Osteoporosis, a bone disease affecting seniors and menopausal women is a growing concern causing over 8.9 million fractures each year worldwide (Johnell et al, 2006). In India, there are an estimated 25 million people who may be suffering from osteoporosis. Both men and women are affected with the disease at an earlier age compared to the West (Malthora and Mittal, 2008).
|Defining the Disease |
Osteoporosis is a disease of the bone where density progressively decreases over the years. Those who suffer from the condition are at high risk of falling and injuring themselves severely resulting in hip fractures. Worldwide, approximately 28-35% of people, over 65 years and above fall annually (Blake et al, Prudham, and Campbell et al) and the incidence rises to 32-42% in seniors over the age of 70 (Tinetti et al, Downton & Andrews, and Stalenhoef et al).
|Is It Genetic? |
There are several causes of osteoporosis. Although certain factors such as age, medications and disease and lack of essential vitamins and mineral for bone development are at the forefront of why osteoporosis occurs, there is also the belief or theory that genetics play a role. In women, who are at a higher risk of contracting the disease especially at an older age, the prevalent threats include sedentary lifestyle, cigarette smoking and an excessive intake of alcohol.
|Studies that Support Osteoporosis is Hereditary |
There are several studies and researches that point to the DNA makeup as one of the culprits when it comes to the bone disease. A senior person whose family history includes bone and hip fractures has a bigger risk of going through or suffering from the same condition. In addition, those with a small body structure and frail bones are at a higher risk of lower bone density even at an early age.
Ralston in the study, ‘Genetic Determinants of Osteoporosis’ explained the genes and genetic variants that are linked to the condition and the management of bone mass. The research also identified the genetic markers in assessing fracture risks.
Another study by Estrada et al identified 56 genetic variants (bone mineral density loci) and determined 14 loci are linked to fracture risks. It gave a better understanding of the genetic structure of bone mineral density and how it affects fracture susceptibility.
Twin and family studies have also demonstrated that 50% to 85% of the differences in BMD is due to genetic variances (Peacock et al, 2002).
|Race and Ethnicity |
Another factor is racial makeup, with Caucasians or Asians more likely to get osteoporosis than other ethnic groups. Cauley in her study, ‘Defining Ethnic and Racial Differences in Osteoporosis and Fragility Fractures’ revealed that race and ethnicity have some bearing on the incidence of fractures, with the highest rates recorded in white women. Among men, there is not much variance with other ethnic and racial groups, but the incidence of bone fracture is higher in white men than those of Asian or African descent. (Cummings et al, 2002).
Hochberg in his study, ‘Racial Differences in Bone Strength’ affirms that fracture risk is higher among whites than blacks in the US. This was due to the greater bone strength (mass, porosity and composition as well as damage) among blacks compared to whites. Stronger bones in blacks are attributed to the development of a sturdier skeleton and lower bone loss during adulthood.
|Management of Osteoporosis |
Osteoporosis is strongly linked to genetics, but its incidence can be prevented. Loss of bone density can be averted by consuming adequate amounts of calcium and vitamin D for stronger bones. Other methods include engaging in weight-bearing exercises, and avoiding certain drugs that affect bone loss. Women also have the option to start estrogen replacement therapy which can reduce bone density.Osteoporosis is a disease of the bone where density progressively decreases over the years. Those who suffer from the condition are at a high risk of falling and injuring themselves severely resulting in hip fractures. Worldwide, approximately 28-35% of people, 65 years and above, fall annually (Blake et al, Prudham, and Campbell et al) and the incidence rises to 32-42% in seniors over the age of 70 (Tinetti et al, Downton & Andrews, and Stalenhoef et al).
[idea]Osteoporosis affects 200 million women worldwide[/idea]
Osteoporosis is a condition in which the bone mass is lowered, resulting in weak bones that are prone to fractures. This condition is often associated with people over 50 years of age, especially in women post menopause. The propensity for people with osteoporosis to fracture their bones is alarmingly high, with estimates stating that every 3 seconds there is an osteoporotic fracture that occurs across the world.
There are no symptoms associated with the condition until there is a fracture, which is a painful indicator of poor bone health. The brittleness of the bone and the higher chance of fracture forces older people to remain in their homes, worrying about possible falls that could lead to a fracture. This is a significant psychological symptom associated with the condition.
Children with osteoporosis also exhibit poor bone health which not only increases their risk for fractures but could also stunt their growth.
This World Osteoporosis Day 2016, there is a need to explore causes for this condition in order to provide effective solutions. The theme for this year’s World osteoporosis Day 2016 is “Love your bones, Protect your future”
Gluten intolerance is a condition in which the body is unable to metabolize gluten, found in wheat, barley and rye. The condition is caused due to a mutation in the gene HLA DQ and it leads to a range of gastrointestinal symptoms that include nausea, diarrhea, bloating, abdominal cramps and pain. There are certain other extra-intestinal symptoms associated with gluten intolerance that include depression, inability to focus, foggy mind and – possibly osteoporosis. In a gluten intolerant individual, the body is unable to digest the gluten in the diet and this triggers an autoimmune condition where the body’s immune cells attack the lining of the small intestine, where important nutrients like calcium are absorbed. This leads to malabsorption and the resultant lowering of bone density and osteoporosis.
[idea]Gluten intolerance found in 10% of the population[/idea]
Studies have shown that eating a gluten free diet will aid in regaining bone mass, both in children as well as in adults. The tricky part is to identify the condition before it leads to considerable loss in bone density or a fracture.
In a study on school children in Ludhiana, 6 children were identified to have gluten intolerance and none of them showed any other symptom, including gastro intestinal, except stunted growth.
It is difficult to assess intolerance in children based on symptoms as they rarely understand the enormity of the situation and will fail to acknowledge it. The process of eliminating specific food from the diet is also difficult as it can take many months before there is a clear association that is found. Instead gene testing affords a quick and cost-effective solution that detects the mutation in the HLA DQ gene, allowing dietary modification that will limit the risk of osteoporosis.
This World Osteoporosis day, get tested for gluten intolerance and safeguard bone health.