Strong bones are essential yet not seen in the present generation. People suffer from problems like osteoporosis since a very young age now-a-days where the bones are brittle and break even on small accidents. Bones have blood and nerve supply like any other cells of the body. The bones are not completely formed until a few years after birth and little children have cartilages in places of bones. These cartilages are elastic in nature. Children start forming bones from the age of 1 and these bones are well formed by the age of 10 to 12 years. The minerals like calcium from our food deposit to form the bones. The formation of bones takes places upto about the age of 30 years and our bones are strongest, hardest and most well formed between the age of 20 and 30 years. After the age of 30, the formation of bone cells gradually decreases.
The process of dying out of old bone cells is known as resorption and this starts around the age of 40 years and gradually increases with age. The new bone formation completely stops around the age of 50 years. The bones are formed of a network made of protein known as collagen and deposits of calcium carbonate and calcium phosphate in it. If the collagen does not form properly or if the supply of the calcium carbonate or calcium phosphate is insufficient, the bones will eventually be damaged.
Also, the new bone formation will be reduced and the resorption will increase. This is the reason for osteoporosis where the formation of the network of collagen and calcium deposition is reduced leading to formation of pores in this network and softening and breakage of bones. The weakening of cartilages due to collagen deficiency may lead to bone depreciation.
Weakening of bone may occur due to
1. Calcium and protein deficiency. The calcium level in the blood may appear to be normal as when there is reduction in blood calcium, it is absorbed from the bones. This mechanism is done because a stable blood calcium level is essential for the proper functioning of the brain and muscles. The bones are also damaged due to the deficiency of protein as it is essential for the formation of collagen network in bone formation. For adequate formation of collagen, our food must contain sufficient amount of protein, copper and zinc, amino acids like proline and glycine, and vitamin C.
2. Deficiency of Vitamin D. This prevents the absorption of calcium from the food. Thus even if sufficient amount of calcium is supplied, the absorption does not occur if there is insufficient vitamin D level.
3. Smoking. This causes decreased absorption of minerals in the body and also prevents the supply of several essential nutrients to the bones in turn leading to wear and tear of bones.
4. Alcoholism. Regular and excessive use of alcohol leads to non-absorption of minerals into the tissues causing loss of body weight and weakening of the bones.
5. Steroid therapy. Continuous use of steroid medications for complaints of allergy, asthma, or some autoimmune diseases causes imbalance in the calcium metabolism and reduced supply of calcium to the bones leading to osteoporosis. Thus, people who are on steroid medications require appropriate calcium supplementation as instructed by a doctor along with calcium rich foods.
6. Chronic liver diseases. Diseases such as cirrhosis of liver lead to deficiency of protein and calcium in the body and cause damage to the bones.
7. Low estrogen. Women around the age of 45, in their perimenopausal or menopausal stages, have gradual reduction in the estrogen levels and imbalance in their calcium metabolism with eventual osteoporosis. This is the reason for a crack in the bone even from slight jerks or mild falls in such women.
Osteoporosis of bones is a very slow process and does not show any specific symptoms other than aching or generalized pains in the limbs or back. Often a fracture or persistent back pain when investigated shows the presence of osteoporosis. Bone mineral density test is done to check the calcium level and detection of osteoporosis.
As the process of resorption is escalated in the later middle age, people must follow certain food habits to maintain the bone strength. Foods rich in calcium such as milk and milk products like curd, yogurt, cheese, paneer, etc., leafy vegetables, broccoli, and mushroom must be regularly included in food. Fishes like anchovy, tuna, mackarel, sardines, and egg yolks and sesame seeds are also rich sources of calcium.
Proteins rich foods such as egg whites which contain the amino acid called proline, chicken with skin containing the amino acid called glycine, etc. help the formation of collagen for the bones. Foods containing copper such as mushroom and leafy vegetables, foods containing zinc such as sprouted pulses and vitamin C rich foods such as lemon, guava, pomegranate, gooseberry etc. help the formation of collagen. Vitamin D supplements must be taken regularly according to the instruction of a doctor to overcome any vitamin D deficiency.
Regular exercises which are done against gravity are good for improvement of bone strength. Activities like running, jumping, walking, jumping jacks, push-ups, sit-ups, etc. are good to improve the bone strength. People of all age groups must do regular exercises according to their capacity to keep their bones strong. Thus, appropriate diet modifications, supplementation of nutrients through food and in the form of tablets if required and regular exercise would help maintain the bone strength in all ages.