Osteoporosis (porous fragile bone) is a common metabolic bone disease characterized by deterioration of bone microstructure, increased fragility and decreased bone mass. diagnosis; It is determined according to the data of the method called Dual Energy X-ray Absorbsiometry (DEXA) and the presence of fracture. possible. It is important to take into account that the body, which works in great balance, maintains this balance in the case of osteoporosis, and that bone tissue is affected by metabolic processes, just like the whole body. Although there are many drugs recommended as osteoporosis treatment, the subject of this article is mainly; It is to discuss that osteoporosis treatment cannot be planned without knowing and taking into account the microelement balance.
In recent years, we have observed an increase in the frequency and severity of osteoporosis along with the increase in chronic diseases all over the world. We cannot ignore the loss of nutrients from food sources, environmental pollution, the increase in the amount of toxins and stress, and the effects of drugs used for chronic diseases on general health and bone health. Hoping to relieve the anxiety created by reporting the Bone Densitometry results as numerical results to our patients and the increase in the numerical percentages, by prescribing standard drugs to patients whose nutrition and living conditions we know nothing about, I guess does not relieve many of us and our patients enough now.
Bones are lifelong. It is characterized by stages of construction and destruction. Old bone is destroyed and replaced by new bone. As people age, the rate of bone destruction begins to exceed the rate of construction. A major cause in women is the decrease in estrogen levels during menopause. Over time, this can lead to low bone density (weak bones). Eventually, it can cause osteoporosis. People with osteoporosis are more likely to have bone fractures than those without osteoporosis, especially after trauma such as a fall. Enough magnesium, vitamin D, adequate protein, vitamin K, flavonoids (plant There is a need for nutritional factors such as the group of nutrients that give the skin their color and have antioxidant and anti-inflammatory effects. The nutritional needs of bones, as well as the amount of bone contained in the skeleton, change significantly throughout life. Until the age of twenty-twenty-five, the bone regeneration capacity of calcium and other minerals taken from food is higher than the rate of bone destruction. The peak bone mass gained in adulthood also determines advanced age osteoporosis. This peak bone mass is gained from pregnancy in infancy, childhood and especially in adolescence. Half of the acquired bone mass is built at puberty. This process continues until the mid-20s and most of the peak bone mass is completed. Peak bone mass is defined as the maximum amount of bone that can be reached during skeletal development. A 10 percent increase in peak bone mineral density is thought to delay osteoporosis by 13 years. For this reason, osteoporosis is less common in women receiving hormone replacement therapy during menopause. One of the biggest benefits of HRT in menopause is that it increases the density of bone tissue. Decreased testosterone in men is one of the most important causes of osteoporosis.
Osteoporosis Risk Factors :
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Body structure: Being small, slim, blond
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Lifestyle: Excessive exercise, sedentary lifestyle, alcohol and cigarette consumption, prolonged bed rest
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Concomitant diseases and some drugs used: Cardiovascular diseases, Diabetes, hyperthyroidism and connective tissue diseases, rheumatic diseases, stomach and intestinal absorption disorders disrupt bone mineralization. It has a negative effect especially on hip bone mineral density. In addition, some drugs accelerate the development of osteoporosis. Although the best known of these drugs are corticosteroids, antiepileptics, diuretics, anti-depressant drugs (SSRIs), lithium, methotraxate, proton pump inhibitors (stomach protectors) and anticoagulant drugs have also been found to have an effect on osteoporosis by impairing calcium absorption.
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Hormonal causes: Decreased estrogen due to menopause in women, decreased testosterone in men ğ; low levels of testosterone in women and estrogen in men, hyperthyroidism, hyperparathyroidism, cushing's disease.
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Nutrition: The "you are what you eat" view bones remains valid for Affecting general health, causing inflammation; Consuming products consisting of sugar, refined carbohydrates and unhealthy fats, various vegetables, fruit and fermented foods, healthy fats and proteins instead of packaged “things” will contribute positively to both general health and bone health.
When it comes to the relationship between osteoporosis and nutrition, the first thing that comes to mind is to question milk in nutrition. In many publications, lack of milk intake is among the risk factors.
The Harvard Nurses' Health Study followed 72,000 women for 18 years and showed that milk had no protective effect from the risk of fractures. It is possible to get the calcium we need by eating colorful vegetables without the risk of food allergy that may occur while drinking milk, or the possibility of taking the hormones and antibiotics that are abundant in industrial milk together.
