1. Osteoporosis – The Sexist, Racist, Thief and Bully … Created by: Dato’ Dr Rajen. M Holista Colltech

2. Osteoporosis A major public threat for more than 2.8 million Malaysians - 80 % are women. 1 in 2 women and 1 in 8 men over 50 will have an osteoporosis related fracture.

3. What is it? A disease in which bones become fragile and more likely to break. Breaks usually occur in the hip, spine and wrist.

4. What is it? Hip and spine fractures are a major concern. Hip fractures almost always require surgery and hospitalization. Spine fractures have serious consequences such as loss of height, severe back pain, and deformity.

5. What causes osteoporosis? Scientist have not yet learned all the reasons this occurs. When you are young your body makes new bone faster than it breaks down old bones. As you get older, this process slows down and you start losing bone density. The risk for osteoporosis depends on how much bone mass you attained between ages 25 and 35 and how fast you lose it.

6. Risk Factors Certain people are more likely to develop this disease than others. Female Thin and/or small frame Advanced age Fair skinned

7. Risk Factors Anorexia nervosa or bulimia Diet low in calcium Use of certain medications Low testosterone levels in men An inactive lifestyle Cigarette smoking Excessive use of alcohol Being Asian or Caucasian

8. Are your bones healthy? Normal bone Osteoporosis

9. Bone Health Bones are living tissue, they provide structural support, protect vital organs and store calcium. Until age 30, we store and build bone effectively. As part of the aging process, bones begin to break down faster than they are formed. Accelerates after menopause. Estrogen is the hormone that protects against bone loss.

10. Detection Bone Density Tests: Can detect osteoporosis before a fracture occurs. Predicts your chances of fracturing in the future. Determines your rate of bone loss and monitors the effects of treatment.

11. Bone Mass Density The National Osteoporosis Foundation Recommends you have a BDT if: You use medications that cause osteoporosis You have type I diabetes, liver disease, kidney disease or a family history You experience early menopause You’re postmenopausal over 50 and have at least one risk factor. You’re postmenopausal over 65 and never had a test.

12. Prevention Diet Building strong bones in childhood and adolescence is the best defense. A balanced diet rich in calcium and Vitamin D Weight bearing exercise A healthy lifestyle with no smoking or excessive alcohol intake. Bone density testing and medication when appropriate.

13. Diet Eat less refined carbohydrates - sugar - starch Avoid wheat Avoid milk

14. Calcium Is needed for heart muscles, and nerves to function properly. Inadequate amounts contribute to osteoporosis. Appropriate calcium intake falls between 1000 and 1300 mg a day.

15. Calcium Increase calcium: Consume calcium rich foods such as, low-fat milk, cheese, broccoli, and others. Calcium supplement, if dietary calcium consumption is inadequate

16. How to get enough Calcium every day! Follow the Food Guide Pyramid for Dietary Calcium Sources Dairy- low fat yogurt, skim milk, cheese, chocolate pudding, ice milk, ice cream or frozen yogurt. Protein- tofu, sardines, salmon Vegetables- turnip greens, Bok Choy, Broccoli, collard greens Other foods: vegetable lasagna, cheese enchilada, cheese pizza, calcium fortified orange juice.

17. Vitamin D Is needed for your body to absorb calcium. Comes from 2 sources : the sun and Fortified dairy products, egg yolks, saltwater fish, and liver. Need 400-800 IU a day.

18. Exercise Exercising regularly in childhood and adolescence can ensure that you will reach peak bone density. Need to participate in weight bearing exercise. For example, walking, dancing, jogging, stair climbing, racquet sports and hiking.

19. Medications There is no cure, but several medications have been approved. Each stops or slows bone loss, increases bone density, and reduces fracture risk. Estrogen Replacement, Alendronate,raloxitene and risedronate are prescribed to prevent and treat the disease.

20. Bone-Building Checklist Maintain a calcium rich diet. Get plenty of vitamin D Engage in weight-bearing exercise Don’t smoke and limit alcohol intake Consider Hormone Replacement or other medications if you are at risk.

21. What’s next? We need to educate young women and teenagers about the risk of osteoporosis.