The word 'osteoporosis' comes from the Greek words 'osteo' meaning bone and 'poros' meaning porous. It is therefore a disease characterised by porous bones. This means that they are full of holes making them weak and more likely to break. The disease affects approximately one in three women and one in every twelve men in Britain. It generally affects people over the age of 50. It can run in families.

The early stages of osteoporosis present no symptoms at all. Only in the advanced stages of the disease do the symptoms start to appear. These include pain in the back, height loss and a bent posture sometimes called a 'dowagers hump', which is caused by the bones of the spine being crushed together to form a deformed and curved shape. Fractures of the wrist, hip and spine are common and can be caused by a slight knock or bump or by bending, lifting or even coughing and sneezing.

Causes

Throughout life, old bone is continually replaced by new bone. Up to the age of about 35, bone mass continually increases and bones become as strong and healthy as they are ever likely to be. After the age of 35, more bone is lost than is replaced therefore bone mass starts to decrease. This is a natural ageing process but if bones become too porous, osteoporosis can occur.

Research has shown that in women, the female hormone oestrogen helps to keep bones strong and healthy. Around the time of the menopause, oestrogen levels fall which means that women who have experienced the menopause are more at risk from developing osteoporosis. Women who go through the menopause before the age of 45 or those who have had an early hysterectomy and their ovaries removed are particularly at risk. Women who have experienced irregular or an absence of menstrual periods may also be at a greater risk of developing osteoporosis. Excessive dieting and exercise can cause a woman's periods to stop.

Avoiding Osteoporosis

Calcium is essential for the maintenance of healthy bones and can be found in dairy produce (including the low fat varieties), green leafy vegetables, dried fruit, nuts, oily fish and pulses such as beans, peas and chickpeas. However, research has shown that oily fish (e.g. pilchards, herring, mackerel, sardines, kippers, salmon, trout and tuna) contain toxic chemicals as a result of polluted waters. The Department of Health therefore advises us not to eat more than one portion of oily fish per week (130g). The pollutants are stored in the fat content of fish so if you grill or bake your fish and remove any skin and visible fat, this will reduce the amount of pollutants that you consume. Fish oil supplements also contain pollutants so it is a good idea not to eat oily fish as well as taking fish oil capsules.Vitamin D is essential for the absorption of calcium. The body produces vitamin D when exposed to sunlight so spending about fifteen minutes a day out in the sunshine will help. Research has shown that too much vitamin A in the diet (retinol) may increase the risk of hip fractures in older women. Vitamin A can be found in liver, fish oils and vitamin supplements. If you take vitamin A supplements, you may wish to discuss this with your pharmacist. Regular weight-bearing exercise will help to keep bones strong and healthy. This type of exercise involves the body supporting its own weight. Examples of weight-bearing exercise are aerobics, jogging, tennis and skipping. Although swimming and cycling are great ways of exercising, they will not help to strengthen bones.Do not smoke.Avoid excessive consumption of alcohol.Plant oestrogens are similar in structure to human oestrogens and can help to keep bones strong and healthy. They can be found in the following foods: soya beans, soya beansprouts, soya flour, tofu, soya milk, soya drinks, soya yoghurt, chickpeas, kidney beans, mung beans, haricot beans, green split peas, green beans, broad beans, citrus fruits, rhubarb, berries and currants, plums, cherries, papaya, pomegranate, cranberries, apples, pumpkin, broccoli, cabbage, carrots, fennel, sweet potato, potatoes, squash, peas, cucumber, celery, peppers, alfalfa, beetroot, garlic, sage, parsley, sesame seeds, linseed, aniseed, sunflower seeds, oatmeal, oat bran, barley, wheat, rye, rice, hops, corn, corn oil, brewer's yeast, olives, olive oil, red clover, red wine, red grape juice and liquorice. Plant oestrogen supplements can also be bought in tablet or capsule form from most good health food shops and pharmacies.

Treatment

  • Hormone replacement therapy (HRT) is widely used to prevent and treat osteoporosis in women. It is available in many forms including tablets, gels, implants and patches. As well as treating osteoporosis, HRT can also help to reduce the long-term risk of heart disease and stroke and can help to relieve the short-term symptoms of the menopause. There is, however, evidence to suggest that HRT can increase the risk of breast cancer and endometrial cancerTestosterone, a male hormone, also helps to keep bones strong and healthy. Men who suffer from osteoporosis often have low levels of this hormone. Testosterone implants or injections can therefore be used to prevent and treat osteoporosis in menBiphosphonates slow down the rate at which old bone is lost whilst allowing new bone to build up. This increases the overall density of the boneCalcium and vitamin D are both essential for the maintenance of healthy bones. Those who do not get enough calcium and vitamin D from their diet may be told to take daily supplementsVitamin D is essential for the absorption of calcium. Calcitriol imitates vitamin D and therefore increases the amount of calcium that the body absorbsCalcitonin slows down the rate at which old bone is lost whilst allowing new bone to build up. This increases the overall density of the bone. It can also be used to relieve pain caused by squashed bonesAnabolic steroids can prevent loss of bone mass in the elderly or frail
  • Selective oestrogen receptor modulators increase bone density and protect the body from osteoporosis. They are used to treat women and are an alternative to hormone therapy

Additional Information

A leaflet about the menopause is also available from this pharmacy. For more information about osteoporosis, contact the National Osteoporosis Society, PO Box 10, Radstock, Bath BA3 3YB. Tel: 01761 471771. Fax: 01761 472721. E-mail address: info@nos.org.uk. Website address: www.nos.org.uk

For more information about the benefits of soya, contact Soya Source, Soya Information Bureau, 47a Marchmont Street, London. Tel: 020 78333759. Fax: 020 72787613.