NON PHARMACOLOGI MANAGEMENT OF OSTEOPOROSIS
Dr.Kiran Adam
Some of the most important aspects of preventing osteoporosis include eating a healthy diet, getting exercise and avoiding smoking
• Diet- An optimal diet for bone health involve making sure you get enough protein and calories as well as plenty of calcium and vitamin D ; which are essential in helping to maintain proper bone formation and density.
• Calcium intake –experts recommend that premenopausal women and men consume at least 1000 mg calcium per day. This includes calcium in foods and beverages plus supplements (eg.pills) which you might need if you don’t get enough calcium from your diet. Post-menopausal women should consume 1200 mg calcium per day (total of diet plus supplement).
• The main dietary sources of calcium include milk and other dairy products, such as cottage cheese, yogurt and hard cheese, green vegetable.
• If you don’t get enough calcium through your diet, your health care provider, Rheumatologist might suggest supplements (calcium carbonate or calcium citrate).
• Supplements are often recommended for women since they are at higher risk of developing osteoporosis and they often don’t consume enough through foods and beverages.
• Vitamin D-experts recommend that men over 70 yrs and post-menopausal women (i.e women who no longer have monthly periods). Mild supplanted with vitamin D is a primary dietary source of vitamin D.
• Exercise-exercise may decrease fracture risk by improving bone mass in premenopausal women and helping to maintain bone density in women who have been through menopause .furthermore exercise can strengthen your muscles, improve your balance and make you less likely to have a fall that could lead to fracture or other injury.
• The benefits of exercise are quietly loss if you stop exercising. Finding a regular exercise regimen that you enjoy doing improves your chances of keeping up the habit over the long term.
• Tobacco use –tobacco use is detrimental to the skeleton. The nicotine and cadmium found in cigarettes can have toxic effects on bone cells, causing direct harm to the skeleton. Smoking may also indirectly harm bone by lowering body weight, as well as reducing the amount of calcium absorbed by intestine and altering the way the body processes vitamin D.
• Smoking- avoiding smoking or quitting smoking is strongly recommended for bone health because smoking aggregates is known to speed bone loss.One study suggested that women who smoke one pack per day throughout adulthood have 5 to 10 % reduction in bone density by menopause, resulting in an increased risk of fracture.
• Alcohol intake-heavy drinking is a health risk for many reasons, including the effects on bones. Chronic alcohol use can dramatically affect bone health and increase risk of osteoporosis later in life. Alcohol also affects the liver which is important for activating vitamin D and calcium absorption.
• Avoiding falls- falling is significantly increased risk of osteoporotic fractures in older adults. The majority of osteoporosis-related fractures results from falls. Among the numerous risk factors for falling, the most important appear to be muscle weakness, problems with vision and balance, and a personal history of falling. Other medical and environmental risk factors for falls are listed in table. In addition to exercise, there are a number of fall-prevention measures that can be implemented to reduce the risk of falling and subsequent fracture. These include evaluation neurologic issues, assessing prescription medication for side effects that can affect balance and stability. Checking vision and hearing and correcting any problems, and providing individual with home safety.
• The prevention of falls is of crucial importance in the very elderly and the strategies to decrease the most common risk factors for falling are recommended.
• Preventing falls in elderly people have been suggested, such as muscle strengthening and balance retraining, home hazard assessment and modification, withdrawal of psychotropic medication. Assistive devices such as chair commode, walker etc.
