Osteoporosis: causes, risk factors, and treatment options

Osteoporosis

Women's health issues are a unique category in the medical field. Specific areas of diagnosis, treatment and prevention refer to health issues largely impacting only women. Thus, there is an importance to targeting women with respect to behavior, lifestyle and nutrition and the specific actions which can be taken to preempt the onsite of female specific conditions. As with such conditions as breast cancer, osteoporosis is one that can impact men but is substantially more likely to occur in women. Indeed, most evidence connects osteoporosis to specific hormonal changes in aging women, meaning that considerations relating to prevention, diagnosis and treatment should be considered a regular and necessary part of adult female health screening. As the discussion will go on to indicate, regular screening and education on positive lifestyle behaviors can be a significant tool in prevention and treatment.

Overview:

All indications are that osteoporosis is a condition that impacts a significant number of sufferers. The condition is essentially the loss of bone density, leading to skeletal fragility and a greater vulnerability to falls and injuries. As the condition specifically impacts older women with the greatest frequency and severity, it can be a contributor to serious injury and even to fatality. The World Health Organization has characterized this as a common female health concern. To the point, the WHO would report in 2003 that "osteoporosis is an established and well-defined disease that affects more than 75 million people in Europe, Japan and the U.S.A., and causes more than 2.3 million fractures annually in Europe and the U.S.A. alone." (WHO, 1)

The permeation of osteoporosis is due to its common correlation to certain hormonal occurrence which tend to occur in women following menopause. For women who have failed to take the proper precautionary measures throughout their lives, who are of compromised health or who are otherwise immobilized, the threat will be higher. But in some instances, the occurrence is connected to natural hormonal changes in the body and cannot be connected to poor lifestyle decisions or health behaviors. Here, available research indicates that "the concept that estrogen deficiency is critical to the pathogenesis of osteoporosis was based initially on the fact that postmenopausal women, whose estrogen levels naturally decline, are at the highest risk for developing the disease." (Raisz, 3320)

Fortunately, a great deal is coming to light on the subject of osteoporosis, with both lifestyle predictors and chemical occurrences in the body revealing new insights to medical professionals. Ongoing research suggests that there is rarely one single explanation for the onset of bone density loss, but that instead there may be a series of interdependent bodily changes leading to the condition's development and intensification. Accordingly, Raisz (2005) indicates that "there is a rapidly expanding amount of information, based on laboratory studies, that indicates that osteoporosis is likely to be caused by complex interactions among local and systemic regulators of bone cell function. The heterogeneity of osteoporosis may be due not only to differences in the production of systemic and local regulators, but also to changes in receptors, signal transduction mechanisms, nuclear transcription factors, and enzymes that produce or inactivate local regulators." (Raisz, 3318)

This underscores the sheer difficult in predicting or preemptively diagnosing osteoporosis, which will generally not show an onset of symptoms until the subject has reached an advanced age. However, there are several demographic clues that at least indicate some individuals to be in higher risk groups and thus more actively recommended for screening. Post-menopausal women are the group most impacted and demanding of screening. Additionally, those who have a genetic or family history of bone density loss or osteoporosis should receive regularly scheduled screening checkups when they have reached the appropriate age. There are also different degrees of vulnerability to this condition depending upon race or ethnicity.

During regular screening, physicians will look to measure skeletal fragility and, where such is presence, to determine its cause. To this point, "skeletal fragility can result from: (a) failure to produce a skeleton of optimal mass and strength during growth; (b) excessive bone resorption resulting in decreased bone mass and microarchitectural deterioration of the skeleton; and (c) an inadequate formation response to increased resorption during bone remodeling." (Raisz, 3319) These are the physiological changes which physicians look for in high-risk groups as a way to gauge the presence and advance of osteoporosis and peripheral skeletal conditions such as spinal compression and deteriorated posture.

Treatment of osteoporosis revolves around specific calcium and vitamin D medication programs but first and foremost in importance is the institution of regular, healthy and appropriately strenuous exercise. This helps to strengthen both muscle support for fragile bones and improves ambulatory abilities to the end of helping to reduce the likelihood of accidents. Additionally, a lifestyle of activity can have decidedly positive preventative properties as well, serving as one of many imperatives to commit to regular exercise.

So is this also the case with respect to nutrition. Dietary habits are both a significant part of prevention and treatment. With respect to the latter, sources on dealing with osteoporosis indicate that there are specific eating patterns which one can commit to as a way of fighting the conditions effects. Accordingly, the U.S. Department of Health and Human Services (2004) indicates that "since many nutrients are important for bone health, it is important to eat a well-balanced diet containing a variety of foods. Following the Dietary Guidelines for Americans (USDA 2000, USDHHS 2000) can help, although attention should be paid to serving sizes. These guidelines urge individuals to eat 6 -- 11 servings of grain foods, 3 -- 5 servings of vegetables, 2 -- 4 servings of fruits, 2 -- 3 servings of dairy or other calcium-rich foods, and 2 -- 3 servings of meat or beans each day." (USDHHS, 1)

Conclusion:

The discussion here denotes that we have sufficient information to identify specific high risk groups for the development of osteoporosis as well as to provide these groups with a set of lifestyle changes that can have distinctly preventative effects. However, the discussion also indicates that diagnosis and treatment are possible and will be beneficial if not lifesaving for those already afflicted. The general discussion here denotes that there is an imperative to produce a greater awareness amongst adult women in various populations of the ways that this condition may be prevented; of the need for regular screening for the onset of the condition; and, where appropriate, of the ways that treatment can be accessed and pursued.

Research Questions:

1. Given the degree to which osteoporosis primarily impacts the female population, what are some effective ways to reach out to female demographics with information campaigns?

2. How do cultural patterns relating to lifestyle and diet contribute to the population presence of osteoporosis?

3. What impact does this condition have on men? Are there outreach groups specifically intended to help the rare male sufferer?

4. Are there genetic predictors that can help to preemptively identify the likelihood of osteoporosis?

5. What are some ways to improve accessibility to treatment for individuals suffering from immobility and other health problems compounding the danger of osteoporosis?

Summation List:

1) Definition

Osteoporosis is a loss of bone density which occurs when a reduction in certain hormonal production rates leads to inadequate absorption of bone strengthening vitamins and nutrients. The result is skeletal fragility and a host of peripheral pains.