Building Strong Bones: Understanding Osteoporosis and Bone Health

Introduction

Women’s health encompasses various aspects, with bone health being a crucial component of overall well-being, especially as women age. Bones provide support for joints, tendons, and ligaments, while also safeguarding vital organs and serving as a storage area for calcium and phosphate to maintain normal mineral balance (Morgan, E. F et al., 2018).

Despite their significance, bone health is often neglected until complications arise. Osteoporosis, in particular, is a prevalent yet silent disease characterized by a systemic decline in bone mass and microarchitecture, leading to fractures caused by fragility (Cheraghi, Z et al., 2019). Unfortunately, osteoporosis frequently goes untreated and unnoticed, presenting a growing global challenge that affects approximately 200 million individuals worldwide (Daroszewska, A. 2015).

In this article, we’ll discuss the intersection of women's and bone health, the complexities of osteoporosis, and the importance of bone health, and explore new ways to build strong bones.

Importance of Bone Health

 Ensuring optimal bone health is crucial for women’s overall well-being and quality of life. Our bones not only provide structural support to the body but also shield vital organs and serve as reservoirs for essential minerals like calcium and phosphorus. These minerals play pivotal roles in numerous physiological functions, including nerve signaling, muscle contraction, and blood clotting (Morgan, E. F et al., 2018).

Bone health is a lifelong concern. We build bone to our adult maximum called peak bone mass and begin losing bone thereafter. Women, in particular, are at higher risk of osteoporosis or other bone-related conditions, due to factors like hormonal changes, low peak bone mass, genetics, nutrition, physical activity, and hormonal balance. These factors can greatly influence bone health (Weaver, C. M. 2017). Throughout their life span, women undergo crucial hormonal changes such as puberty, pregnancy, and menopause, which can directly impact bone density and metabolism. Estrogen, in particular, plays an important role in bone remodeling and maintenance, making postmenopausal women more vulnerable to bone loss and osteoporosis. Women experience rapid bone loss during the first few years after menopause due to estrogen deficiency, highlighting the need for early intervention strategies to prevent osteoporosis. (Eastell et al., 2016). Understanding these factors is important to prevent bone-related conditions and maintaining skeletal strength throughout life.

Understanding Osteoporosis in Women

Osteoporosis is the most common metabolic bone disorder. Around 2 million women in the UK and 200 million women worldwide are affected by osteoporosis and the prevalence is expected to rise as the population ages (Daroszewska, A. 2015). Osteoporosis increases the risk of fractures, particularly in, the spine (40%), hip, and wrist. Wrist fractures are the most common type of fracture among US women aged younger than 65 years. Moreover, wrist fractures are associated with functional decline. In 5 years after a distal forearm fracture, the risk of impermanence ranges from 12% among women aged 65 and 74 years to 43% for women aged 85+ (Crandall, C. J et al,.2015). Osteoporosis is said to be a silent disorder because it progresses silently, without any symptoms until a fracture occurs, making early detection and prevention important.

Various factors contribute to the development of osteoporosis:

1.  Age: Osteoporosis is an age-associated disease, that is influenced by genetic, epigenetic, and environmental factors. Insufficiency of Vitamin D and reduction of calcium absorption are common in the elderly. Deficits in cognition and coordination promote falls and fragility fractures (Jakob, F et al., 2014).
2.  Gender: Women especially postmenopausal women are at greater risk than men, but in recent years it has become more evident that osteoporosis represents a significantly important problem also for men. However, osteoporosis in men is still poorly studied, underdiagnosed, and inadequately treated (De Martinis, M et al., 2021).
3.  Nutrition: Bone is a living tissue requiring all important nutrients for growth and maintenance. Bone largely consists of protein, the main constituent of connective tissue, which occupies half of the bone by volume and 20% by weight. Bone mineral is the other main component of bone organized as hydroxyapatite crystals (largely calcium phosphate) deposited along collagen fibrils (Weaver, C. M. 2017).
4.  Physical Activity:  About the effects of physical activity on bone metabolism, it is proven that exercise acts on molecular pathways of bone remodeling involving all cellular types of bone tissue. In clinical trials adopted in patients with osteoporosis, it is evident that multi-component training, including aerobic activity and other types of training (resistance and/or strength exercises), is the best kind of exercise in improving bone mass and bone metabolism in older adults and especially osteopenic and osteoporotic women (Castrogiovanni, P et al., 2016).

Building and Maintaining Strong Bones in Women

Empowering women to take proactive steps to build and maintain strong bones is crucial for preventing osteoporosis and reducing fracture risk. A comprehensive approach to bone health in women includes:

1.  Nutritious diet: A balanced diet rich in Calcium and Vitamin D including essential nutrients is important for bone health. United States (US) dietary guidelines recommend a daily calcium intake of 1200 mg for women. Calcium may be obtained in the diet from such foods as dairy products. Supplemental calcium is available in the form of calcium citrate and calcium carbonate. Calcium citrate tends to be better absorbed than calcium carbonate because it dissolves at all pH levels. Dairy products, leafy greens, nuts, and fortified foods are excellent sources of calcium, while vitamin D can be obtained from sunlight exposure and dietary supplements (Weaver, C. M et al., 2019).
2.  Regular Exercise: Exercise training can increase BMD (Bone Mineral Density), according to reports, postmenopausal women who wore weighted vests and participated in jumping exercises, engaging in weight-bearing exercises, resistance training, and balance activities can help women maintain bone mass, improve muscle strength, and reduce the risk of falls and fractures (Zhao, R., Zhao, M., & Zhang, L. 2014).
3.  Avoiding Harmful Habits: Chronic heavy drinking, can dramatically compromise bone quality and may increase osteoporosis risk. Further, research indicates that the effects of heavy alcohol use on bone cannot be reversed, even if alcohol consumption is terminated. Research suggests that in addition to alcohol, other lifestyle factors—such as tobacco use affect bone development and osteoporosis risk in women (Cheraghi, Z et al., 2019).
4.  Bone Density Testing: Regular bone density testing especially for people at higher risk can help in early detection and can guide in taking preventive measures and treatment interventions (Cosman, F et al., 2014).
5.  Fall Prevention: Programs like balance training, can significantly improve the balance parameters and reduce the number of falls in postmenopausal women who have already had at least one fracture in the past. (Mikó, I et al., 2017)
6.  Medication and Supplements: Pharmacologic treatment of patients with osteoporosis includes calcium and Vitamin D (Bischoff-Ferrari, H. A et al., 2016), bisphosphonates (Tsourdi et al., 2018), calcitonin, estrogen, and selective estrogen receptor modulators. New medications in development show promise in the treatment of osteoporosis. Treatment of pain is essential to promote increased mobility.

Conclusion

Building and maintaining strong bones is crucial for women’s health and overall well-being. Osteoporosis poses a significant threat to women's health, particularly postmenopausal women, but proactive measures can mitigate this risk. By learning and understanding the factors that can influence bone health, recognizing the signs of osteoporosis, and adopting a healthy lifestyle and habits can reduce the risk of fracture and bone-related diseases. By taking charge of your body and prioritizing nutrition, exercise, avoiding harmful habits, and taking your supplements regularly, you can invest in the strength and resilience of your skeletal system, enabling yourself to lead active and independent lives well into old age. Remember, it's never too late to start prioritizing bone health, so take the first step today toward stronger bones and a healthier future.

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