Prevention and treatment of osteoporosis in older people

Types of osteoporosis

It is a mistake to believe that this disease develops in adulthood: after 50 years, the disease is diagnosed in approximately every fifth woman and every third man. Bone fragility associated with a lack of calcium in the body affects children, adolescents, and young people under the age of 30. There are several types of this disease:

• juvenile - occurs in children from 8 to 15 years old;
• postmenopausal - typical for women aged 50 years and older;
• idiopathic - it affects mature men, the origin of the pathology is still not clear;
• senile - occurs in older people of both sexes.

The use of products with chitosan and its derivatives for osteoporosis

Chitosan oligosaccharides are a building block of the structural basis of joints, bone and muscle tissue, stimulating the restoration of osteoarticular and muscle tissue by normalizing mineral metabolism (strengthening the absorption of Ca, Mg, P from food). In addition, they protect articular cartilage from destruction and have an analgesic effect comparable to the effect of nonspecific anti-inflammatory drugs that have a toxic effect on the liver. In addition, they improve blood circulation in the joints. They help restore bone strength and increase joint mobility by restoring cartilage. The use of chitosan products and its derivatives does not have a toxic effect on the body with long-term use. Indicated to eliminate all causes of osteoporosis in humans.

Reasons for the development of the disease

In most cases, problems with bone tissue arise due to improper and unbalanced nutrition. Less commonly, due to regular use of certain groups of medications that help wash calcium out of the body. Factors that influence bone fragility also include:

• genetic predisposition;
• disturbances in the functioning of the endocrine and nervous systems;
• chronic inflammatory diseases;
• blood problems;
• systemic and chronic diseases.

The use of alternative therapy for osteoporosis

Manual therapy, physical therapy, herbal medicine, and the inclusion of natural substances and dietary supplements with natural multivitamins and minerals in the diet have a good effect. Phototherapy is the use of eggshells, vitamin cocktails, onion decoctions, mumiyo with honey and milk, berry smoothies and herbal preparations.

How to recognize osteoporosis?

At the initial stage, the disease develops asymptomatically; the presence of osteoporosis can be judged by fractures and compression injuries. Most often we are talking about problems with the spine - pain appears in the back and chest, and problems arise when walking. Indirectly, osteoporosis can be indicated by decreased height, heartburn and chest pain (the so-called symptoms of reflux disease), a protruding stomach, subsidence of the spine, in which the lower ribs come into contact with the pelvic bones. You should also pay attention to frequent and causeless headaches, surges in blood pressure, back pain when walking or sitting for long periods of time, numbness in the hands, and general weakness. A sure sign of calcium being washed out of the body is problems with teeth and hair, splitting nails, although this may not always indicate brittle bones.

Weight loss can indicate osteoporosis, since due to deformation of the spine and, accordingly, internal organs, a person reduces the amount of food consumed, since even a light snack gives a feeling of fullness. Mood swings caused by hormonal imbalances should not be discounted. Most likely, in this case, osteoporosis will be a background disease, so it is important to undergo a comprehensive examination and take measures to relieve the disease.

Osteoporosis – a fragile epidemic of the 21st century

The disease got its name because of increased bone fragility, when not only the quantity, but also the quality of bone tissue and its microarchitecture suffers. In terms of prevalence, osteoporosis ranks 4th after diseases of the cardiovascular system, oncology and diabetes. In Russia, the cost of its treatment is 300 billion rubles a year.

It may seem that osteoporosis is about fragile older people, not about you and me. I want to upset you. Every tenth resident of Russia suffers from osteoporosis. And this is 14 million people. It manifests itself with characteristic fractures that occur with minimal loads. For example, when falling from your own height.

Walked, fell, woke up - plaster

This situation is a sign of osteoporosis. Characteristic fractures were detected in 6% of the population of our country. That is, 9 million people. Every minute in Russia there are 17 fractures due to osteoporosis. Most often these are fractures of the femoral neck, compression fractures of the vertebrae and radius in a typical place - in the wrist.

The most formidable and dangerous is a fracture of the femoral neck. Reading time for this article is five minutes. During this time, one person in Russia will receive such an injury. Two million vertebral compression fractures are reported annually in women and one million in men. Every second patient will die within the first year after a spinal compression fracture. What about the rest?

Of those who survive, one in three will remain bedridden forever. Only one in ten returns to active life.

Osteoporosis is spreading in giant strides. In 1990, there were 1.7 million fractures due to osteoporosis worldwide. In 2025, their number is predicted to be 6.25 million.

