Only Prevention, No Cure
While it is true that bones become progressively fragile with age, structural weakening begins much earlier — usually in your 20s and 30s — and almost always goes unnoticed. Unlike the rest of our body which groans and protests every time it is not feeling good, your skeleton will send no warning signals till it is too late.

After all, aren’t they just inert stockpiles of calcium? “Far from being a lifeless tissue, our bones are living and constantly build and rebuild themselves,” explains Dr R. Handa, consultant rheumatologist, All India Institute of Medical Sciences, Delhi and secretary-general of the Osteoporosis Society of India.

“Peak bone mass is built between the ages of 25 and 35. If you are getting enough calcium and exercise, you build up a good bone balance and strengthen your bone matrix. It is what you gain during this period that carries you through life,” explains Dr Naveen Talwar, a consultant orthopaedic surgeon affiliated with DOF and Ganga Ram Hospital, Delhi.

“Once you are over 35, you lose more bone than you gain, meaning that your skeletal framework erodes if you don’t take constant care of your bone health,” says Dr Jha. In fact, in women who are fast losers, the bone loss can be as high as five per cent per year.

While manifestation of osteoporosis, also referred to as the brittle-bone disease, usually occurs only after menopause in women, how you take care of your skeletal structure and bones in your 20s and 30s determines whether or not you are likely to be affected by it.

“The best time to think about protecting yourself from this dreaded disease is now, because though osteoporosis is largely preventable, there is no complete cure available for it,” warns Dr Chopra. For young women who do not want to spend their later years in pain and misery, here is a four-step preventive programme. However, all four steps must be practised in unison to snuff out the problem at its roots.

Eat A Balanced Diet
A healthy, balanced diet is the key. Avoid crash diets or starving yourself. Eat at least three meals a day with plenty of fresh vegetables and fruits. Pay special attention to calcium-rich foods. Most women and young girls typically consume less than half the amount of calcium required. If you have difficulty getting enough calcium from the foods, pop calcium supplements to make up the difference. Apart from calcium, Vitamin D and K, potassium and magnesium are also needed by the body to maintain good bone health.

Keep In Shape
“Physical activity is very important to boost bone building,” says Dr Jha, “because it provides stimulus for bone mass to form.” Apart from this, exercising also improves balance and co-ordination. Weight- bearing exercises, where the bones and muscles work against gravity, effect bone mass formation positively. Dancing, jogging, stair climbing, aerobics and hiking are all examples of weight-bearing exercise.

“The best exercise for your bones is brisk walking for about 40 minutes at least five times week or walking six to eight km for about 30 minutes on a treadmill (without incline) at least four times a week,” adds Dr Talwar.

Maintain A Healthy Lifestyle
“You may have heard this a number of times from your parents and your doctor, but it is so important that it is worth repeating: Stop smoking,” advises Dr Chopra. Postmenopausal smokers have lower oestrogen levels than non-smokers and smokers tend to have an earlier menopause than their non-smoking counterparts, contributing to increased osteoporosis and fracture risk.

Consume alcohol rarely if you must. Reduce your intake of tea and coffee to the bare minimum. “And totally avoid aerated drinks,” says Dr Handa.

Get Tested Early
“I would recommend that you get a bone mineral density (BMD) test at least once before the age of 30,” says Dr Chopra. A BMD test is the only way to diagnose osteoporosis and determine your risk for future fractures. “During your next check-up, ask your GP or gynaecologist to schedule one for you,” says Dr Jha.

Taking a test can tell you if you need to take precautions early or start medication. “Although there is no cure for osteoporosis, currently bisphosphonates (Alendronate and Risedronate), Calcitonin, etc. are approved for the prevention and treatment of osteoporosis. But consult your doctor before starting on any supplements,” says Dr Chopra.

Osteoporosis is a chronic disease and ignorance about it — whether on your part or your doctor’s — is a huge risk. Instead of waiting for the first twinge of pain in your back or a hairline hip fracture to make its appearance, act now and prevent this ‘silent thief’ from depleting your bone bank balance.

Additional inputs by Dr Avnish B Chopra

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