Less is said about the health of women in Delhi is the better. Every second woman is obese, every fourth woman is diabetic and hypertensive. They find one excuse or the other for not exercising. Annual check-up of health does not fit in their psyche. It was no surprise to us that only 12 per cent of 9,444 women coming from middle class resident societies in East Delhi for Hb detection and Bone Mineral Density (BMD) in ?Help yourself workshop cum camps? organised by Delhi Gynecologist Forum had hemoglobin of 12gm or more. What is more surprising is that osteoporosis and osteopenia are other very common problems which need urgent attention by women.
In India, women get married early and about 70 per cent of them complete their families before 25 years. Women don'tcare about their diet during pregnancy and totally neglect it thereafter. There is a definite link between high incidence of premature osteopenia/osteoporosis and chronic inactivity.
As we grow older than 35 years, the bone loss exceeds bone formation, leading to fragile bones and late age fractures. But to remain mobile and independent we need to keep our bones healthy. No excuse is a valid one, if it compromises our bone health and can lead to a debilitating sickness in the long run.
Calcium is the most abundant in human body. More than 99 per cent of the total body calcium is stored in the bones and teeth. The remaining 1 per cent is found throughout the body in blood, muscles and the fluid between cells.
Bones undergo continuous remodeling with constant, resorption and deposition of calcium into newly deposited bone. The balance between bone resorption and deposition changes as per age. In aging adults, particularly among postmenopausal woman, bone breakdown exceeds its formation, resulting in bone loss which increases the risk for osteopenia and osteoporosis.
What is Osteoporosis and Osteopenia?
As we know, bone is constantly remodeled i.e continuous resorption of old bones, which is followed by the deposition of new bones. The cells that form new bones are called osteobiast and the cells responsible for resorption of old bones are called osteoclast. Osteoporosis occurs as a result of mismatch between osteoclastic and osteoblastic activity. This mismatch may be due to diseased state, aging, etc. In osteoporosis, osteoclasts outperform osteoblasts so that more bone is taken up than is formed and there is a depletion of calcium and bone proteins.
Osteopenia is generally considered the first step along the road to osteoporosis.
Osteoporosis and osteopenia literally means Porous Bone or Brittle Bone Disease. Trivial injury such as a tight hug or sudden jerk can break a bone in someone with osteoporosis. These bone fractures usually occur in hip, back bone and the wrist. Hip fractures are the most serious as they can lead to permanent disability and even death.
Osteoporosis gives no warning signals. It is a silent thief till complications like fractures and back pain occur. The good news is that test for early detection are now available in India. Only we have to create public awareness and individually need to get obsessed about osteoporosis orosteopenia.
Bone Mineral Density
BMD is a measure of bone density to find out calcium in bones. BMD testing is a way to see if your bones are healthy and strong. It is different from bone scan which is used to look for fractures or areas of bone inflammation.
Why is this test done?
It may be done for several possible reasons such as a routine screening test and when the risk for having weak bones is high.
Bones naturally lose some density as one gets older. The loss of density weaken the bones. If bones are somewhat less dense than normal, we have osteopenia. If bones have lost a lot of density, we have osteoporosis.
Who is affected?
Not only osteoporosis is common in India, Indian women are the most vulnerable. The findings show that it occurs at a younger age in India. BMD screening in middle class communities in Delhi shows that it affects all of us, old and young, men and women. We screened 9,444 patients for Bone Mineral Density during our 126 ?Help yourself workshops?. All these women belonged to middle and upper middle class in East Delhi. Only 47 per cent patients had normal bone density findings, while 53 per cent women had osteoporosis (14 per cent) and osteopenia 39 per cent. In our study, younger women in their thirties are worst sufferer as compared to older women. These women need to watch out as timely treatment and change in lifestyle can prevent or treat the disease.
Men were found to be worse sufferer than women as we screened 2,005 men as well. Though 52 per cent had normal report, 45 per cent had osteopenia and 3 per cent were diagnosed to have osteroporosis. All these men were below the age 50 years. This is something to be worried about Indian men.
It'stime we Indians should take Osteopenia and Osteoporosis seriously. Timely remedy can retard the process of aging, thus preserving vitality and youth. In west women after 50 years take 1.2 gm calcium everyday. Lack of awareness and access to calcium rich food/chronic inactivity is the real issue in Indian families.
(The writer is chairperson Women Wing of IMA.)