There are risk factors for developing the disease. These include:

• early menopause. Once a woman enters menopause, bone loss begins. Therefore, in addition to the gynecologist, a woman should definitely visit a rheumatologist and discuss how to maintain bone mass at the proper level;
• long-term use of thyroid hormones and glucocorticoids. This also applies to inhalation forms. Asthmatics, take note;
• long periods of immobilization. For example, after surgery;
• low body mass index. Unfortunately, sudden weight loss, highly restrictive diets, and fasting can become a trigger for the development of osteoporosis;
• insufficient physical activity. Vertical loads, such as walking, help calcium to be absorbed into the bones;
• deficiency of calcium and vitamin D. Again, diets and an unbalanced diet may be to blame.

Home test for self-diagnosis

There is time between the onset of the disease and its manifestations that can be used to stop the process of bone loss and prevent fractures. For this it is important:

1. Prevent bone loss.
2. Recognize (diagnose) osteoporosis if it already exists.
3. Treat osteoporosis in the early stages, preventing fractures from occurring.
4. If there are already fractures, prevent further ones. Alas, each fracture doubles the risk of a new one. This phenomenon is called the fracture cascade.

There are ways to determine osteoporosis “by eye” - by typical posture and by the patient’s complaints of decreased height. And each of you can conduct a simple test at home.

Remember Leonardo da Vinci's Vitruvian Man? The span of his arms is equal to his height. Stand in the same position. Your height to span ratio should be the same. An error of three centimeters is allowed. If the difference between your arm span and height is greater, then your height is already decreasing. Most often this occurs due to osteoporosis.

It is also recommended to pay attention to:

• change in posture. Osteoporosis can be identified by the appearance of stoop, “supplicant posture”, increased lumbar lordosis (curvature);
• decreasing the distance between the lower ribs and the iliac crest;
• the appearance of small skin folds on the sides of the abdomen;
• women may notice that older dresses become longer.

Found signs of osteoporosis. What to do?

Of course, see a doctor! But first, you can independently calculate the risk of fractures in the next ten years in just a minute. To do this, use the FRAX automatic calculator, which was developed for this purpose by the World Health Organization.

You must enter the requested parameters. If some factors are unknown to you, omit them. The resulting figure is your personal risk of fracture. Plug it into the graph on the same page. If it is in the green zone, your bone density is fine. If it’s red, we begin to fight for bone density and prevent fractures. We will discuss how exactly in the next article.

Elena Vystavkina, Candidate of Medical Sciences, rheumatologist
Photo depositphotos.com The author’s opinion may not coincide with the opinion of the editors

Features of disease diagnosis

In most cases, osteoporosis is detected after the patient consults doctors with a fracture of the collarbone or femoral neck or serious spinal deformity. Therefore, it is important for people who are at risk for this disease to undergo regular medical examinations. The risk of bone fragility is very high in menopausal women, overweight people, and in teenagers who lead a sedentary lifestyle. All people aged 65 years and older should be examined regularly - they automatically fall into the risk group.

Osteoporosis can be detected by densitometry, a procedure aimed at determining bone density using ultrasound or x-rays. Ultrasound is considered a more informative diagnostic method, as it allows one to determine a decrease in bone tissue density at the level of 3–5%. X-rays can detect changes in bones, provided that their density has decreased by about 30%. Blood and urine tests may be prescribed as additional types of diagnostics.

General prevention of osteoporosis

A system of measures aimed at maintaining metabolic processes in the bones, reducing catabolism, improving joint function, which results in an improved quality of life. Preventive measures reduce the risk of osteoporosis by 50%.

Main principle

- preventive consistency.
Prevention
is the use of moderate physical activity, the use of proper nutrition with sufficient amounts of calcium and vitamin D, as well as other essential substances necessary for the body. The use of hormone replacement therapy in menopausal women in the prevention of osteoporosis. Developing healthy lifestyle habits (full sleep, physical activity, sufficient insolation, obtaining medical supervision, healthy eating) is of great importance.

All recommendations for prevention are not only good for the skeleton, but they are applied to a full life, increasing life expectancy and rejuvenation.

Diet therapy is the most important method of preventing and treating osteoporosis. It helps to replenish the differentiation of necessary substances in bone tissue, stop the pathological process and strengthen the skeleton.

How is the disease treated?

Reducing the risk of fractures is the main goal of physicians working with patients diagnosed with osteoporosis. The basis is drug therapy aimed at reducing pain and preventing bone tissue destruction. In addition, calcium-containing preparations are used.

