Osteopenia is a medical term for the loss of bone mineral density, which translate to lack of mineral content that they should have. This makes your bones weaker than normal and increases the risk of bone breaking. If not addressed, osteopenia can become osteoporosis. The two are related but not the same, simply put osteopenia is the midpoint between healthy bones and osteoporosis.
People with osteoporosis are much more likely to suffer from a bone fracture, especially from falls. Many healthcare professionals call both osteopenia and osteoporosis as “silent diseases” as we are not able to feel and it does not cause any symptoms, hence it is important to know what some of the early signs of osteopenia, diagnosis and treatment options are.
Early Signs
Ageing – Ageing is the most risk factor for osteopenia. Our bones are usually the densest around 25 to 30 years old. Most people start to lose bone density as they get older, breaking down faster than it builds new bone. While losing bone density is a natural process as we age, losing too much can develop osteopenia which may lead to osteoporosis at a later stage.
For most adults, osteopenia usually occurs after the age of 50. In Singapore, it is estimated that the average risk of osteopenia to be 40% for women and 13% for men. Women also lose bone density at a faster rate after menopause, due to lower estrogen levels.
Loss of height/ postural changes – A gradual decrease in height may be a tell-tale sign vertebral compression fractures associated with osteopenia or osteoporosis. Osteopenia may contribute to postural changes such as stooping or kyphosis (curvature of the spine) as well. These can be commonly seen with elderlies.
Risk Factors
The following are some of the risk factors associated with osteopenia. The more risk factors you have, the higher your risk of developing osteopenia is:
- Being a female
- Adults older than 50
- Removal of ovaries before menopause
- Post menopause
- Smoking or other forms of tobacco
- Lack of calcium or vitamin D
- Lack of exercise, especially strength training and weight bearing activities
- Drinking excessive alcohol or caffeine
Medical conditions that can increase risk of osteopenia
- Hormonal imbalances such as Cushing’s syndrome
- Hyperthyroidism
- Eating disorders such as anorexia and bulimia, which can lead to nutrients deficiency to keep bones healthy
Diagnosis
As osteopenia does not have symptoms, a bone mineral density test will be needed for diagnosis for osteopenia. The most common way to measure will be the DEXA or also known as dual energy x-ray absorptiometry. It uses x-rays that has lower radiation than normal x-rays to measure how much calcium and other minerals in your bones. A T-score from the measurements will then be used for diagnosis. A T-score ranging from -1.0 to -2.5 indicates osteopenia, below -2.5 is classified as osteoporosis. A healthy bone will be between 1.0 to – 1.0.
Treatment Options
The most important part of treating osteopenia is preventing bone fractures and becoming osteoporosis. Again, we are not able to stop the process of losing bone density as we age, it is a natural process. However, we can slow down the process of bone loss and strengthen existing bone tissues through physical activities and modify our diet to include the right vitamin and nutrients our bones need.
Staying physically active plays an important role to strengthen our bones and preventing osteopenia from worsening. Weight bearing exercises promotes stronger bones through bearing of our own bodyweight. Exercises such as walking, jogging, climbing of stairs or strength training. Strength training can help not only improve bone strength but also build our muscles.
Both calcium and vitamin D are vital in supporting stronger bones. Good sources of calcium can be found in:
- Dairy products such as yoghurt, cheese and milk
- Salmon
- Spinach and Broccoli
- Dried Beans
Vitamin D can be found in eggs and oily fishes such as salmon and sardines. Sunlight is also a good source of vitamin D. Staying under the sun for 10-15mins a day can help increase vitamin D intake.
Our bones will naturally get weaker as we age, but we can take early preventive measures from becoming osteopenia. Adopting an active lifestyle and having food rich in calcium with sources of vitamin D can help boost our bone health. Remember to always consult a healthcare professional before starting any exercise regime or modifying your nutrition plan, especially if you have any existing medical condition or have been diagnosed with osteopenia or osteoporosis.
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National Institute of Arthritis and Musculoskeletal and Skin Diseases (U.S.). Bone Health and Osteoporosis (https://www.niams.nih.gov/health-topics/bone-health-and-osteoporosis).
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