Twenty percent of Asian women older than 50 have osteoporosis and over 50% of them are at risk. Asian American women are at a higher risk for developing osteoporosis compared with Caucasian women. The main reasons for this disparity are due to low-dairy Asian diets (90% of Asians are lactose intolerant) and the fact that Asian women generally have smaller frames. These two factors both lead to the development of significantly less bone mass.
Derived from Latin, osteoporosis literally means “porous bone”. Osteoporosis is the process by which bone turnover, or the ratio between the breakdown and regeneration of bones is increased. About 10-30% of the skeleton is remodeled in this bone turnover process. The balance of the body’s hormones and other chemical factors control the rate of this process. Older women are at a greater risk of osteoporosis than younger women or the average man because the estrogen reduction after menopause leads to the imbalance of hormones, increasing the rate of bone breakdown.
There are two main types of osteoporosis: type I and type II.
Type I (high turnover): this occurs in 5-20% of women, mostly between the ages of 50 and 75. It is usually caused by the sudden decrease in estrogen levels after menopause, resulting in the rapid breakdown of calcium from the bones. This type is significantly greater in women than in men.
Type II (low turnover): this occurs in everyone to some degree. It is when the process of formation and resorption of the bone are no longer coordinated and the breakdown of the bone eventually overcomes the rebuilding of the bone. This type affects both women and men. Older women can have both types.
The actual effects of osteoporosis are greatly dependent on amount of calcium in the skeleton. A person with dense bones will likely never reach the point where osteoporosis is a danger, however, a person with low bone density could very easily develop osteoporosis despite losing only a small amount of calcium.
Some of the other risk factors for osteoporosis include: having a family history of osteoporosis, being thin, being a smoker, corticosteroids use, hyperthyroidism and early menopause. Women are five times more likely to get it than men and the following events are associated with estrogen deficiencies, putting women at a greater risk for osteoporosis: menopause, removal of ovaries, missed periods, never giving birth.
Symptoms
Unfortunately, osteoporosis is usually only detected after a fracture occurs, most likely in the hip, forearm, or vertebra. In the later stages of the disease, disfigurement will develop: the “dowager’s hump” and loss of height occur due to spinal collapse.
Prevention
Get your calcium. The amount of calcium in the bloodstream is your body’s main priority. If the body senses a loss in calcium in the blood, the process by which calcium is taken from the bone and deposited back into the bloodstream is increased—leeching your bones of calcium. Women of all ages should take 1,000 to 1,500mg of supplemental calcium daily.
Drink milk or soak up the sun. Vitamin D is a hormone-like vitamin that is essential for the absorption of calcium into the bone and for normal bone growth. Lower levels result in a decrease in calcium absorption and lead to the increase of bone resorption, or bone loss.
Don’t smoke, and drink alcohol in moderation. Women over the age of 65 who drank 1-2 drinks of alcohol weekly had higher bone density than non-drinkers. Excessive drinking, however, leads to brittle bones.
Exercise. The best exercises for preventing osteoporosis are walking, jogging, stair-climbing, dancing and strength training. Exercises specifically targeting the back will help prevent fractures. For older women, low-impact exercises that improve balance and strength like yoga and tai chi will decrease the risk of a serious fall.
Eat fat. It sounds unappealing but eating fat helps protect bones. In one study, women who ate more fat in their diet were better able to absorb calcium than women who were on a high-fiber, low-fat diet. Avoid saturated fats and opt for fats found in fish or olive and canola oils.
Treatment
While there is no cure for osteoporosis, medications are available to promote the reformation of bones and slow the effects of bone density loss:
Biphosphonates: these drugs block resorption and slow the rate of bone remodeling, but they cannot rebuild bone. However, because resorption and reformation occur as a continuous process, this may eventually lead to reduced bone formation.
SERM (selective estrogen receptor modulator): Like Biphosphonates these are also used to slow the resorption process, generally used for preventing and treating postmenopausal osteoporosis.
Anabolic Drugs: An injectible low-dose of the parathyroid hormone. It has been shown to effectively restore bone and thus preventing fractures. It is used for men and postmenopausal women with osteoporosis.
Estrogen Therapy: Recommended only for women at a high risk of osteoporosis and used to prevent postmenopausal osteoporosis.