The list of therapeutic measures often includes:

1. Physiotherapy. A set of exercises is individually selected for the patient to help reduce pain and strengthen muscles.
2. Hydrokinesitherapy - physical exercises in water.
3. Mechanotherapy is a hardware effect on certain muscle groups in order to strengthen them.
4. Training for coordination of movements (relevant for older people, who receive most injuries due to tripping or incorrectly calculating the distance to the nearest object).

The set of therapeutic and rehabilitation measures is selected individually and depends on the patient’s age, physical condition, and general well-being. However, without exception, all people who are faced with bone fragility are prescribed a special diet. Its principle is simple: you need to include in your diet those foods that strengthen bone tissue, and exclude everything that can lead to its destruction. At the same time, nutrition for osteoporosis in women will differ significantly from the diet for osteoporosis in men.

What can you eat

The main goal of a diet for osteoporosis is to consume foods rich in microelements, but containing a minimum of fat, which prevents their absorption. The daily diet should include:

• Fermented milk products - low-fat or low-fat kefir, cottage cheese, yogurt, fermented baked milk, sour cream, natural lightly salted cheeses without preservatives and other harmful additives.
• Fresh vegetables and fruits, herbs, seeds, nuts and berries. Among the main ones are beans, pumpkin, bell peppers, zucchini, broccoli, green peas, carrots, olives, apricots, oranges, dates, green salad, parsley, dill, pistachios, sesame, dried apricots, nuts, poppy seeds, raspberries, almonds, etc. .
• Wholemeal rye or wheat bread.
• Seafood - shrimp, mussels, squid, octopus, as well as fish, including canned fish in its own juice without oil or other additives, for example, sardine, tuna, pike perch or trout.
• Lean pork, veal, boiled chicken.

In addition, here is a short table with the products that form the basis of the diet for osteoporosis and what essential substances they contain:

What foods will definitely need to be excluded from your diet?

There is a fairly large group of foods for osteoporosis in women and men that will have to be excluded from the diet. First of all, these are chocolate, cocoa, coffee, sweets and flour products. Alcohol, sweet carbonated drinks, fatty meat (especially lamb), and unrefined sunflower oil have an adverse effect on bone health. You will also have to give up margarine and mayonnaise, butter, and any fatty sauces.

Products whose consumption should be limited include salt, various marinades and pickles, smoked meats and fast food. Do not overuse rhubarb and spinach, which contribute to the leaching of calcium from the body.

What needs to be excluded

Some foods that are familiar to everyone should not be consumed, as they can cause the progression of pathology and lead to serious complications. Salt should be excluded from the diet. It is very difficult to completely give up, so you need to reduce its amount. This is explained by the fact that sodium chloride increases urination, which leads to leaching of calcium from the body. The list of prohibited products also includes:

• packaged juices;
• rhubarb, sorrel;
• sweets, cookies, pastries, cakes;
• mayonnaise, heavy cream;
• fatty pork, including lard and bacon;
• semi-finished products;
• sausages;
• crackers, chips, fast food;
• marinades and pickles;
• smoked, marinated and highly salted fish;
• unrefined vegetable oil, butter margarine, cooking oil;
• alcoholic drinks;
• soda, coffee, strong black tea, cocoa.

Proper diet for women

Women are much more likely to suffer from osteoporosis due to physiological characteristics. During menopause, calcium is intensively washed out of their body, which can lead to brittle bones in just six months. However, in addition to foods that contain calcium, the diet for osteoporosis in women should include foods rich in folic acid. It is responsible for the condition of the blood, promotes metabolism and the natural deposition of mineral salts in the body, which are so important for strengthening the joints and spine. In addition, a calcium diet for osteoporosis must be diluted with foods that contain vitamin D.

When treating osteoporosis, meals should be balanced and divided: food should be taken in small portions 4-5 times a day. The diet should definitely include vegetables without heat treatment, dried fruits, various types of lettuce, cilantro, dill, and parsley. What foods can and cannot be eaten if you have osteoporosis? To the general list of what is prohibited, it is worth adding lard and ham, as well as jam - products that are really difficult for many to refuse. Those who don’t know what they can eat if they have osteoporosis should start their day with cereals without butter and sugar. The ideal option is to cook buckwheat or oatmeal in milk with a little salt and add a salad seasoned with low-fat kefir to your breakfast.

Dairy products must be present in your daily diet, as they contain the most calcium. Hard cheeses, feta cheese, kefir, fermented baked milk, milk and yoghurts with a fat content of up to 2%, as well as cottage cheese are suitable. Dairy products are ideal for snacking in combination with fruit: it turns out quite satisfying and healthy.

