Bones are porous. They consist of a flexible porous framework of a protein substance known as collagen, plus a lot of calcium phosphate that serves as a mineral filler.  Bone degeneration has many causes.  It can be brought about by[10]:

• An autoimmune disease (e.g., rheumatoid arthritis, osteoarthritis)

• The lack of a a key enzyme

• A more pressing need for bone calcium elsewhere in the body

• A medication such as synthroid (used for underactive thyroid)

which can lead to osteoporosis.

It is a serious public health problem for more than 10 million Americans, 80% of whom are women. Another 34 million Americans have osteopenia, or low bone mass, which precedes osteoporosis.  According to a recent analysis of bone scans done by Fonterra in Asia[8], the results show that:

• From the age of 35 years old, one in three people in Singapore could be at risk of developing osteoporosis

• The risk increases dramatically for men and women in their 50s, with nearly 45 per cent of Singaporeans at risk

• By the age of 25 year old, almost 20 per cent of Singaporeans were vulnerable to the disease

Breaking A Bone

A bone fracture is the clearest — and most often the only — indication of osteoporosis. Because osteoporosis, 1 in five women breaks hip before the age of 75. Studies also show that 45% of 50-year-old women will fracture a hip, vertebra, forearm, wrist or other bone at some point in the remaining years of their lives. For men, the chances of breaking a bone increase greatly beyond age 75.

For young kids, breaking a bone is usually a non-event and eventually get repaired later. For older adults, breaking a bone can be a serious event, resulting in complications that severely reduce their independence or may even turn fatal.  Therefore, Dr. Ethel Siris recommends you to take a bone density test once you're 65 years old.  Also, if you have high risks of osteoporosis, you probably should take the test at an earlier age—60.

Several technologies can assess bone density.  For example, the DEXA (dual energy x-ray absorptiometry) scan or ultrasound will give you a number called a T-score, which represents how close you are to average peak bone density. The World Health Organization has established the following classification system for bone density:

• If your T-score is –1 or greater: your bone density is considered normal.

• If your T-score is between –1 and –2.5: you have low bone density, known as osteopenia, but not osteoporosis.

• If your T-score is –2.5 or less: you have osteoporosis, even if you haven't yet broken a bone.

Risk Factors

Generally speaking, your risk of osteoporosis and fracturing depends on your bone health. Bone health is a result of how well your skeleton developed during childhood and early adulthood and how much bone was present at the time of your peak bone mass, usually between the ages of 30 and 40. Therefore, some people consider osteoporosis as a pediatric disease that originates in pubescence and adolescence and it is the cumulative outcome of a lack of anti-gravity exercise, calcium, vitamin D, and other factors.[11] Its prevention begins in childhood and continues throughout life.

Uncontrollable Risk Factors

• Sex — 80% of all Americans with osteoporosis are women. Especially, it is most common in women after menopause, when it is called postmenopausal osteoporosis. Women are also 3 times as likely as men to break a bone because of osteoporosis.

• Age — The older you are the more likely you are to get osteoporosis and fractured bones.

• Heredity — Family history is a strong predictor of low bone mass, but it's not a very good predictor of your chances of fracturing due to osteoporosis.

• Race — Whites and Asians have the highest risk of osteoporosis. Blacks have the lowest risk of osteoporosis, and Hispanics and American Indians appear to have an intermediate risk.

• Body size — Because weight increases the load on your skeleton, your bones compensate by growing stronger. Petite women with a thinly boned frame are at greater risk of osteoporosis.

• Exposure to estrogen or testosterone — The greater your exposure to estrogen over your lifetime, the lower your risk of osteoporosis. In men, a delayed onset of puberty after age 16 can shorten their lifetime exposure to bone-building hormone testosterone and lower their peak bone mass.

Risk Factors You May Influence

• Childbearing — There is an old saying that predicts losing "a tooth a child." Particularly in the latter months of pregnancy, the mother's skeleton will lose bone if she is not taking enough calcium.

• Medications — Certain medications are known to accelerate bone loss and thus increase your risk of osteoporosis.

  • Corticosteroid medicines — For example, prednisone, cortisone, prednisolone and desxmethasone used for treating asthma, rheumatoid arthritis and other inflammatory conditions.

  • Anticonvulsants — For example, phenobarbital, phenytoin, and carbarmazepine used to control seizures.

  • Thyroid medicine — For example, levothyroxine can cause hyperthyroidism, leading to accelerated bone loss.

