By EDUARDO GONZALEZ, MD
Q: Why do our bones become weaker as we grow older? How can I keep my bones strong so I don’t stoop in my old age? I am presently 40 years old.—firstname.lastname@example.org
A: Stooping, a posture of carrying the torso bent forward
at the waist, is so common among the elderly that it is sometimes referred to as “old man’s posture.”Among old people, stooping is generally caused by the painless collapse of some vertebrae—the bones that comprise our spinal column—because of osteoporosis, the most common disease of bones that is characterized by bones that lack mass and density and
therefore, porous and weak.
Bone formation and bone destruction (resorption) occur continuously in our body. In young people, bone formation outpaces resorption that is why there is a continuous increase in bone mass or density from childhood to about age 30, when bones are at their strongest. Thereafter, bone resorption outstrips formation and bones slowly, but progressively, decrease in mass and density. Then, osteoporosis sets in.
Osteoporosis can be secondary to a variety of disease conditions, but by and large, it spontaneously occurs as a person ages.
Who are at risk for osteoporosis?
Osteoporosis affects people of all races, but it is more prevalent among Asians including Filipinos and Caucasians. It affects both sexes, but women are four times more often than men. Women are particularly vulnerable to the disease after menopause because they have ceased to produce estrogen, the female hormone, which has bone-strengthening effects.
Aside from advancing age, menopause, and race, the other risk factors for osteoporosis are a family history of osteoporosis, thin build, sedentary lifestyle, diet that is poor in calcium or vitamin D, excessive alcohol consumption, smoking, prolonged intake of corticosteroids, and some diseases, especially of the kidneys and endocrine glands.
Osteoporosis brings about disabilities and premature deaths
Osteoporosis doesn’t kill directly, but it is the underlying cause of the most painful, most crippling fractures—especially of the hip, spine, and wrist—among the elderly, which often result in premature death. Experts estimate that half of menopausal women and a fifth of elderly men will have an osteoporotic bone fracture within their remaining lifetime. Incidentally, hip fracture is the most common fracture that results in hospitalization of people above age 65, and approximately 40 percent of these people die within six months of their injury.
Vertebrae weakened by osteoporosis, on the other hand, can collapse and get deformed painlessly and give rise to “old man’s posture.”
You can prevent osteoporosis
You won’t stoop in your old age if you:
- Ensure that you get enough calcium and vitamin D. Calcium accounts for the hardness and density of bone while vitamin D helps your body absorb calcium. A calcium-rich diet can provide you with all the calcium you need. Good sources of dietary calcium include dairy products (milk, yogurt, cheese, and ice cream); dark green, leafy vegetables (e.g., broccoli, and spinach); sardines and salmon with bones; soya beans and calcium fortified juices, cereals, and breads.
Vitamin D, on the other hand, can be produced by your skin in the presence of sunlight. Your skin can produce enough vitamin D if you get exposed to the sun a few minutes a day. Additionally, vitamin D can be derived from milk, fortified breakfast cereals, and eggs. You need not take calcium or vitamin D supplements.
- Exercise regularly. Exercise such as weight training, tennis, dancing, jumping rope, hiking, and stair-climbing boost bone density.
- Maintain a healthy body weight. Underweight individuals are prone to poor bone mineral density while overweight people have decreased growth hormone levels and, consequently, decreased bone formation.
- Moderate your alcohol consumption. Heavy alcohol drinking decreases sex hormone production, which results in poor bone production.
- Do not smoke. Nicotine and toxins in cigarettes accelerates the rate of bone loss, especially in adolescents and postmenopausal women.
- Be judicious in taking medications, some, such as corticosteroids, can promote osteoporosis.
- Get enough sleep. Bone resorption outpaces bone formation in people who sleep less than the seven to nine hours that is recommended for adults.
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