Lean meat is another product for the diet for osteoporosis, which should be included in the menu if you have a sore spine or fractures. Meat contains a lot of micro- and macroelements, they are necessary for the female body, if you consider what foods cannot be eaten with osteoporosis. Much will have to be excluded from the diet, and boiled meat or steamed cutlets can fully compensate for the lack of magnesium, fluorine, and iron. But to replenish potassium reserves, the menu will have to include raisins or grapes, persimmons, and nuts.

Another source of nutrients is fish and seafood. Therefore, you can safely include sushi, seaweed, and various delicacies in your diet. True, fish should not be fatty, and it is better to boil and bake it, rather than fry it.

The best option is to create a table of foods for osteoporosis, dividing it into two parts. In one column you should write what you cannot eat if you have osteoporosis, in the other - what you can and should eat. Everything is not as scary as it seems: there will be many more permitted products.

With osteoporosis, you need to know that you can’t not only eat, but also drink. Alcohol will have to be completely excluded, as well as hot chocolate and cocoa. It is recommended to replace coffee with a drink made from chicory or ground acorns, which, by the way, are very useful for restoring metabolism. But you can drink any tea in unlimited quantities. You will have to be careful with juices. Fresh juices are allowed, but it is better to exclude packaged drinks from the diet: they contain dyes, preservatives and sugar.

Authorized Products

The list of permitted products for osteoporosis is quite wide. Typically, such a diet does not have strict restrictions, so a woman does not have to significantly change her usual diet. It is enough just to adjust it by including more foods containing calcium.

The basis of the diet for osteoporosis is dairy products, lean meat, fruits and vegetables.

Table of permitted products

The presented table contains a list of basic products approved for consumption for osteoporosis over the age of 50-60 years. The permissible serving size is also indicated here.

These are the products that you should focus on. However, you can also add other familiar options to them, excluding those that are included in the category of prohibited ones. It is also worth including in your diet the consumption of a large amount of greens - parsley, dill, sunflower seeds in moderation, refined oil, preferably olive oil.

It is important to cook dishes from such products in a gentle manner - steamed or stewed. This will allow them to retain maximum nutrients.

Advice:

At the age of over 50-60 years, to treat or prevent the development of osteoporosis, it is recommended to include foods with estrogenic activity in the diet. These include legumes, soybeans, cereals, and apricots.

Valuable microelements

Nutrition for osteoporosis must take into account the importance of receiving sufficient amounts of chemical elements that are important for maintaining bone strength:

1. Phosphorus - participates in the formation of bones and teeth, is necessary for normal growth of the body, a deficiency leads to muscle pain, anemia, and decreased immunity. Phosphorus is found in meat, fish, and egg yolk.
2. Copper - makes bone tissue strong; with a deficiency of the microelement, the condition of hair and nails significantly worsens, cholesterol increases, and endocrine disorders occur. Liver, squid, and seeds are rich in copper.
3. Magnesium – prevents a decrease in bone strength, strengthens ligaments and tendons. With a lack of magnesium, the functioning of the heart, muscles, and nervous system deteriorates. High magnesium content is found in wheat bran, pumpkin seeds, nuts, and beans.
4. Boron – is involved in strengthening the bone and connective tissue of the human skeleton. Microelement deficiency leads to brittle bones, negatively affects mental development, and leads to anemia. Grapes, apples, prunes, nuts are sources of an important microelement.

Osteoporosis - symptoms and signs

Unfortunately, osteoporosis is a hidden disease that occurs for a long time without noticeable symptoms, and therefore its diagnosis is often delayed. Very often, the first symptom is a fracture - only after the fracture does the patient begin the examination and learn that the cause of the injury was osteoporosis.

At the same time, there are symptoms that make it possible to notice this disease at an earlier stage, before fractures appear. Patients are often concerned about changes in posture, stooping, decreased height, and accelerated destruction of dental tissue. Bone pain is one of the important signs to suspect the development of osteoporosis. Most often, pain occurs in the spine, hip bones, bones of the forearms and wrist. Often the pain intensifies with prolonged exposure to an uncomfortable position or mechanical stress. When there is a fracture or a sharp decrease in the height of the vertebrae, the pain is localized in the back, between the shoulder blades, and in the lumbar region. A symptom of calcium deficiency in the blood may be the appearance of convulsive muscle contractions.

What is osteoporosis

During the development of osteoporosis, there is a loss of bone density in the human skeleton. As a result, it becomes too fragile and there is a risk of fractures.

