a national survey on osteoporosis gets underway, experts stress
the need for awareness programmes
In the claws of a silent bone-eater
By Esther Williams
Osteoporosis can sneak up on you. The silent disease is dangerous
as there are no warning signs or symptoms. A fracture in the hip,
spine or forearm resulting from a sudden strain or a simple fall
is often the first indication that you have osteoporosis. But by
then, it may be too late for effective treatment.
to common belief, osteoporosis is not inevitable with age. "It
is a preventable disease and not a condition of ageing," said
Sri Jayawardenepura University's Senior Lecturer Dr. Udul Hewage.
was addressing a gathering at the launch of the National Osteoporosis
Survey by the Ruhuna Medical Faculty's Centre for Metabolic Bone
is a bone disease that results in its softening, eventually increasing
the risk of fractures caused by the fragile state of the bones.
Around the world, osteoporosis has increased mortality, morbidity,
the health care burden to society and the risk of complications.
studies carried out in Sri Lanka show a high prevalence of osteoporosis
among postmenopausal women. While it has been established that low
calcium intake, low body weight, lack of exercise, smoking and excessive
intake of alcohol or caffeine can lead to osteoporosis, backache,
changed curvature of spine, hunched appearance and reduction in
height are considered non-specific symptoms. It has to be noted
that absence of proof is not absence of disease. Needless to say,
the condition should be diagnosed early for it to be prevented and
is worth noting that bone mineral is acquired only until a person
reaches the age of 30 and not after that. A rapid decline is seen
in bone density after 50. It is, therefore, important to build one’s
calcium reserves before one reaches 30.
National Osteoporosis Survey has been launched to determine the
prevalence of the disease in Sri Lanka. It has been established
that osteoporosis is a disease affecting older men and women, an
age group that is expected to grow in future in this country.
University’s senior lecturer Dr. Sarath Lekamwasam, who is
heading the project, said the survey, the first of its kind, would
help them obtain data on age related changes in bone density; age
at which bone density reaches its height; how bone mineral density
(BMD) changes with age; proportion of people with low BMD; association
of age, weight, age of menopause, smoking and alcohol with BMD and
association of milk consumption with BMD.
first phase of the research will target a 5000-sample base representing
different demographic and geographic strata. Research together with
analysis of the findings is expected to take 9-12 months.
the next few months, a mobile clinic manned by well-trained personnel
will visit earmarked areas to collect data. A bone-scanning machine
(AccuDXA system) will be used for the BMD tests. The equipment is
not available in most hospitals in the country.
process is fairly simple as demonstrated during the launch of the
survey on October 7. A person's middle finger of their non-dominant
hand is placed in the slot of a machine. Fingers are easy to measure,
as they are rich in trabecular bone, which is the most affected
by osteoporosis. Within a few minutes a report is produced showing
levels of calcium in the area being measured.
addition, those being tested are required to fill in a questionnaire
stating details pertaining to their age, menstruation, children,
physical activity, milk intake, etc. Those found with low levels
of calcium will be provided with referral letters to their GPs and
contact numbers for further treatment. They will also be advised
on lifestyle modifications. The entire process would take less than
20 minutes. Announcements will be made to keep people informed of
the tests being done in their localities.
age, female gender, sedentary lifestyle, diet and steroid therapy
as risk factors and outlining measures to prevent osteoporosis,
Professor Devaka Fernando of the Sri Jayawardenepura University
said the government, food industry and media had to play an important
role in preventing the disease through awareness and other programmes.
the rate of mortality and the health burden it represents, the government
should make osteoporosis a priority in health policy, set recommendations
for calorie intake, educate children in schools and provide incentives
to health-food industries and fitness institutions, he said.
Fernando feels that the food industry should act in a more socially
responsible manner and the media be more vigilant for hard evidence
on medical issues before presenting information to the public.
Zealand Milk Lanka Limited (NZML), the marketers of Anlene, is sponsoring
the survey, as part of their corporate social responsibility commitment.
Speaking at the launch, an NZML official said their studies had
revealed a high prevalence of osteoporosis and low levels of awareness
in the country. "It is our key responsibility to educate the
public and support the study to tackle the disease," he said.
is a BMD test?
The only way to determine your bone health and fracture risk for
osteoporosis is to have a bone mineral density test (BMD). A BMD
is a safe painless test that measures the amount of mineral or density/thickness
in a specific area of bone.
more mineral (calcium) you have, the greater your bone density or
bone mass is. BMD testing is more sensitive than normal X-rays,
its accuracy reported to be quite high - ranging from 85% to 99%.