Experts say that osteoporosis is a disease that weakens the bones. Your bones become fragile and break easily, particularly the ones in the hip, spine, and wrist. Dr Eric Mutabazi, a senior physiotherapist at Oshen-King Faisal Hospital, Kigali, says that osteoporosis is a condition that is characterised by decreased bone mineral density and structural bone changes on the microscopic level. He says that osteoporosis is a silent disease because people are unaware of these bony changes until a fracture has already occurred. CAUSES “Unfortunately, many of the risk factors associated with osteoporosis are not easily modified. Women are more commonly affected by osteoporosis, small stature, age, genetics, and medical conditions, for example, renal failure, diabetes, hyperthyroidism, among others,” Mutabazi says. He adds that post-menopausal statuses are all factors contributing to risk. Certain medications, such as prolonged steroid use, can cause higher risk of bone mineral density changes as well. Mutabazi also says that there are some causes of the disease that are adaptable. These include, but are not limited to, avoiding excessive alcohol consumption, avoiding tobacco, maintaining a healthy BMI (low BMI is linked to increased risk), adequate calcium and Vitamin D consumption, minimising soft drink intake and participating in regular weight-bearing and resistive exercises. EXERCISE RECOMMENDATION “Children should undertake 60 minutes of moderate-intensity physical activity each day. Adults should be doing 30 minutes of moderate-intensity physical activity at least five days a week (or 150 minutes or more in total). They should also undertake physical activity to improve muscle strength on at least two days a week,” Mutabazi says. He also says that older adults (over the age of 65) who are at risk of falls, should also incorporate specific exercises to improve balance and co-ordination for at least two days a week and reduce the amount of time spent being inactive. WHY EXERCISE? Mutabazi explains that exercise can decrease bone loss, increase bone density, and reduce the risk of fractures. Choosing the wrong exercise can be harmful and should be avoided. A safe and effective exercise programme includes weight-bearing, resistance, postural, and balance exercises. “Weight-bearing exercises are any exercise in which you are supporting your own body weight through your feet and legs, these loads and forces ensure that the skeleton remains able to resist the everyday burdens imposed on it. Bone is a living tissue that reacts to increase in loads and forces by growing stronger. It does this all the time, so exercise will only increase bone strength if it increases the loading above normal levels,” Mutabazi states. He suggests gentle exercise to warm up before you begin your main exercise. Muscles and joints work most effectively when they are warm and the risk of injury is reduced. Stretches too improve flexibility and are best performed after muscles are thoroughly warm at the end of the exercise session. However, they should be done gently and slowly. TREATMENT AND PREVENTION According to Dieudonne’ Bukaba, a private nutritionist in Kigali, treating osteoporosis involves a combination of a balanced diet rich in calcium and Vitamin D. Quitting smoking and drinking alcohol in moderation are also important to keep bones strong. He notes that getting enough calcium and Vitamin D is needed to build strong, dense bones when you are young and to keep them strong and healthy as you age. Bukaba says that good food sources of calcium include, dairy products, such as low-fat and non-fat milk, yoghurt and cheese, vegetables such as spinach, soybeans and white beans, some fish, including sardines, salmon, calcium-fortified foods, such as some orange juice, oatmeal and breakfast cereal. Foods that provide Vitamin D include fatty fish, like tuna and salmon, among others. MEDICATION “Bisphosphonates are drugs (alendronate, risedronate, ibandronate, and zoledronic acid) that slow bone loss, reduce risk of fractures and may in some cases increase bone density. Estrogen is approved to treat menopausal symptoms and osteoporosis in women after menopause,” he says. Bukaba adds that the Food and Drug Administration recommends women to take the lowest effective dose for the shortest period possible, because some studies have found women who take estrogen may be at increased risk of breast cancer, strokes, blood clots and heart attacks. He says that raloxifene is a non-hormonal drug that has estrogen-like effects on the bone, but blocks estrogen effects in the breast and uterus. It slows bone loss, and reduces the risk of spinal fractures. WHAT TO TAKE NOTE OF Studies say that choose sturdy shoes with non-skid soles, avoid high heels, floppy slippers and shoes with slick soles, remove potential tripping hazards such as boxes, newspapers, electrical cords and phone cords from walkways. Only use a stepladder that is stable and has a handrail. Consider having a personal emergency-response system that you can use to call for help if you fall. Be careful when you walk on highly polished floors, especially when they are wet. editorial@newtimes.co.rw