People who have this pathological process are often at risk of breaking one or more groups of bones due to minor injuries, for example, falling even from a small height. This is a very common diagnosis among older people. It is diagnosed more often in men. In women, it often appears during the postmenstrual period, when dramatic hormonal changes occur in the body.

This disease is insidious due to its slow and inconspicuous development. Symptoms begin to appear at the stage of irreversible changes in bone structures. Bone mass decreases significantly, bone density and strength decrease. They become brittle and break easily. The decrease in bone mass occurs gradually. These degenerative processes begin around the age of 35. Over time they progress. In people over 50 years of age, these processes are clearly expressed.

Osteoporosis is a chronic progressive systemic disease. Accompanied by a decrease in bone mass density. The microarchitecture of bone structures is also disrupted, bone strength decreases, and the risk of fractures increases. According to studies, after 60 years, every third woman is diagnosed with osteoporosis. After 70 years, almost every woman has this disease.

The main role in the mechanism of development of the disease is played by the inconsistency of the processes of mineralization of young bone tissue and destruction of old tissue. The body cannot form the required number of these structures within a certain period of time, and the destruction of old tissues occurs actively. Therefore, it is very important to prevent pathological processes.

Fully or partially limited products

A diet for osteoporosis is based not only on including foods containing a lot of calcium in the diet, but also on excluding from it foods that enhance the excretion of calcium from the body and disrupt its absorption processes. These products include:

• refractory animals and freeze-dried fats (lamb fat, lard, margarine, mayonnaise), sausages, sweets, coffee and caffeine-containing drinks, chocolate and cocoa;
• fatty meats, sauces, canned, pickled and salted foods;
• unrefined vegetable oils, snacks (salty crackers, chips), salt, baked goods;
• alcoholic and carbonated drinks;
• melted butter;
• foods high in oxalic acid (rhubarb, sorrel), and limit the consumption of table salt to 5 g/day.

Table of prohibited products

Adviсe

Treatment of osteoporosis will be more effective when combining dietary nutrition with physical activity, the intensity of which is selected strictly individually, taking into account age, health status, concomitant diseases, and profession.

Vitamin D is actively produced under the influence of ultraviolet radiation when walking in sunny weather or visiting a solarium, so do not miss the opportunity to walk in the fresh air.

Lead an active lifestyle. The development of calcium deficiency in the body is facilitated by a sedentary or sedentary lifestyle, since immobilization helps to reduce the absorption of calcium in the gastrointestinal tract and, if possible, avoid stressful conditions.

Check the calcium content of your drinking water (less than 8 mg/l is considered low). Chlorination of water increases its deficiency.

Basic principles of the diet

The main goal of a diet for osteoporosis is to provide the body with the daily requirement of calcium, which helps strengthen bones. But in addition to calcium, the diet of patients with osteoporosis should include a number of other microelements and vitamins. On the one hand, they are also involved in the formation and strengthening of bones, like calcium, and on the other hand, without them, the full absorption of calcium by the body is impossible.

Recommended daily intake of calcium:

• children (11-18 years old) – 1200 mg;
• premenopausal women – 800 mg;
• postmenopausal women – 1500 mg;
• men (over 18 years old) – 800 mg.

In addition, other microelements are also needed:

• magnesium – 400-800 mg;
• phosphorus 800-1000 mg;
• copper – 3 mg.

And also vitamins: vitamin D (400 IU), C, A, K, group B and folic acid.

Diet

The diet is normal, 4 times a day. The only rule that applies to all diets is to have breakfast, lunch and dinner at the same time.

Food processing and temperature conditions

There are no restrictions on the cooking of food, as well as on the temperature of the food served.

Exercise stress

In order for calcium to be better absorbed in the body, it is necessary to exercise. Physical activity should not be significant; regular exercise in the morning is sufficient.

Squirrels

The protein content in the daily diet should not exceed 100-150 g, which is similar to the general table according to Pevzner (No. 15).

This amount of proteins does not overload the digestive tract and prevents fermentation, which contributes to the development of pathogenic microflora and the inhibition of normal intestinal bacteria. And if they are deficient, calcium and other microelements will be less absorbed by the body.

Bad habits

It is better to give up smoking and alcohol, especially if you have pre-existing osteoporosis.

Staying outdoors

It is known that under the influence of sunlight, vitamin D is formed in the body. But if tanning is relevant for young people, then sunbathing is contraindicated for older people. It is enough to walk under the dim sun every day for half an hour.

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