Bone Appetit

The president of the Malta Osteoporosis Society, Ray Galea, has urged people at a higher risk of osteoporosis to take a bone density test.

A bone disease mainly of the older age group, osteoporosis affects an estimated 75 million people in Europe, the USA and Japan.

It is known as the silent disease because bone is lost with no symptoms. If not prevented or if left untreated, osteoporosis can progress painlessly until a bone fractures, most commonly in the hip, spine or wrist.

The disease can impair a person's ability to walk unassisted and may cause prolonged or permanent disability or even death. Spinal or vertebral fractures also have serious consequences, including loss of height, severe back pain and deformity.

Women are four times more likely than men to develop the disease. Around the world, osteoporosis affects one in three women and one in five men over the age of 50.

Moira Mizzi, a medical doctor, said there are many factors which contribute to loss of bone as people age. Women, especially older ones, those with a small frame, white and Asian women and those with family history of osteoporosis are at a greater risk.

Other risk factors include anorexia nervosa, a low calcium and vitamin D intake, the use of certain medication such as steroids, a low activity level, smoking, alcohol and use of sun block. The latter is because UV rays absorbed through the skin trigger the synthesis of vitamin D, which is vital to the blood-bone calcium circulation.

Women, Dr Mizzi said, should get screened for osteoporosis especially after menopause. Those at a higher risk should be screened more frequently. High risk categories should in fact be screened even before the menopause.

While a person's bone mass increases until one reaches the age of 35, it then starts a downhill slide of one per cent per year. Post-menopausal individuals, especially those known to be in the high risk group should speak to their doctor who could then determine whether they are actually at a risk and refer them for tests, she said.

World Osteoporosis Day is being celebrated on the theme Bone Appetit - the role of food and nutrition in building and maintaining strong bones.

The International Osteoporosis Foundation is conveying the message that while osteoporosis is serious, individuals can take responsibility for their bone health by building strong bones through a healthy lifestyle.

Treatment

A wide range of options and several safe and effective pharmacological treatments have been shown to act within one year to reduce the risk of vertebral fractures by up to 65 per cent and non-vertebral fractures by up to 53 per cent.

Drugs which help to rebuild the skeleton are used to treat the disease.

The newest drug on the Maltese market is Roche's and GlaxoSmithKline's Bonviva, the first once-monthly tablet. Other drug treatments available are weekly or daily.

Bonviva, a potent bisphosphonate, has been studied in clinical trials involving over 11,000 patients. It has proved effective, is well tolerated and patients only need to postpone morning tea and breakfast and adjust other medication schedules once a month.

Bonviva reduces bone turnover, increases bone mineral density and reduces the incidence of vertebral fractures.

Last April, the EU Osteoporosis Consultation Panel reviewed a new method of improving fracture prediction so that treatments can be offered to more high-risk women.

This tool is being developed by the World Health Organisation Collaborating Centre in Sheffield, UK. Supported by the International Osteoporosis Foundation, the consultation panel plans to recommend that EU member states adopt this approach to help tackle the growing threat of osteoporosis in Europe.

Malta Osteoporosis Society

The Malta Osteoporosis Society (MOS) is a voluntary support group for sufferers and their relatives. No membership fee is paid and the society gets financial support from the pharmaceutical companies providing pills for the treatment of the disease.

President Ray Galea said the society, which now has about 250 members, is in the process of becoming a member of the International Osteoporosis Foundation. It holds meetings every six weeks or so and these are always attended by over 100 people. Ninety-five per cent of the association's members are sufferers. Only three per cent are men.

Dr Galea said the organisation is mainly promoted through word of mouth and attendance at meetings is very encouraging. Besides medical issues, subjects such as nutrition and exercise are also discussed.

He said the society aimed to create awareness. With the rise in average life expectancy, the problem of osteoporosis was also on the rise. It was also coming out more into the open since the advent of bone density testing, which is the golden standard in the diagnosis of osteoporosis but which had not been available in the past.

The society, Dr Galea said, would like to create a system whereby members would be able to offer each other support.

The major problem of osteoporosis, he said, is that all treatments available are costly, amounting to some Lm20 per month, and most sufferers are women on a pension.