Increase in cortisol in the body: Cortisol accelerates bone destruction. It reduces bone formation, weakens the bone by reducing the absorption of calcium from the intestine. The increase in cortisol in the body happens either for external or internal reasons. external causes; to use cortisone as a medicine during the treatment of some diseases. The amount of bone loss varies according to the dose and duration of use of these drugs. It begins immediately after the start of treatment and occurs most often in the first 6 months. The measures to be taken in the treatment do not differ from my general osteoporosis approach.
Internal causes leading to an increase in body cortisol; some hormone-related diseases that cause the increase of cortisol in the body and stress, which is perhaps the most important problem of our age. Although there are studies on the relationship between osteoporosis and depression, research on the relationship between chronic stress and osteoporosis has been increasing in recent years. Today, unlike thousands of years ago, we are exposed to various stresses that affect almost all physiological mechanisms in the body. Chronic psychosocial stress has been shown to be a risk factor for osteoporosis through several mechanisms. or. Increasing evidence confirms the physiological importance of the central nervous system, particularly the hypothalamus, in the regulation of bone metabolism. Both animal and human studies show that chronic psychological stress also affects the hypothalamic-pituitary-adrenocortical (HPA) axis, sympathetic nervous system, endocrine and immune factors, resulting in decreased bone mass and deterioration in bone quality. Chronic stress activates the HPA axis and the sympathetic nervous system, suppressing the secretion of reproductive hormone and growth hormone, increasing the inflammatory secretion of tissue cells, resulting in bone loss by inhibiting bone formation and stimulating bone resorption.
Chronic psychosocial stress, In adolescent mice, it has been shown to inhibit both longitudinal and transverse bone growth and ossification in the growth plate.
Calcium / magnesium balance:
In terms of bone health, calcium / magnesium balance is more important than increasing calcium intake. Magnesium is a mineral that every cell in our body needs. Half of the magnesium stores are found in the cells of tissues and organs, the other half in the bone with calcium and phosphate, and only 1% in the blood. Keeping the magnesium level in the blood constant is important for maintaining the functions. In the body, magnesium must be in a certain balance with calcium. If the balance between magnesium and calcium is not maintained, excess calcium becomes toxic to the body and causes heart disease, arthritis, osteoporosis, atherosclerosis, calcification of tissues and organs. Magnesium is a co-factor in many biochemical reactions, helping to maintain normal muscle and nerve function, maintain heart rhythm and maintain bone strength
Sodium / Potassium balance:
When osteoporosis is mentioned, it is the most recommended calcium intake. However, another very important issue in this regard is the sodium / potassium balance. While the human species evolved to have potassium intake 4-10 times sodium intake, today this ratio has been reversed, with sodium intake 3-10 times potassium intake. As it stands, we are the only mammal species in nature that takes in more sodium than potassium. The sodium/potassium ratio is higher than my sodium intake in hypertension. in the case of a damp criterion. Sodium intake also increases urinary calcium excretion, therefore, when it comes to osteoporosis, it is necessary to show more salt intake than the dietary calcium intake deserves. Increasing dietary potassium bicarbonate intake reduces urinary calcium excretion caused by excess salt (sodium) intake, thus contributing to the prevention of osteoporosis.
Packaged foods disrupt the sodium / potassium balance:
The first thing to do is to regulate the sodium potassium balance; It is to exclude packaged foods containing large amounts of salt from the diet. Emphasizing the key role of potassium support, let's say that all plants are rich in potassium and poor in salt. For example, the potassium / sodium ratio is 220 in walnuts, 75 in mushrooms, 70 in avocados, 705 in almonds, 10 in parsley and 10 in kale. Plant foods contribute to our health both with the phytonutrients they contain and with alkaline salts.
The effect of tissue acidosis on osteoporosis:
We call Western diet; A diet suitable for the fast pace of life, packed with processed foods, rich in unhealthy fats and sugar keeps our body in a metabolic acidosis that continues without symptoms for years. This tissue acidosis both increases calcium withdrawal from the bone and decreases bone formation and supports its destruction. Excess protein intake also contributes to osteoporosis as it causes acidosis. As in all matters, balance is essential in protein intake. In other words, just like taking more protein than necessary, taking less also weakens the bone structure.
The relationship between bowel and bone structure / osteoporosis;
There are more than seven thousand people living in the gut. Millions of types of bacteria make up the body's micro ecosystem, the gut microbiome. Recent studies have shown that the microbiome may have an impact on bone remodeling and bone mass. The gut microbiome has a bidirectional relationship with the endocrine, immune, and nervous systems. Probiotic treatment has been shown to reduce bone loss in estrogen-deficient animals.
Prebiotics, when consumed, have health benefits
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