he ER doctor remarked that her damaged back looked as if it were caused by someone brutally striking her several times with a baseball bat. Salima’s pain was excruciating, and her emotional anguish began to take a toll on her new marriage. Initially she wasn’t able to walk, shower or dress herself. The pain medication left her constantly sleepy and lethargic. How could a fall cause such dramatic injuries along with a height loss of one inch?
In hindsight, Salima recognized the unmistakable clues of osteoporosis, but she thought she was too young. Her risk factors include: both parents have osteoporosis; she is petite and small boned; and as a teen she was more concerned with obtaining a model-thin frame than focusing on consuming adequate calcium or participating in physical activities. Likewise, she’d reported previous episodes of back pain to physicians who, because of her age, didn’t consider osteoporosis as a cause. After her fall, Salima’s bone density test revealed osteoporosis in the spine and hip areas as well as four fractures in her thoracic spine and evidence of older, healing fractures.
Dr. Famida Jiwa, President and CEO of Osteoporosis Canada, is all too familiar
with stories like Salima’s. Osteoporosis is the ‘paediatric disease with geriatric consequences’ because our peak period of bone building occurs in teen years.
Dr. Jiwa says, “It’s particularly important that our teens enjoy regular physical activity and eat a nutritious diet with adequate amounts of calcium and Vitamin D to support bone development.” Jiwa is most concerned that teen girls get the message that dieting to be fashionably thin can lead to frailty sooner rather than later, as it did for Salima.
As time goes by
If your teen years are well behind you, Jiwa reports there is plenty you can do to maintain and build your bones. As living tissue, bone is constantly
renewing itself. Osteoclasts excavate areas of crumbling or weakened bone and then osteoblasts fill in the crevices with material that calcifies to form new bone. Bone remodeling is completed every three to four months in healthy, young adults.
As we age, however, the osteoclasts remove old bone faster than the osteoblasts are able to rebuild it; and, calcium, like many nutrients, absorbs less effectively. In people with relatively healthy bones, adequate calcium intake can help the remodeling process stay balanced. Studies of older adults show that adequate calcium intake can slow bone loss and lower the risk of fracture. Dr. Jiwa recommends adults consume 1200 mg of calcium daily, along with 1000 IU of Vitamin D to support bone health. When it comes to calcium, it’s important to note that more is not necessarily better, as excess calcium accumulates in the arteries and is a factor in cardiovascular disease.
Dr. Jiwa suggests weight bearing exercises
several times a week (exercise done from a vertical position). Physical activity places an increased load or force on our bones. Bones respond by forming new bone and remodelling the bone to be stronger. It also improves balance and coordination, reducing the risk of falls that can lead to fractures. As part of your regular health screening, Dr. Jiwa recommends measuring bone density.
After her fall, Salima took a proactive approach to preserving her bones. She consumes adequate daily calcium and Vitamin D, and includes weight bearing exercises three times a week. She is very conscious of her posture, including proper bending and sitting techniques. Happily, Salima’s lifestyle choices have brought about success. Her bone density has improved significantly in her hip bones, though she still has low bone mass in her spine.
Despite her pain, Salima is dedicated to bone health awareness. She has co-founded a community-based health facility in Toronto – The Bone Wellness Centre, whose mission is to promote awareness, prevention and early detection of osteoporosis. Salima is passionate about her mission, “Osteoporosis is not an old person’s disease, and it’s not part of the natural aging process. That’s what I want people to know.” bonewellness.com H&L