Osteoporosis is a metabolic disease of bone which leads to a reduction in bone density. The affected bones become thinner, and are more likely to break (fractures) which may result in pain and other complications, including loss of independence.

What are the symptoms and signs of osteoporosis?

Osteoporosis produces no symptoms on its own. If osteoporosis-related fracture occurs, there may be localized pain over the fracture sites. Common sites of osteoporotic fracture include thigh bone near the hip joint, spine (vertebrae) and forearm near the wrist. While hip fracture may occur after minor fall, spine can fracture without any trauma. Vertebral fracture can result in a hunched-back and a decrease in body height, and sometimes back pain.

Who are at higher risk?

1. Elders.
2. Female: Osteoporosis is more common in women than in men, particularly in postmenopausal women due to estrogen deficiency.
3. Persons of small frame.
4. Having a family history.
5. Unhealthy lifestyle, for example
   • Smoking
   • Inadequate calcium intake
   • Inadequate vitamin D intake
   • Excessive caffeine intake
   • Consuming too much salty food
   • Doing little or no weight-bearing exercise
   • Excessive alcohol consumption
6. Diseases, such as
   • Estrogen deficiency, e.g. early menopause as a result of ovarian failure after chemotherapy, radiotherapy or surgical removal of ovaries
   • Testosterone deficiency
   • Endocrine diseases such as hyperthyroidism
7. Medications such as long term use of high dose steroid

How do I know if I am suffering from osteoporosis?

Those who are at risk may consult doctor for a test. The followings are common methods of measuring bone density.

• Dual Energy X-ray Absorptiometry (DEXA)---for diagnosis and monitoring of treatment effect.
• Quantitative Ultrasound (QUS)---for screening purpose, not suitable for diagnosis.

Is osteoporosis preventable?

Adequate calcium and vitamin D intake, together with weight-bearing exercise are essential for normal bone growth. As it is necessary to build strong and healthy bones starting at an early age, everyone should maintain balanced diet and perform regular exercise over a lifetime to avoid osteoporosis later in life.

1. Balanced diet.

• Eat calcium-rich foods, for example
  • Dairy products such as milk, yogurt, and cheese (low-fat milk and skimmed milk contain less saturated fat and are healthier choices)
  • Seafood eaten with bones or shells, such as whitebait, dried silver fish and dried shrimps
  • Soya bean products such as tofu, fortified soy milk, soy chicken, beancurd stick and beancurd sheet
  • Dark green leafy vegetables, e.g. white cabbage, broccoli and Chinese flowering cabbage
  • Nuts, e.g. almond and sesame
• Ensure adequate vitamin D intake, such as egg yolk and fortified milk
• Avoid salty food, such as salted fish and soy sauce which affects calcium absorption

2.Don't smoke and don't drink too much. Reduce drinks that contain caffeine such as coffee and tea.

3. Perform weight-bearing exercises, e.g. brisk walking, Tai Chi or gymnastic exercises, at least 3 times a week and for 30-60 minutes each time.

4. Perform outdoor activities to absorb sunlight which will help the body to produce more vitamin D in order to enhance the absorption of calcium. Beware of sunburn.

What can I do if I am suffering from osteoporosis?

The above lifestyle tips are also useful to slow down further bone loss in persons diagnosed with osteoporosis. Depending on individual conditions, doctors will prescribe medications for osteoporosis, such as bisphosphate, SERM, calcitonin, teriparatide, strontium ranleate and vitamin D and calcium supplement.

Fall prevention is of paramount importance in preventing fractures and other complications, especially for those who have osteoporosis. Everyone should pay attention to home safety and road safety, wear non-skid footwear, avoid medicines which cause dizziness and wear appropriate corrective eyeglasses.

Concluding remarks

Bone metabolism is a continuing process and bone loss starts as early as 35-years-old. Hence everyone should take steps to prevent osteoporosis.