An osteoporotic fracture occurs every 3 seconds worldwide. One third of women and one fifth of men will experience a fracture in their lives after age 50. Osteoporosis (osteoporosis) is a systemic bone disease caused by multiple causes of decreased bone density and bone mass and destruction of bone microarchitecture, resulting in increased bone fragility and thus susceptibility to fracture.
Osteoporosis is divided into two major categories: primary and secondary. Primary osteoporosis is divided into postmenopausal osteoporosis (type I), senile osteoporosis (type II) and idiopathic osteoporosis (including adolescent type). Postmenopausal osteoporosis generally occurs within 5 to 10 years after menopause in women; senile osteoporosis generally refers to osteoporosis occurring after the age of 70 years in the elderly; and idiopathic osteoporosis mainly occurs in adolescents, the cause of which is unknown. There are no signs or symptoms until a fracture occurs, so it is often referred to as a “silent disease”. What should we do to prevent it during our lifetime to stay away from osteoporosis? Let’s listen to the advice of experts.
1. Pay attention to nutrition during pregnancy and seize the opportunity of bone development
There is a direct relationship between early stunting caused by insufficient nutritional intake during pregnancy and reduced peak bone mineral content and increased risk of hip fracture in adulthood. Therefore, it is important to start “planning ahead” even before the baby is born.
What to take: Good nutrition, including 3 types of substances: adequate calcium, vitamin D and protein. Of these, the micronutrient of pregnancy that is most closely related to the development of your child’s bones is vitamin D.
The National Health Service (NHS) recommends that mothers-to-be should take 10 micrograms (400 IU) of vitamin D a day during pregnancy and breastfeeding. it is recommended that multivitamin supplements should be taken for vitamin D, and that no vitamin A (excessive retinol may be harmful to the fetus) should be taken.
2. Shape bones during adolescence and build up bone mass for the future
Primary goal: to achieve maximum potential for peak bone mass.
Again, calcium, vitamin D and protein are the most important nutrients for perfecting bone health in children and adolescents.
After the age of 2 years, 80% of children’s dietary calcium intake comes primarily from milk and related dairy products.
3. Maintain bone mass and curb bone loss
Primary goal: to avoid premature bone loss and maintain healthy bones.
In fact, most people can maintain bone mass with a normal diet, but they need to avoid some bad lifestyle practices that may accelerate bone loss.
Factors that may have a negative impact on bone health are as follows
Alcohol: For both men and women, more than two units of alcohol per day may increase the risk of fragility fractures, while more than four units per day will double the risk of fractures.
2, caffeine
3, undernutrition and overnutrition
4. Elderly people pay attention to fight vulnerability and reduce fall fractures
Main goal: Prevention and treatment of osteoporosis.
Main recommendations for the elderly
1. Screening is recommended for people who are at risk of developing vitamin D deficiency, but not for people who are not at risk.
2. Adults aged 50 to 70 years or over 70 years need at least 600 and 800 international units of vitamin D per day, respectively.
3. Adults who are vitamin D deficient should supplement with 50,000 IU of vitamin D2 or vitamin D3 per week for 8 weeks, or the equivalent of 6,000 IU of vitamin D2 or vitamin D3 per day.
Prevention of muscle atrophy is important because it reduces the risk of falls and associated injuries, including the risk of fragility fractures by.
1. The optimal dietary protein intake is 1.0-1.2 g/kg body weight per day, with at least 20-25 g of high-quality protein per main meal.
2. To maintain a serum concentration of 25(OH)D above 50 nM/L (20 ng/mL), the daily intake of vitamin D is 800 IU.
3.Calcium intake is 1000 mg per day.
4. Regular physical exercise/exercise 3-5 times a week, with protein supplementation near the end of exercise.
While it is important to adopt habits that are beneficial to bone health at all stages of life, the use of pharmacotherapy in patients at high risk of fracture is critical to prevent fractures. Common types of pharmacotherapy include: bisphosphonates (alendronate, risedronate, ibandronate, zoledronic acid); denosumab; hormone replacement therapy; SERMs: raloxifene; strontium ranelate; parathyroid hormone: teriparatide and PTH (1-84).
The biggest challenge is that patients do not take their osteoporosis medications as prescribed. Unfortunately, up to half of the patients stop treatment after one year. Patients should be encouraged to continue taking their medications as prescribed and to consult with their physician if they experience any problems while taking their medications.
Strengthening exercise and ensuring adequate calcium intake from adolescence, as well as preventing and actively treating various diseases, especially chronic wasting diseases with malnutrition and malabsorption, preventing various gonadal dysfunctional diseases and growth disorders; avoiding long-term use of drugs that affect bone metabolism, etc., can try to obtain ideal peak bone mass and reduce the risk of osteoporosis in the future. Calcium supplementation in adulthood is a basic measure for the prevention of osteoporosis and cannot be used as an osteoporosis treatment drug alone, but only as a basic adjunct.
Prevention in adulthood mainly includes two aspects
1, try to delay the rate and extent of bone loss, for postmenopausal women, the recognized measure is early supplementation of estrogen or estrogen and progestin combination.
2. Preventing fractures in patients with osteoporosis and avoiding risk factors for fractures can significantly reduce the incidence of fractures.