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OSTEOPOROSIS IN WOMEN
Osteoporosis is a progressive, systemic, skeletal disease characterized by decreased bone mass and microarchitectural deterioration of bone tissue leading to increased bone fragility and susceptibility to fractures.
The more risk factors (eg history of fracture, advanced age, comorbidities, etc) that are present, the greater the risk of fracture.

Lifestyle Modification

Nutrition

Calcium (Ca) and Vitamin D

  • Prevention of osteoporosis
    • Lifelong intake of adequate Ca is associated with higher peak bone mass which reduces the risk of osteoporosis/fracture in later life
    • Recommended Ca intake for patients >50 years of age: 500-1200 mg/day
    • The main sources of Ca are from dairy products; vegetables (eg broccoli, cabbage) are also a good source
    • Vitamin D helps in intestinal Ca absorption and bone mineralization, and enhances response to bisphosphonate therapy
    • Recommended vitamin D intake for patients ≥50 years of age: 800-1000 IU/day
      • Higher doses may be needed in patients with malabsorption, obesity, older individuals, transplant patients 
    • The main sources of vitamin D are from sun exposure (>15 minutes/day), fortified milk, cereals, egg yolks, salt water fish and liver
  • Treatment of osteoporosis
    • Ca and vitamin D supplements may be administered as adjunct to other drug therapies in the treatment of osteoporosis
    • Helps to increase bone mineral density (BMD) and may reduce fracture risk in postmenopausal women with osteoporosis
  • Glucocorticoid-induced osteoporosis (GIOP)
    • Recommended in secondary prevention and treatment
    • Has been shown to reduce bone loss

Good General Nutrition

  • Excessive dieting and low body weight are associated with increased risk of fracture
    • Recommend body mass index (BMI) ≥19 kg/m2
  • Maintenance of adequate energy and protein intake is important as well as consuming a balanced diet

Exercise

  • Regular weight-bearing exercises and muscle strengthening exercises can improve agility, strength, posture and balance, which may help to prevent falls
    • Jogging, brisk walking, tai chi, weight training
    • Type of exercise will depend on age of patient and physical ability
    • At least 30 minutes of regular exercise 3-4x/week is recommended
  • May modestly increase bone density (for as long as exercise is being done)

Avoid Cigarette Smoking and Excessive Alcohol Consumption

  • Both associated with increased risk of osteoporotic fractures and should be avoided
  • Alcohol intake may be limited to <2 units/day 
Limit Caffeine Intake
  • Caffeinated drinks should be limited to <1-2 servings/day (240-360 mL/serving) 
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