Osteoporosis? Not me. Some people believe that they are not at risk for this disease behind a loss of bone density, both in quality and quantity – a precursor to potential fractures that can seriously impair our ability to live life to the fullest.
Myths around bone health persist, everything from thinking osteoporosis only affects the elderly to holding onto the idea that popping supplements provide enough protection. Or that men can dismiss the disease as something only women need to worry about.
Let’s start with a hard truth: We need to be cognizant of bone health at every stage of life, especially post-menopausal women who are the most vulnerable to developing osteoporosis. According to data from Osteoporosis Canada, two million Canadians are affected by the disease.
Its impact is far-reaching and potentially devastating, says Dr. Aliya Khan, director of McMaster University’s Calcium Disorders Clinic in Oakville, Ont. and director of the fellowship in metabolic bone disease. Fractures from osteoporosis are alarmingly common: They outnumber annual incidences of heart attack, stroke and breast cancer combined.
An estimated one in three women and one in five men will break a bone in their lifetime due to osteoporosis. And approximately 30,000 Canadians will experience a hip fracture. “There’s a mortality associated with that,” notes Dr. Khan. “People may die after a hip fracture. There’s 25 per cent mortality in women [in the calendar year after a hip fracture]…. In men, the mortality rate is 40 per cent. Even though men are less likely to develop osteoporosis, if they have fractures they’re more likely to die.”
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The higher mortality rates among hip fracture patients is tied to a number of factors. They tend to be older and face a greater risk of a pulmonary embolism, infection and heart failure, and may have multiple co-morbidities. The health consequences of a hip fracture persist even after 10 years later, according to a study published by the Journal of Clinical Endocrinology and Metabolism in July 2018. It stated that a fracture is a starting point for much wider health issues long after bones have healed. With a rising life expectancy in Canada, the number of hip fractures will continue to increase and pose a threat to health.
approximately 30,000 Canadians will experience a hip fracture. “There’s a mortality associated with that,” notes Dr. Khan.
Looking at the bigger picture, the consequences of ignoring osteoporosis are high. “It costs our healthcare system a significant amount of money,” she explains. “It’s in the billions of dollars.” Dr. Khan says the Canadian public needs to be more aware of the potentially deadly complications of fractures, because “we’re not dealing with osteoporosis as effectively as we should be.”
She cites a couple of alarming statistics: Only about 20 per cent of those who experience a fragility fracture, which is defined as a fall from a standing height or less, are investigated for osteoporosis and treated for it post-fracture. “The remaining 80 per cent are being left to have another fracture and another fracture. That’s totally unacceptable,” Dr. Khan says. “It’s a huge care gap.”
Those facts elevate the urgency for awareness around understanding the risk factors of osteoporosis and putting aside the notion that it can’t happen to you. Women are most likely to develop the disease for a number of reasons and should know why. Bone strength decreases very quickly after menopause (average age of onset for Canadian women is 51), in terms of quality and quantity due to declining estrogen levels. As Dr. Khan notes, “Estrogen is a very, very critical hormone for the achievement and the maintenance of normal bone density and structure and quality.”
While that applies to men too, since testosterone is converted into estrogen that helps protect the skeleton, they have the advantage of being able to maintain testosterone levels until later in life, into their 70s and 80s. Women are more vulnerable to osteoporosis because of the effect of menopause on estrogen. “A woman who is a rapid bone loser could lose five percent bone density per year for the five to seven years after the onset of menopause. If you do the math, that’s 35 per cent bone loss. That’s a lot of bone to lose in a very rapid manner.”
Lifestyle choices are also key to determining the chances of developing osteoporosis, known as the ‘silent thief’ because it causes the deterioration of bone over time without any signs or symptoms.
“Everyone should be aware of bone health,” Dr. Khan emphasizes. “Everybody should be eating properly, following the Canada Food Guide, ensuring that they’re getting three to four daily servings of dairy, being physically active, avoiding smoking and limiting alcohol, salt intake and coffee consumption. These are all important steps that we all need to do.”
Add one more thing to your to-do list: Let go of the myths that might make you think you won’t be someone who develops osteoporosis. “The danger of hanging on to old beliefs is that you’re not going to know that you have a problem until you’ve had a fracture,” she says. “There’s an 80 per cent chance that you won’t even know after you’ve had a fracture that you have a problem and realize that you could have taken steps to prevent it from getting worse.”
As she points out, making bone health a priority means making good choices, empowering yourself with knowledge and taking steps to prevent osteoporosis. That’s something to keep in mind with the arrival of World Osteoporosis Month in November.
Presented through a sponsorship from Amgen Canada Inc.