How to prevent osteoporosis
Bones of the Capital
How Muscovites can prevent osteoporosisEkaterina Pichugina, "Moskovsky Komsomolets" from July 10, 2012
Doctors call osteoporosis a "silent epidemic" or a "silent killer" – a disease in which bones become brittle and break easily. Today, osteoporosis is one of the four main causes of death in the world. It affects every third Muscovite over the age of 50 and every fifth Muscovite of her age. About 40% of people of this age are at risk.
Readers of MK were able to learn about the danger of osteoporosis, how to treat, and most importantly, prevent this disease during a direct line with the head of the Osteoporosis Prevention Department of the Federal State Budgetary Institution of the State Research Center for Preventive Medicine of the Ministry of Health and Social Development of the Russian Federation, Irina Anatolyevna Skripnikova.
– My mom is over 60... How often do I need to undergo preventive examinations (and which ones) in order to detect the disease in time? Where can I apply for an examination and consultation, we live in the north of Moscow?
– It is advisable for women to conduct the first examination to detect osteoporosis (to do X-ray densitometry) immediately after menopause. You can be examined in many centers and institutions of the city of Moscow (for example, there is a list of them on the website of the Association for Osteoporosis www.osteoporoz.ru ) and, in particular, at our Center for Preventive Medicine. Unfortunately, this survey is not included in the system of state guarantees and is carried out almost everywhere on a paid basis. Perhaps there are osteoporosis prevention offices in your area where you can get examined for free. On the main page of this site there is a calculator (FRAX) for calculating the ten-year risk of fractures associated with osteoporosis, where, without taking into account the bone mineral density index, you can assess your individual fracture risk.
– Why do women in the pre-menopausal and menopausal periods often have hip fractures?
– The frequency of hip fractures increases significantly in women in the late postmenopausal period, after 65 years. Bone tissue is divided into compact and trabecular. The femoral neck is dominated by compact bone, which begins to thin out by the age of 70. At this age, muscle strength decreases, coordination deteriorates and the tendency to fall increases. Elderly people usually fall on their side, which leads to a fracture of the femoral neck. But in early postmenopausal women more often break the bones of the forearm: in comparison with men, women are less trained, they are worse grouped when falling and often fall on their hands.
Along with low bone mass, the tendency to fall is one of the important risk factors for fractures. This tendency can be assessed using the simplest functional tests. For example, this: get up five times and sit on a chair without help as quickly as possible. If the exercise is performed for more than 10 seconds, the risk of falls is high. Or, for example, take eight steps in a straight line, putting your feet one to the other "in single file". If the balance is lost, the risk of falls is high. Inability to stand on one leg for 10 seconds increases the risk of fracture by 9.11 times.
– Is it true that sesame has more calcium than cottage cheese and fish? And what should calcium be taken with for better absorption?
– Sesame really has more calcium than other foods. However, it is not well understood how much this calcium is absorbed. And it is best absorbed from dairy or fish products, so the emphasis in the diet should be done just on them. In summer, it is useful to add vegetables: a lot of calcium is contained in cabbage, spinach, green onions. The absorption of calcium is affected by sufficient intake of vitamin D.
– I read that the more calcium there is in bones, the more often they break. And so that they do not break down, you do not need calcium, but various trace elements. It's true?
– If you want to learn something about the disease, you need to use scientific literature, not popular, where the truth may be somewhat distorted. Today it is known that calcium is the only mineral that affects the remodeling of bone tissue. The effectiveness of other trace elements has not been proven. Calcium affects bone metabolism in conjunction with vitamin D, which improves the absorption of calcium in the intestine.
– I was recently diagnosed with osteoporosis. The doctor prescribed medications, said what foods to eat, recommended physical exercises. But I am very afraid of fractures. Is this inevitable?
– Prevention of fractures associated with osteoporosis should be comprehensive. Along with the main medications prescribed by the doctor and which should be taken regularly, it is necessary to eat rationally (eat foods rich in calcium), lead an active lifestyle, walk a lot, do gymnastics and avoid falls. All this will help to avoid complications of osteoporosis – fractures.
– Does calcium remain in the kidneys when using calcium and vitamin D3 preparations? What consequences can there be with an excess of calcium?
– Today there is no convincing evidence that the use of calcium and vitamin D preparations contributes to the formation of kidney stones. Urolithiasis is a genetically determined disease, and its development is influenced by other factors. There are standards for the consumption of calcium and vitamin D in different age periods, which you can find on the websites: www.osteoporoz.ru , www.osteoporos.ru . For a postmenopausal woman, two calcium D3 tablets containing 1000 mg of calcium and 800 international units of vitamin D completely cover the daily requirement. It is not recommended to exceed this amount.
– Who has osteoporosis more often – thin or overweight? Is there any pattern here?
– It is well known that low body weight is a risk factor for osteoporosis, however, osteoporosis occurs in more than 50% of overweight people. Currently, research is underway on the effect of body composition (fat and fat-free mass) on the bone tissue. It seems that adipose tissue itself has no effect on bone mass. Some products of adipose tissue metabolism contribute to a decrease in bone mass. Osteoporosis can occur in both thin and overweight people.
– My mother was diagnosed with osteoporosis, but no treatment was prescribed, since she has kidney failure and pills for osteoporosis are contraindicated. What can still be taken by the kidneys?
– The drug of choice in this situation is the active metabolites of vitamin D (for example, alpha D3 or ethalpha). The dose should be determined by the attending physician, depending on the degree of renal insufficiency. You can consult with your doctor about innovative therapy with denosumab, which is safe in this group of patients.
– I do a lot of sports: I swim, run in the morning. Is it true that people with an active lifestyle are less likely to suffer from osteoporosis?
– Yes, it is. But this does not mean that people who do sports are 100% insured against osteoporosis, because it is a genetically determined disease. In order to diagnose osteoporosis in time, it is necessary to conduct X–ray densitometry for women after 65 years, and for men after 70 years. If there are risk factors for osteoporosis, such as previous bone fractures, hip fractures in parents, long experience of smoking or alcohol abuse, concomitant diseases or taking drugs that contribute to the development of osteoporosis, then densitometry should be done at an earlier age.
– What are the modern methods of treating osteoporosis?
– With the help of bisphosphonates, strontium salts, it is possible to delay the progressive loss of bone mass and prevent fractures. But science does not stand still. Now innovative drugs with a clearly directed effect on certain parts of bone metabolism (monoclonal antibodies) are appearing on the Russian market, which help strengthen bones and reduce the risk of fractures. But in any case, the attending physician should prescribe therapy after evaluating all indications and contraindications.
Portal "Eternal youth" http://vechnayamolodost.ru10.07.2012