Rib and spine fractures are the most common fractures, often unrecognized by the patient or physician. They are likely to recur one after the other. In this case, severe pain, shortening of stature and hunchback formation may occur. But they are usually not life-threatening. But hip fractures are not. One quarter of the elderly people who break their hip will never be able to stand up again, i.e. they will be bedridden. Death within 1 year after a hip fracture is 12 to 30 percent. Most of this happens in the first 3 months.
Which factors related to both health and environment increase the risk of fracture after osteoporosis occurs?
Muscle weakness, impaired balance and coordination, inadequate protective reflexes during falls, dizziness, short-term fainting spells, loss of consciousness, Parkinson's disease, visual impairment, alcoholism, fatigue, fatigue due to medications are among these risks. At home, telephone and other vehicle cables lying haphazardly on the floor, carpet fringes, slippery floors, lack of handholds and inadequate lighting can also pave the way for environmental fall risk and thus fracture formation. Efforts should be made to minimize risk factors to prevent osteoporosis and fractures.
If we list the modifiable risk factors below, these are the risks that we can change to prevent osteoporosis.
Hormones: Natural or surgically induced early menopause is an important risk factor. Testosterone deficiency in men also causes osteoporosis. Alcoholism and anorexia nervosa can contribute to testosterone deficiency. Birth control pills contain a combination of estrogen and progesterone, both of which can increase bone mass.
Inactivity: Lack of physical activity is the most important risk factor for osteoporosis. This is also true for bed-bound young people. These patients lose about 30% of their bone mass within a few months and it can take years to regain the initial level. If the arm is immobilized for 3 weeks due to a wrist fracture, this leads to a 6% loss in bone density. For this reason, the rest period should be kept as short as possible in diseases.
Excessive sports: Continuous and strenuous exercise, excessive dieting and strict control of body weight can lead to an excessive reduction in body fat and, in women, a decrease in estrogen levels, which can increase the risk of fractures.
Excessive thinness: Thin women have an increased risk of fractures. Weight gain leads to bone strengthening and estrogen metabolites produced by fat cells protect bones from osteoporosis. Excessive weight gain can lead to undesirable conditions such as deterioration of the vertebrae, wear and tear of the knee and ankle joints, and calcification, just as excessive thinness can lead to osteoporosis. Decreased bone density and increased fracture risk due to low body weight affect men and women equally. Because of thinness, millions of women try to get thinner and stay thin at the expense of their bones. Eating only a low-calorie diet does not provide the nutrients necessary for the development and maintenance of bones. In addition to diet, it is necessary to strengthen muscles and bones with vitamin and mineral supplements and regular exercise.
Low calcium intake throughout life: If calcium intake from food is not sufficient during growth, skeletal construction does not reach its peak. When calcium intake is low over the years, the release of parathormone stimulates the removal of calcium from bone stores and osteoporosis can develop. The higher the calcium intake during childhood and adulthood, the better the peak bone mass and the lower the risk of fractures with aging in men and women. Milk and dairy products are the main sources of calcium. Dark green leafy vegetables, non-genetically modified soybeans, legumes, nuts, molasses, tahini, small fish can meet the daily calcium requirement.
Depression Depression itself is not a cause of osteoporosis, but conditions accompanying depression may predispose to osteoporosis. High levels of stress hormones in depression, medications, deterioration in nutrition due to loss of appetite and decreased physical activity play a role in the development of osteoporosis.
Smoking: Smoking doubles the risk of osteoporosis. Women who smoke 1 pack a day in adulthood have 5-10% lower bone mineral density at menopause than non-smokers. Smoking increases the lifetime risk of spinal fracture by 13-32% in men and women. The risk of hip fracture increases by 30-40%. Smoking increases blood cortisol levels and decreases the activation of vitamin D. It affects estrogen metabolism in the liver and increases its destruction. It causes deficiency of some vitamins such as vitamin C, which is necessary for bone formation. Smoking has been shown to reduce the bone-protective effect of dietary calcium. It is also known to reduce bone blood circulation by rendering bone-building cells (osteoblasts) unable to function.
Alcohol: Alcohol reduces bone formation by affecting the hormones that regulate calcium and predisposes to osteoporosis. In excessive alcohol consumption, calcium absorption decreases and excretion increases. The determining factors here are malnutrition, low body weight, liver damage, decreased calcium absorption, and decreased estrogen levels.
Inadequate nutrition: Nutrition plays an important role in bone health. In particular, the following factors should be kept in mind and paid attention to.
*Minerals: Calcium, phosphorus, magnesium, zinc, manganese, copper, boron, silica
*Vitamins: D, C, K, B6, B12 and folic acid
*Proteins
*Essential fatty acids
Adequate and appropriate eating habits are very important for bone health during childhood, adolescence and pregnancy.
Preventing osteoporosis before it occurs is an important public health issue. Complications that may occur after osteoporosis occurs bring about a series of procedures that will require the patient to be hospitalized, undergo surgery and recover his/her health through a long treatment process. In today's world where life expectancy is increasing, I recommend that you follow the recommendations of your physician and have your bone measurements done and be under regular follow-up to prevent osteoporosis.