Be bone-healthy

With winter at its peak, it is crucial to take care of your bones. Bones form an important part of the body and they undergo several changes as we age. Winter often means lack of sunlight and chill in the air. Sunlight is the most important source of vitamin D, which is essential to maintain bone health. Winter also means lack of physical activity, since the body seeks warmth.
When we are young, new bones grow faster and the rate of fractures are lesser. This results in an increase in bone mass. Though the bone remodelling continues after we reach 30, the body tends to lose more bone mass. The first sign of bone loss is osteopenia, a condition that can lead to osteoporosis later in life. But with a balanced diet and exercise, bone loss can be reduced to a great extent.
Let's take a look at the factors that affect our bone health:
* Calcium intake: Calcium contributes to bone density. If a person's diet is low in calcium, it could result in bone loss at an early age and increase the risk of fractures. Leafy vegetables are an important source of calcium.
* Physical activity: Physically inactive people are at a greater risk of having unhealthy bones. Winters often force us to stay indoors in the warmth of our homes and heading to the gym is not on our list of priorities.
* Tobacco & alcohol use: Regular consumption of tobacco products can weaken the bones. Alcohol can stop the body from absorbing calcium.
* Gender: Women are at a greater risk of developing bone-related disorders, as they have less bone tissue compared to men.
* Size: People who are extremely thin (body mass index of 19 or less) or have a small body frame due to lesser bone mass, may have unhealthy bones.
* Age: The bones in a body get thinner with age, causing a lot of wear and tear.
* Family history: People of Asian descent are at a risk of developing osteoporosis. The disease can also be genetic.
* Hormone levels: Increased production of thyroid-stimulating hormone in the body can cause bone loss. Another reason could be a drop in oestrogen levels in women after menopause. In men, low testosterone levels also cause loss of bone mass.
* Medications: It is found that medicines like prednisone, cortisone, prednisolone and dexamethasone can cause damage to the bone.

Keeping bones healthy

One should include plenty of calcium in diet. For women between the ages of 19 and 50 years, and men aged between 51 and 70 years, the recommended dietary allowance (RDA) is 1,000 milligrams (mg) of calcium a day. Women after the age of 50 and men after the age of 70 must consume 1,200 mg of calcium a day. Dairy products, almonds, kale, broccoli, salmon with bones and soy products like tofu are a good natural sources of the nutrient.
The body needs to have adequate amount of vitamin D to absorb calcium. Consume oily fish like tuna and sardines, egg yolks and fortified milk to supplement your body with vitamin D. Exposure to sunlight can also increase vitamin D levels. Exercises such as walking, playing tennis, jogging and climbing stairs can help build strong bones and reduce the rate of bone loss.

Treatment

* Bone density test: This test is recommended to check bone health. The patient's bone mineral density (BMD) is compared with a healthy 30-year-old and the bone density is measured in different ranges.
* Bone-boosting drugs: People diagnosed with osteoporosis may be prescribed a biophosphonate like actonel, boniva, fosamax, or reclast. The risk of fracture and bone mass loss reduces with these medicines.
* Estrogen agents: Hormonal change after menopause  causes loss of bone mass. Women with weak bones may be advised to undergo hormone replacement therapy. Evista, an oral sedative, has bone-strengthening effects. A synthetic parathyroid hormone, forteo, can be recommended to some. This has to be injected every day.
* A biological alternative: Prolia, a lab-produced antibody, is prescribed to women whose bodies have not responded to other drugs. The drugs mentioned above must be ingested under your doctor's guidance only.

(The author is a consultant orthopaedic, Fortis Hospital)