THEOctober 20 is celebrated the World Osteoporosis Day, a disease that affects 5 million people in Italy, of which almost 80% are postmenopausal women. The World Health Organization (WHO) has repeatedly drawn attention to this pathology, especially its best known consequences, namely the fragility fracturesthat have significant consequences both in terms of mortality that of motor disability, with high health and social costs. There early diagnosis plays a fundamental role as on the other hand also the prevention. The rules to follow to limit the risk of osteoporosis? Cure nutrition but also physical activity, choosing the right sport. On the occasion of World Osteoporosis Day, we asked the doctor a few questions on the subject Emanuela Raimondo, orthopedic referent ofHumanitas San Pio X Osteoporosis Clinic.
Osteoporosis: what is it all about?
«In the meantime, let’s start by debunking a false myth: osteoporosis is first and foremost one pathology – explains Dr. Raimondo – Many think that this is an inevitable condition, linked to physiological aging when it is absolutely not the case. It is a disease in which it occurs a reduction in the quantity and quality of bonewhich therefore becomes more fragile and poorer ».
The women most affected
According to estimates, osteoporosis is of interest about one in three women after menopause.
«This is due to the drop in estrogen typical of menopause which exposes most to the risk of loss of bone density – explains the expert – But it is good to remember that osteoporosis is a disease that, albeit to a lesser extent, it also affects man. Men, indeed, are less aware of this problem and therefore less attentive, for example, to screening activities “.
Osteoporosis: what symptoms?
To complicate the picture, then, the lack of alarm bells that can lead to suspicion of the disease.
«Osteoporosis is a disease devious – explains Dr. Raimondo – the onset of symptoms, in fact, often coincides with the appearance of a fragility fracture. While Vitamin D deficiency gives symptoms, unfortunately osteoporosis does not ».
The risk factors
However, there are risk factors for the disease.
“The first is the age – explains the orthopedist – in general over 65 it would be a good idea to do a screening. Also there familiarity is one of the most relevant risk factors, as well as an unbalanced dietlow in calcium and Vitamin D, and then certainly the low physical activity“.
Osteoporosis: the social costs
An important aspect to underline, as we said, is what concerns the social costs, often underestimated, that the disease entails.
“Unfortunately, not so much the pathology itself as yours direct consequences such as fragility fracturesinvolve a very high social cost – explains the expert – in terms above all of loss of patient autonomy. Just think of what is the most serious osteoporotic fracture, that of the femur: L’80% of patients loses the ability to perform at least one of the activities which he was previously able to complete independently. Not only that, the hip fracture also has one very high mortality and, in general, all fragility fractures increase mortality and disability ”.
The importance of prevention
With this in mind, the prevention therefore plays a fundamental role and it must begin from childhood, the period in which calcium accumulates in the skeleton which will then serve as a supply in old age.
Bone tissue in fact develops during childhood and adolescence to reach around 20-25 years of age il so-called peak bone mass, or the maximal bone mineral density, the value of which then influences the probability of manifesting osteoporosis over the years.
Osteoporosis: prevention and sport
So how is the disease prevented? With a healthy diet but also doing physical activity. Numerous studies have indeed shown that those who carry out constant physical activity increases bone mineral density values in a greater way than in sedentary people: muscle contractions and the stresses of the tendons on the bones stimulate bone remodeling in a positive way.
“Physical activity stimulates bone formation and above all improves bone quality – explains the expert – but be careful: it must be a physical exercise in load. So swimming, which is very good at a general level for many problems, is actually useless for osteoporosis. In fact, they must be activities where the muscle has an active contraction and is mechanically stressed ».
Therefore, even practicing yoga or stretching does not have a positive effect on bone mineral density.
The most recommended activities
“For the people elderlyin order to prevent the risk of osteoporosis, all those physical activities are recommended that not only stimulate bone formation with weight-bearing exercises but also train balance – explains Dr. Raimondo – tai chi, for example, it’s perfect. The youngeron the other hand, who may have a familiarity with osteoporosis and therefore want to limit the risks, they can bet on many different activities that are also very fun: from rock or wall climbing to pole dancing to capoeira. In fact, they are all activities that involve physical exercise in charge and that train the balance ».
… And those to avoid
On the contrary, all those would have less positive effects activities that take place in gravitational discharge: like swimming, in fact, but also cycling. If the stimulus of gravity is missing, in fact, the bone is not positively affected. I am a curious example of this astronauts that, remaining for long periods in absence of gravity, they suffer from a decrease in bone mineral densitywith the risk of developing a form of osteoporosis.
Physical activity yes, but regular
«For physical activity to play a preventive role, however, it must be practiced regularly – specifies the expert – At least twice a week, three would be ideal. If, instead of practicing a sport, you aim for walkwe can say that 20 minutes of brisk walking every day can be a cure-all for the femur ».
Osteoporosis: can you continue to play sports?
But beware: even in the case of diagnosis of osteoporosis continuing to exercise can make a difference.
«Those suffering from osteoporosis not only can but must do physical activity – emphasizes Dr. Raimonodo – Many stop for fear of running into fractures, in reality this is not the case. L’physical exercise should never be interrupted because there would be a decrease in bone and muscle mass and consequently a loss of balanceproblems that do nothing but increase the risk of falls and fractures. It is good then to move on to exercise, obviously controlled: the ideal is to focus on gentle gymnastics, such as the pilates. Stretching exercises, in general, are great for helping the bones to strengthen ».
The role of nutrition
Alongside the role played by physical activity, lifestyle and in particular nutrition is also of fundamental importance in a preventive perspective.
“A varied and balanced diet is the main prerequisite – concludes the expert – For the health of the bones then the right is important intake of calcium, Vitamin D and phosphorus. Paying attention to false beliefs: Calcium, for example, is not only contained in dairy products, as is commonly thought. Some types of fish, vegetables and legumes they are rich in calcium and there are also added waters. Therefore there is no need to focus on cheese and milk to take it in the right amount. A tasty one rocket and octopus saladfor example, it is a dietary dish that can provide half of the daily calcium requirement ».
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