds to taking medications.
Blood and urine tests are mainly used to check the level of serum calcium, phosphoremia, alkaline phosphatase, and parathyroid hormone (PTH).


How do you interpret the results of BMD? When to worry?

The BMD returns a score or “T score” based on the bone density that is interpreted as follows:

  • If the T score values ​​are between +1 and -1 the bone is normal;
  • A T score between -1 and -2.5 corresponds to a lower bone density than normal, but it is not a severe osteoporosis, in this case it is osteopenia;
  • OT score less than -2.5 indicates the presence of osteoporosis, this category includes people suffering from fractures due to minor trauma.

 

What is the most appropriate treatment for osteoporosis?

Osteoporosis is a problem that must be addressed by several professionals because the causes can be many.
The physician should consider the patient’s medical history, check for risk factors, and monitor the hormone level to determine if it is appropriate to begin hormone replacement therapy after menopause.
If the person examined has already suffered single, spontaneous fractures or multiple fractures should consider osteoporosis as a serious disorder.
A vertebral fracture in the lower back can cause constant pain, limited movement and breathing can make it more difficult.
The doctor may prescribe medications that inhibit osteoclasts (cells responsible for bone scrapping) such as phytoestrogens or vitamin D that serves to absorb calcium in the intestine and may also recommend magnesium supplements.
Among the vitamin D supplements, in pharmacy can be found the D-base.
Today, the so-called bisphosphonates that interact with hydroxyapatite and retard or inhibit the action of osteoclasts


Natural Diet and Remedies for Osteoporosis

The natural remedies against osteoporosis are: physical activity, a healthy diet and sun exposure

Is physical activity useful for treating or preventing osteoporosis? 
Physical activity is one of the most effective natural remedies to control and prevent prevalent osteoporosis for several reasons:

  • Improves balance and coordination, thus reducing the risk of falls
  • Stimulates calcium build-up and deposition in bones and increases resistance in case of trauma
  • It improves general physical condition and cardiovascular condition.

The most indicated activities are: walking, dancing, gymnastics and exercises for thespine.
According to the degree of osteoporosis, if one can choose one activity over another, slow running may be useful in the first phase and in the case of osteopenia, but if osteoporosis is serious you should avoid it because you have a risk of fracture of the femur .
Among the sports indicated are: swimming and water aerobics ( gymnastics in the water ) are activities done in the absence of load, so it does not favor the balance and the reinforcement of the bone.
In cycling, the load is reduced, so it is a sport that helps in case of knee and hip disorders, but is ineffective for osteoporosis.
It is recommended a standing activities to give the mechanical stimulus in the bone that reacts with the osteogenesis.
Exercise should be regular for best results and to avoid fractures, 3 sessions per week are required for at least 30 minutes.
It is best to avoid an orthopedic brace  for the spine as it reduces the weight on the spine and then promotes loss of bone density.


How important is feeding in the treatment and prevention of osteoporosis?

Food is essential to treat and prevent osteoporosis. A diet rich in vitamin D is one of the best tools to combat this disease.
Vitamin D is water soluble and found primarily in fish, especially in liver oil, is also found in meat, butter, fatty cheeses and egg yolk.
You do not need to take this substance with food because the body can synthesize vitamin D at the skin level. The sun’s ultraviolet rays allow the formation of vitamin D from the cholesterol precursor.
Calcium metabolism is complex, bones play an important role in the balance of mineral salts and extract the basic calcium salts to buffer the excess acid in the blood.
It is important a feeding program that maintains the ph neutral of the blood, we must avoid in particular the meat.


Guidelines for the prevention of osteoporosis

According to the guidelines of the Ministry of Health, the actions useful for the prevention of the disease are:

  • Amount of calcium in proper diet
  • Balance diet
  • The amount of Vit D should be 400-600 IU / day in adults
  • Regular exercise against gravity (a walk, lifting of light weights, climbing stairs) suitable for pediatric or senile age
  • Avoid smoking and alcohol
  • Treatment of diseases that cause secondary osteoporosis
  • Prevention of falls in the elderly with the use of a stick, shoes with non-slip soles, adequate lighting inside the house, avoiding rugs, mounting the handles or other supports on stairs and risk areas of the house

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