Greater sensitivity towards osteoporosis patients can only come through increased awareness.

Sonali Sharma, 56, a housewife and resident of New Alipore, Calcutta, had a fall two months ago and fractured her right leg. Diagnosed with osteoporosis, she took a long time to recover. “I had difficulty moving around and the treatment was prolonged,” recalls Sharma.

Few symptoms

“Osteoporosis is on the rise in India,” says Dr S.M. Lakhotia, chairman of the Osteoporosis Committee of the Indian Orthopaedic Association. He attributes several reasons to this, including a sedentary lifestyle and increased longevity. Since it principally affects the elderly, the increase in longevity also means more osteoporosis cases than before.

Says Dr Lakhotia, “It is a disorder of the bones in which they become fragile and are likely to fracture easily”. It has been described as a silent killer since it has very few symptoms. Low bone mass coupled with a history of fractures contributes most to the risk of suffering new fractures. Low bone mass can be due to inadequate calcium or vitamin D intake, lack of exercise, excessive smoking or consumption of coffee or alcohol. “Physicians try to diagnose this disease early by measuring the bone mass by using techniques called bone densitometry,” says Dr Kalyan Mukherjee, former president of the West Bengal Orthopaedic Association and a fellow of the British Orthopaedic Association.

“People should be made aware of the concepts of bone formation to understand the cause of osteoporosis better,” says Dr Niloy Das, professor of paediatric orthopaedics at the Institute of Child Health, Calcutta. Bone formation and bone resorption (loss of bone mass) take place throughout life. Osteoporosis results when the rate of bone formation is less than the rate of bone resorption.

In the dark

“The incidence of osteoporosis, when considered against the increase in life expectancy, has trebled over the last decade,” says Dr Mukherjee, adding that post-menopausal osteoporosis is not adequately treated in India.

Osteoporosis may affect children too. Osteogenesis imperfecta is a condition of imperfect bone maturation in youngsters. “One of the signs is back pain,” says Dr Dilip Majumdar, former professor of Orthopaedic Surgery at SSKM hospital, Calcutta. He, however, stresses that all such cases of back pain may not mean osteoporosis. But since the rate of bone formation in children is more than the rate of bone resorption, cases of osteoporosis can be avoided with a balanced diet.

Recommended

The daily recommended dose of calcium is 1,000 milligram/day for men and pre-menopausal women and 1,500 milligram/day for post-menopausal women. “The best sources of calcium are dairy products and calcium-rich citrus fruits,” says Dr Kalyan Mukherjee. One cup of milk, one ounce of cheese, one cup of yoghurt or one cup of citrus juice contains approximately 300 mg of calcium and an adequate intake of these products is enough to prevent osteoporosis.

Dr Mukherjee offers another option for people who may not be able to avail of dairy products: dried chicken eggshells ground as fine powder after proper cleaning can provide adequate calcium supplement.

Walking, running and cycling improve bone mass and strengthen the lower spine, hips and legs. Resistance exercises or weight training strengthens whatever bones are used during the activity and these are particularly good for the upper spine and the arms.

The West Bengal Osteoporotic Association has started awareness programmes on the issue. “We have guidelines for effective treatment of osteoporosis. DEXA (Dual Energy X Ray Absorptiometry) Scan is the right method for diagnostic investigation,” says Dr Lakhotia. Many elderly people suffer greatly from osteoporosis and have no one to look after them. Greater sensitivity towards their plight can only come through increased awareness, he adds.