They say a woman's work is never done. No matter how empowered we may be, the society always expects women to juggle her career and family life more efficiently. The pressure to excel in both leads many women to neglect their diet and nutrition, giving rise to problems like osteoporosis. "Known as the 'Silent Disease,' osteoporosis is characterised by low bone mass and deterioration of bone, causing fragility and increases fracture risks," says Dr Raghavendra KS, Consultant, Joint Replacement and Spine Surgeon, Fortis Hospital, Kalyan. He says that it is one of the most under recognised and underdiagnosed medical conditions in the country. "In India, men and women seem to be more prone to Osteoporosis and sustain fractures about 10-20 years earlier than their western counterparts. This is probably due to their genetic make-up, poor Calcium and Vitamin D intake," he adds.

In women, however, the risk is five times more than men. The doctor says that 50 percent of all the women above the age of 45 could be affected by osteoporosis! "A lot of it is to be blamed on lifestyle habits, many people do not venture into the sun as much as they should," he adds.

A staggering 70 percent of the Indian rural population and a whopping 94 percent of the urban population have a vitamin D deficiency. Women, who should have 1000mg of calcium daily are only having 260 mg a day! Worried? Here's what the doctor observes:

The incidence of osteoporotic fractures in women after the age of 50:

• Shortly after menopause (45-50yrs), the incidence of wrist fracture increases and continues up to 60yrs at which it plateaus

• The incidence of hip fracture increases slowly with age and undergoes steep rise later in life

• The incidence of vertebral fracture clearly begins to rise shortly after Menopause and continues with age without reaching a plateau

Consequences:

• 1/ 5 patients do not survive after hip fracture (10-20% mortality rate)

• 1/ 3 patients end up with a permanent disability

• 40 percent patients cannot walk independently

• 3/ 5 patients cannot carry out daily activities and will be dependent on others rest of their life. This leads to social disability, economic disability and mental disability.

People at Risk:

• People with advancing age (more than 50 yrs)

• People who are short, thin and small bone framed

• Smokers are at very high risk.

• Women after menopause due to oestrogen hormone deficiency

• Old fractures and limited daily activity

• Excessive intake of alcohol

• Prolonged use of certain medications like steroids (in asthma), thyroid medicines, oestrogen (for hormone supplementation).

Steps for evaluation and treatment:

Step 1: Identify patients at risk for Osteoporotic fractures by clinical assessment and Bone Mineral Density test

Step 2: Measures to minimise the rate of bone loss

a) Regular physical activity.

b) Avoiding alcohol and smoking

c) Judicious use of medicines like steroids, thyroid hormones and oestrogen

Step 3: Consider therapeutic agents to increase bone mass, which can be explained by an Orthopedic Surgeon

Step 4: Counsel patient’s to avoid falls and mechanical stress that may contribute to fractures

Step 5: Addressing the complications of osteoporotic fractures with surgical and non-surgical means

Step 6: Food supplements(calcium-rich, vitamin D rich)

• Milk and milk products, raagi(cereal), green leafy vegetables, almonds, soya bean, chicken liver, fish (sardines, mackerel), eggs and orange juice

Take Home Message:

• Generate more awareness of osteoporosis

• Supplementation of calcium and vitamin D, as the natural intake is very low

• Fortification of food with milk, soya bean, bread and juices enriched with vitamin D

• Regularly exercise

• Avoid smoking and alcohol consumption

• Judicious use of medication

• Early and proper management of fractures

• Regular follow up with an orthopaedic doctor

• Periodically undergo bone mineral density and other relevant tests

(The above story first appeared on LatestLY on Mar 29, 2018 12:02 AM IST. For more news and updates on politics, world, sports, entertainment and lifestyle, log on to our website latestly.com).