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Osteoporosis - prevention needs to begin in childhood/teenage years




Osteoporosis can be and often is an insidious degenerative condition.

It is not just a condition of the elderly; it is a disorder than can begin decades before it is diagnosed and can affect women in pre-menopause, peri-menopause and post-menopause.


It is necessary to understand what contributes to, or causes bone loss and implement that knowledge to assist ourselves, our families, our children, and grandchildren through knowing what the best type of nutrition, lifestyle, and exercise is, as well as knowing what we are eating, absorbing, and ingesting that could be causing our bones to become brittle.


There are so many different factors that could be contributing to this life changing condition that we need to be aware of what they are so we can protect ourselves, and our families, and pass this information on to our friends and community to support the future health and wellbeing of all women and children.


It is not black and white, and it is certainly not just about taking calcium and vitamin D. My aim is to write articles to assist you with evidenced based information to support you in maintaining the health of your bones, or to improve the health of your bones.



What is osteoporosis?



Ostoporosis literally means porous bone.


Osteo means = bone

Porosis means = porous.


80% of our peak bone mass is achieved by the time we are 18 years old! Bone mass will continue to increase until around 30, although some research indicates it is achieved by the early 20’s.


Peak bone mass is the amount of bone tissue present at the end of the maturation of the skeletal bones, it is the maximum amount of bone has person has during their lifetime (Weaver et al. , 2016).








Reasons that prevent children and teenagers from building peak bone mass?




As Peak Bone Mass is reached in early adulthood it is thought to be what establishes the risks of osteoporosis later in life (Bachrack, 2001). As the foundation for bone health is determined in early life, osteoporosis prevention has to begin in childhood and adolescence by maximising bone mineral uptake throughout childhood and adolescent years (Bachrack, 2001).


Generally, children's lifestyles tend to have less physical activity and sun exposure than in previous generations and diets that are higher in salt, (Bachrack, 2001) sugar & junk food and low in varied mineral and vitamin containing foods, all contributing to less than ideal Peak Bone Mass.



· Eating disorders such as anorexia and bulimia

· Excessive stress

· Exercise induced amenorrhoea (absence of menstrual period)

· Malnutrition in early life

· Junk food – soft drink, sugary foods

· Chronic illness in childhood

· Deficiency of Vitamin D & other vitamins & minerals

· Medications

· Malabsorption of nutrients due to gut issues – coeliac disease

· Gluten intolerance




Reasons women are susceptible to

osteoporosis pre-menopause








Osteoporosis can occur at any age in pre-menopausal women and peak bone mass (PBM) may be disturbed which can be be a contributing factor, as discussed above.


Accelerated bone loss can occur in young women and some of the reasons for this could be; long term glucocorticoid therapy, rheumatoid arthritis, and diseases that affect calcium and vitamin D metabolism (Gourlay, 2004).


I have listed other reasons below:


· Family history of osteoporosis

· Long term amenorrhea (lack of menstrual period)

· Glucocorticoid use

· Lactose intolerance

· Malabsorption syndromes

· Inflammatory bowel diseases

· Hyper parathyroid disease

· Hyperthyroidism

· Smoking

· Excessive exercise

· Low body weight

· Rheumatoid arthritis

· Premature ovarian failure due to chemotherapy

Chronic diseases like kidney disease

· Cystic fibrosis


Particular occupational groups are more at risk of hypothalamic amenorrhea that can lead to osteopenia and stress fractures such as female military recruits, ballerinas and athletes (Bonjour, 1994).



Osteoporosis screening is not supported in the pre-menopausal population. However, as discussed, there are many women that are more at risk of becoming osteoporotic at an early age. If you are at a higher risk of bone loss due to not building peak bone mass throughout your childhood and teen years or due to issues as listed above , it is important to discuss your concerns with your Doctor or Primary Care Practitioner regarding testing for bone health assessment and preventive strategies.


Osteoporosis prevention is imperative and it needs to start with optimal nutrition from birth, appropriate physical activity for all ages, and for health professionals to assess pre-menopausal women who are at risk for osteoporosis and implement therapeutic interventions.



REFERENCES


Bachrach LK. Acquisition of optimal bone mass in childhood and adolescence. Trends Endocrinol Metab. 2001;12:22–8. [PubMed] [Google Scholar]


J. –Ph.Bonjour, G.Theintz, F. Law, D. losman, R. Rizzoli. Peak Bone Mass Osteoporosis International (Internet). 1994 , January, (cited 2019 Nov,4); 4, ppS7-S13 Available from: https://www.ncbi.nlm.nih.gov/pubmed/8081064


Gourlay ML, Brown SA. Clinical considerations in premenopausal osteoporosis. Arch Intern Med. 2004;164:603–14. [PubMed] [Google Scholar]


Weaver, C.M., Gordon, C.M., Janz, K.F. et al. Osteoporos Int (2016) 27: 1281. https://doi.org/10.1007/s00198-015-3440-3




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