  • Diuretics — For example, furosemide, bumetanide, ethacrynic acid and torsemide used to prevent fluid buildup. However, other diuretics, called thiazides, may actually help your body retain calcium.

  • Other medications — For example, heparin used to prevent blood clots; leuprolide acetate and nafarelin used to suppress blood levels of estrogen and testosterone.

• Medical conditions — Certain medical conditions can slow bone formation or speed up bone resorption.

  • Endocrine disorders —Problems with endocrine glands associated with bone growth and maintenance (e.g., Hypogonadism, Hyperparathyroideism, Cushing's syndrome and Type 1 diabetes) can disrupt your bone-remodeling cycle.

  • Disorders of the stomach, intestine and liver — For example, Crohn's disease, celiac disease, primary biliary cirrhosis and lactose intolerance.

  • Rheumatoid arthritis —RA prevents people from being physical active, increasing their risk of bone loss.

  • Amenorrhea —Absent or irregular menstrual cycles in women of childbearing age may be a sign of low estrogen levels.

• Surgical procedures —For example, organ transplants treated with immuno-suppressant medications; gastric surgery or intestinal bypass surgery which may cause you to less able to absorb calcium and vitamin D from the food.

• Prolonged bed rest

Controllable Risk Factors

• Not getting enough calcium and vitamin D in your diet

  • However, if you take calcium without co-minerals, it can still lead to osteoporosis[10].

• High-acid eating[4,6,7,10]— Diets rich in animal protein, including meat and dairy, add acid to the blood.  This acid accelerates osteoporosis by depleting bones of calcium, phosphorus, and sodium.

• Excessive weight loss and dieting

• Not getting enough physical activity

• Smoking

• Excessive alcohol use — Alcohol is toxic to bone-building osteoblasts. Meanwhile, bone-removing osteoclasts may be stimulated by alcohol, increasing bone loss.

• Eating a high amount of refined flour products and sweets[5]

• Not eating enough vegetables, especially greens[5,10]

• Not including enough good-quality fats in the diet[5]

• Insufficient protein in the diet[5]

Try More

Building strong bones starts from childhood. Weight-bearing exercise is vital, and getting out in the sunshine lets your body produce vitamin D, which helps turn the calcium you eat into bone. Dairy foods and oily fish also provide vitamin D. Vitamin K and several other minerals are also important. To build strong bones, try eating more of the following:

• [2]: kale, onions, green beans, spinach, cashew nuts, chicken, cheese, peas, arugula, soy, sea vegetables, figs, cherries, lettuce, olive oil, chard, tea

• [3]: yogurt (fat-free, low-fat), milk (fat-free, reduced-fat), tofu with calcium, sardines (with bones), wild salmon (with bones), soybeans, frozen yogurt (fat-free, low-fat), low-fat ice cream, calcium-fortified whole grain waffles, bok choy, white beans, kale, broccoli, almonds.

• [4]: predominantly fruits, vegetables, legumes, and soy products-with little, if any, meat, dairy, and fish and a modest amount of breads, cereals, and pastas

• [10]: food high in alkaline particles and mucilage—partially cooked or raw potatoes, celery, and gelatin sprinkled on foods or in drinks.

Also read these important articles:

1. Building Strong Bones

2. Acid-Alkaline Balance

3. Health Effects of Element Fluorine (F) (Travel to Health)

   • High amounts of fluoride over several years can cause brittle bones.

References

1. Mayo Clinic on Osteoporosis edited by Stephen Hodgson, M.D.

2. The Top 100 Health Tips by Janet Wright.

3. Food Cures by Joy Bauer with Carol Svec, MS, RD, CDN.

4. Building Bone Vitality by Amy Joy Lanou, Ph.D. and Michael Castleman

5. The Wholefood Guide to Strong Bones by Annemarie Colbin, Ph.D.

6. The Swiss Secret to Optimal Health by Thomas Rau, M.D.

7. Acid-Alkaline Balance (Travel and Health)

8. Singapore News

9. Building Strong Bones

10. The Acid alkaline Balance Diet by Felicia Drury Kliment

11. Risk Factors of Osteoporosis (in Chinese)

    • Smoking, Drinking, Long-term use of steroids, Hyperparathyroidism, Thyroid diseases, Chronic lung disease, Anorexia, Diabetes, Impaired renal functions, Gastrointestinal diseases, Rheumatoid Arthritis, Lupus Erythematosus, Ankylosing spondylitis

12. A new therapy for osteoporosis: Romosozumab