Three or more cups of coffee per day puts you at risk of osteoporosis

THREE OR MORE CUPS OF COFFEE PER DAY PUTS YOU AT RISK OF OSTEOPOROSIS

APRIL 1, 2019 @ 8.12 AM

Women aged 50 years or older and those who have menopause before age 45 due to surgical removal of ovaries (oophorectomy) are at risk of getting osteoporosis.

Four stages of osteoporosis

Osteoporosis means “porous bones” - inner bones which are full of holes and spaces. It is a bone disease which occurs when the body makes too little bone or the body looses too much bone, or both. Therefore, bones become weak and are more likely to break from a fall, typically from a standing height (aka “low-trauma” fracture)”.

What makes a woman more susceptible?
During childhood and adolescence, more bones are deposited and thus, the skeleton grows in size and density.

“The amount of bone tissue in skeleton (aka bone mass) can keep growing until age 30. By then, bones have reached their maximum strength and density (aka peak bone mass). Between age 30 and menopause, there is minimal change in total bone mass," explained Dr Lee Ling Lim, senior lecturer and consultant Endocrinologist, Faculty of Medicine, University of Malaya.

“However, during the first few years after menopause, most women have rapid bone loss due to the loss of estrogen, which then slows but continues throughout the postmenopausal period. This loss of bone mass can lead to osteoporosis."

Age group affected?
Women who have attained menopause. In general, women aged 50 years or older are at risk. There are some risk factors for osteoporosis:

Menopause before age 45 such as surgical removal of ovaries (oophorectomy)
Family history of osteoporosis or low-trauma fracture in first degree of relatives
Low calcium/vitamin D intake
Sedentary lifestyle
Smoking
Alcohol intake more than three units per day
Caffeine intake more than 330 mg per day (about three cups)
Low body weight (body mass index lower than 19 kg calculated as body weight in kg divided by height in squared metre)
Frequent falls
Certain medications such as steroids, anti-epileptic agents

Early signs and symptoms
Osteoporosis commonly affects women. Men can also develop osteoporosis, although relatively uncommon. In adults who are suspected to have osteoporosis, additional blood and urine tests to exclude other causes of bone loss especially other hormonal abnormalities (“secondary osteoporosis”) are required.

Osteoporosis is usually regarded as a silent disease as one can’t feel the bones weakening. Adults may have low back pain.

"Bone fracture with no or minimal trauma (“fall from a standing height”) is typically the first sign of osteoporosis. Adults who have silent spine fracture(s) may notice that she is getting shorter or their upper back is curving forward. Other common fracture sites are hips and wrists," added Lim.

How to screen?
Based on the Malaysian Osteoporosis Guideline, the Osteoporosis Self-Assessment Tool for Asians (OSTA) is a simple tool to identify at-risk women who may need a bone density measurement. The best method for assessing bone density and diagnosing osteoporosis is using dual energy x-ray absorptiometry (DXA) test at the lower spine and hip. DXA can further guide and monitor the effect of treatment. All women aged 65 years and above should have a DXA test.

The aims of treatment for osteoporosis are to avoid the risk factors as listed and to prevent falls/fractures.

Preventive measures
Lifestyle
Exercise: The best activity is weight-bearing exercise such as brisk walking, hiking, jogging, playing tennis, dancing and weight training. Quit smoking, consume alcohol moderately (lesser than three units per day) and have adequate sunshine exposure.

Medications
There are oral and injectable agents which act by either slowing bone loss or promoting bone formation to a certain extent. However, discussion with health care professionals on the appropriate medications is required.

Ensure that you have adequate calcium and vitamin D intake. In the elderly, adequate protein for energy is essential to prevent falls.

For adults aged 50 years and older, the recommended daily intake of total elemental calcium (both diet plus calcium supplements) and vitamin D (1000 mg and 800-1000 IU) are recommended for optimal bone health.

THREE OR MORE CUPS OF COFFEE PER DAY PUTS YOU AT RISK OF OSTEOPOROSIS

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