Osteoporosis is a disease of ageing. One out of eight males and one out of three females in India suffer from osteoporosis, making India one of the largest affected countries in the world. It is a disease in which the density and quality of bone is reduced, which leads to weakness of bones and increased risk of fractures, particularly of the spine, wrist and hip.

Bone is a living tissue and old bone is constantly replaced with new. Osteoporosis is not an inevitable part of aging, but rather occurs when bone loss outpaces the growth of new bone. Often, bone loss occurs progressively without any symptoms until a fracture occurs.

The hormonal changes that take place at menopause put women at greater risk of osteoporosis than men. Five to seven years after menopause, women can lose 20 per cent or more of their bone density. Besides age, genes and family history, poor lifestyle choices also have a negative effect on bone health and increase the risk of developing disease. Inactivity, smoking, drinking and bad diet contribute to weak bones.

Diet plays a major role in the development of osteoporosis. Low calcium intake contributes to diminished bone density and an increased risk of fractures. Lower level of awareness, widespread vitamin D deficiency (vitamin D helps the absorption of calcium) and lower amounts of calcium intake than the ideal daily intake put Indian population at a higher risk.

Certain commonly prescribed medicines such as steroids, anti coagulants, seizure medicines also increase the risk, so the balance of benefits and harms has to be assessed.

Osteoporosis may be a silent disease, but can be diagnosed through a bone density scan or dual-energy X-ray absorptiometry (DXA) and routine screening is recommended for women ages 65 and older while for men the current evidence for routine screening is insufficient. Test results are reported as T-scores. Based on risk factors an individual’s 10-year risk of osteoporotic fracture can be estimated by a web-based (FRAX) Fracture Risk Assessment Tool, www.shef.ac.uk/frax/.

The good news is — the clock can be rolled back. Healthy lifestyle choices and available therapies can slow down bone loss and help prevent fractures.