As we age, our bodies change and become more prone to
disease. Some diseases progress gradually and do not cause
symptoms right away. One such disease is osteoporosis, often
referred to as the silent disease.
Osteoporosis is a disease where there is both a loss of the
amount of bone and also a change in the structure of the
bone. And both of these lead to an increase in the fragility
of the bone and a subsequent risk of breaking or fracturing
the bone.
By our early twenties, we have reached what is called "peak
bone mass" or the maximum amount of bone mass we will achieve
in our lifetimes.
We know that bone mass is the single most important
determinant of the risk of fracture, and having a low bone
mass is the major diagnostic criterion for osteoporosis. Bone
mass at any age is related to the bone mass that you have at
peak, which occurs approximately at the age of 20-25, minus
the amount of bone that you subsequently lose.
Peak bone mass is determined largely by genetic factors. We
know that gender is important. Women have a lower peak bone
mass than men. We know that a variety of different genes are
involved. Some of these are Vitamin D receptor genes,
collagen genes and others. And we know that family history is
very important in predicting your risk of having an
osteoporosis-related problem.
Also, environmental factors are important. Nutrition, such as
calcium, and exercise during youth are important determinants
of peak bone mass.
As achieving peak bone mass plays such an important role in
the prevention of osteoporosis, it's important to get a head
start. Yet even with an early start, some people are still
more at risk of osteoporosis than others.
People as they age, both women and men, are at risk for
osteoporosis and in addition, all women at the time of their
change-of-life are at risk. At change-of-life women lose a
large percentage of their bone mass. If they start out with a
low bone mass, that is that they have a low peak bone mass
and then lose a lot of bone at change-of-life, they're going
to be in trouble at that stage in their lives and
thereafter.
The prevention of osteoporosis starts at birth when we first
begin to build bone mass. Lifestyle and genetics are
determining factors in the development of the disease. Key
measures taken early in life can help prevent osteoporosis
later in life.
Preventive measures that are important in keeping bone
healthy throughout life include trying to optimize nutrition
as much as possible, making sure that the calcium intake is
adequate -- and that involves what's in the diet and
sometimes a supplement if necessary. Also making sure that
there is Vitamin D in the diet, particularly in older women
and men.
And exercising. Exercise, both of the weight-bearing type,
meaning just an exercise you do while standing, as well as
exercising the muscles against some kind of resistance or
weight training are both important in keeping both bones and
muscles healthy, and reducing the risk of osteoporosis later
in life.
Smoking is a definite thing to avoid for bone as well as for
all other organ systems. Even though a little bit of alcohol
is okay in the diet for bone, and probably for general
health, a lot of alcohol or alcohol abuse may be detrimental
to bone.
There are many factors that determine how one's life is
changed by this disease. We believe that there are a few
basic steps that all of us can follow that will help in the
prevention of osteoporosis.
The way to prevent osteoporosis is to get the right genes and
to live a very healthy lifestyle with good nutrition and
exercise, no smoking and no excessive drinking. However, even
all of those measures may not be enough in all individuals
and some people actually need medical therapies in addition
to prevent fractures.
Editor's Note: Of course, living a morally correct life
according to the Torah is also very important for good
health.
2004 Dr. Reuven Bruner, PhD. All Rights Reserved.
Contact him at: POB 1903, Jerusalem, 91314, Israel; Tel: (02)
652-7684; Mobile: 052 2865-821; Fax: (02) 652-7227; Email:
dr_bruner@hotmail.com
