Osteoporosis has been called “the silent disease because bone loss caused by this condition is without symptoms. In many cases, patients with osteoporosis don’t know they have it until the bones become so weak that a sudden strain, bump or fall causes a hip or vertebra fracture.

The medical term “osteoporosis” means “porous bones.” People with this condition lose too much bone mass, make too little new bone tissue, or both, according to the National Osteoporosis Foundation.

According to the foundation, about 54 million Americans already have osteoporosis or low bone mass (osteopenia), a condition that increases the risk for osteoporosis. Related complications can cause pain, disability, and even death.

“Losing bone density is a normal part of aging,” noted Dr. Elsharkawy, an orthopedic surgeon specializing in joint replacement who is a member of the referral line at Texas Health Spine & Orthopedic Center. We reach our peak bone mass between ages 25 and 30, and then slowly begin to start losing bone mass at age 40. For women, who lose about 2 percent of their bone density per year in the first 10 years after menopause, reduced levels of estrogen after this time accelerate the loss of bone density.

Men get osteoporosis later in life than women. This is because they have greater bone density going into middle age, and their rate of bone density loss is generally more gradual. If men develop osteoporosis, they are more likely than women to experience a fracture.”

Osteoporosis and Joint Replacement

Because of the fragility of the bone in patients with osteoporosis, special care must be taken when they seek a joint replacement. Dr. Elsharkawy explains.

“Severe osteoporosis can be a challenge for joint replacement surgery because bones may be too brittle to properly support and adhere to the new joint prostheses,” he said. “However, patients with mild to moderate osteoporosis can still be candidates for joint replacement surgery.

“This condition affects the way we plan for the joint replacement surgery. For example, we may want to take steps to improve bone density before hip replacement surgery, or we may choose to use bone cement rather than a cementless adhesive to attach the new prostheses to the existing bone. If osteoporosis can be reversed, the lifespan of the replacement can be enhanced.”

A bone density scan can help determine if someone is experiencing a decrease in bone density. If this determination is made, there are five lifestyle changes that should be made immediately.

#1 Stop Smoking  

Aside from contributing to heart and lung disease, smoking cigarettes can cause increased porosity of bones. Unfortunately, the American Lung Association estimates that 15 percent (about 35 million) of the U.S. population age 18 and older are regular smokers, and many older people have been smoking for decades. “By stopping smoking immediately, the bones will begin to repair themselves and osteoporosis can be improved,” Dr. Elsharkawy said.

Ideally, we recommend quitting smoking prior to joint replacement surgery, however, if not feasible, then we advise at least 6-8 week of refraining from smoking prior to surgery.

#2 Stay Away from Salty Foods

According to the Osteoporosis Foundation, “Eating foods that have a lot of salt (sodium) causes your body to lose calcium and can lead to bone loss. It is advisable to try to limit the amount of processed foods, canned foods and salt added to the foods you eat each day. To learn if a food is high in sodium, look at the Nutrition Facts label. If it lists 20 percent or more for the percentage Daily Value, it is high in sodium. Aim to get no more than 2,300 mg of sodium per day.”

#3 Reduce the Amount of Alcohol, Caffeine and Soft Drinks Consumed

“Drinking alcohol heavily can lead to bone loss,” Dr. Elsharkawy said. “The rule-of-thumb should be to consume no more than two alcoholic drinks per day. Caffeine, which is found in coffee, tea, and soft drinks, can also decrease calcium absorption. In order to reverse osteoporosis, no more than three cups of coffee and/or tea each day should be consumed. In addition to caffeine, research suggests that soft drinks also have phosphorous which can limit calcium absorption and lead to a decrease in bone density.”

#4 Don’t Rely on Spinach, Beets and other Vegetables for Calcium

Otherwise healthy foods such as spinach, beets, rhubarb and other vegetables that are high in oxalic acid prevent the body from absorbing calcium. “While these vegetables have other health benefits, it is a mistake to think that they are helping prevent osteoporosis,” said Dr. Elsharkawy.

#5 Reduce Meat Consumption

For those with osteoporosis, experts at the Osteoporosis Foundation caution about increasing protein through a greater than normal consumption of meat. “Special high protein diets that contain multiple servings of meat and protein with each meal can also cause the body to lose calcium. You can make up for this loss by getting enough calcium for your body’s needs. For example, dairy products, although high in protein, also contain calcium that is important for healthy bones.”

Other Suggestions for Improving Bone Density

In addition to stopping these bad habits, bone density can be improved by undertaking a proactive approach. Dr. Elsharkawy suggests adding the following foods to one’s diet:

  • Consume daily amounts of low-fat or non-fat milk, cheese, and yogurt. They increase Vitamin D.
  • Increase calcium intake by eating fish, especially salmon, at least once a week.
  • Load up on vegetables, such as collard greens, turnip greens, kale, okra and broccoli for added calcium.
  • Increase consumption of potassium by eating bananas, tomatoes, potatoes, oranges, and prunes.
  • Increase the amount of Vitamin C by consuming red and green peppers, oranges, grapefruits, strawberries, papaya, and pineapples.
  • Increase Vitamin K in the body by eating dark green, leafy vegetables, such as kale, collard greens, spinach, mustard greens and Brussels sprouts.

Physical activity is also important if you want to increase bone density.

“Exercise is the least expensive and most effective strategy for reversing osteoporosis,” Dr. Elsharkawy said. “Bone is living tissue that responds to exercise by becoming stronger. Weight-bearing exercises are very beneficial. They help build bones and keep them strong..

“Good examples of this type of exercise include walking, hiking, jogging, climbing stairs, weight training, tennis, and dancing.”

If you are concerned about your bone density and the onset of osteoporosis, contact us  at the Texas Health Spine & Orthopedic Center referral line to set an appointment with an orthopedic surgeon.

Physicians who are members of the referral program practice independently and are not employees or agents of THSOC.

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