ACP releases new guidelines on the treatment of osteoporosis

ACP releases new guidelines on the treatment of osteoporosis The American College of Physicians (ACP) has released new guidelines on the treatment of osteoporosis, which have been published in the Annals of Internal Medicine. The recommendations for treating osteoporosis were last published in 2008. • Physicians should treat women with osteoporosis with bisphosphonates (alendronate, risedronate, or zoledronic acid) or denosumab, a biologic agent for five years. Continuing treatment after the initial five years may be beneficial for some patients and may be appropriate after reassessing the risks and benefits of continuing therapy. • Bisphosphonates are also recommended in men with osteoporosis to reduce fracture risk. • Bone density monitoring during the five-year treatment period is not recommended due to lack of evidence of the benefit of monitoring. • Use of hormone-replacement therapy (HRT), either estrogen alone or estrogen + progestin or raloxifene for the treatment of osteoporosis in women is not recommended. The serious adverse effects of estrogen treatment such as increased risk for cerebrovascular accidents and venous thromboembolic events outweigh the potential benefits. • The decision to treat osteopenic women 65 years of age or older at a high risk for fracture should be based on fracture risk profile; and the benefits, harms, and costs of medications and patient preference. • Most women with normal bone density measurements do not progress to osteoporosis within 15 years; hence, ACP does not support frequent monitoring of women with normal bone density for osteoporosis At the same time, the ACP does not recommend physicians use, (Source: ACP Press Release, May 9, 2017)

Keep osteoporosis at bay with 20 minutes in sunlight and a glass of milk

Keep osteoporosis at bay with 20 minutes in sunlight and a glass of milk Osteoporosis and vitamin D deficiencies are the two silent epidemics of the society. New Delhi, March 17, 2017: Estimates report that 1 out of 8 males and 1 out of 3 females in India suffers from osteoporosis, this essentially makes India one of the worst hit countries of the world. Drinking less milk, avoiding sunlight exposure and omitting the traditional aerobic indoor games are few reasons for these new epidemics. Most young professionals now remain confined to their offices or workplace, with practically no exposure to sunlight. This is especially true for the medical residents.
Padma Shri Awardee Dr K K Aggarwal, President Heart Care Foundation of India (HCFI) and National President Indian Medical Association (IMA) in a joint statement said, “Osteoporosis, also called ‘the silent disease’ often goes unnoticed until the symptoms start to manifest. Early recognition of symptoms and preventive measures can help those who suffer. Identify your risk factors: and bring these to your doctor’s attention, especially if you’ve had a previous fracture or have specific diseases and/or are taking medications that affect bone health. Take osteoporosis medicine, if needed: Treatment will help to improve bone miner density (BMD) and reduce risk of fracture.”
“A bone healthy diet including good amount of protein and calories as well as optimal amounts of calcium and vitamin D, which are important in maintaining proper bone formation and bone density is crucial for managing osteoporosis. Moreover, controlling caffeine, alcohol and salt has been proven to prevent bone loss. To strengthen the skeletal architecture and improve bone density, exercising for at least 30 minutes three times per week is advised”, adds Dr K K Aggarwal.
Here are a few tips for preventing osteoporosis and strengthening the bones.  Stop smoking as it increases bone loss.  Eat a calcium-rich diet: The aim should be to get 1,500 mg of calcium a day in postmenopausal woman or a man over age 65. Good dietary sources of calcium include dairy products, tofu and other soy products, orange juice fortified with calcium, canned salmon with the bones, and cooked spinach.  Get enough vitamin D: Vitamin D levels are influenced by how much sunlight one gets. Levels tend to decrease in older adults, especially in winter and in people who are unable to leave their home. Consider taking a supplement to ensure intake of the recommended daily amount.  Get exposure to sunlight of at least 20 min per day. The exposure should be for duration of 20 min every day for a month in a year.  Get enough protein in diet: An adequate intake of protein in diet, combined with an adequate intake of calcium helps increase bone density. One should aim for about 12% of calories to come from proteins such as legumes, poultry, seafood, meat, dairy products, nuts and seeds. However, too much protein with too little calcium can be harmful.  Weight-bearing exercise: These are activities such as walking, jogging and climbing stairs that one should do on the feet, with your bones supporting your weight. They work directly on the bones of the legs, hips and lower spine to slow mineral loss.  Weightlifting exercises: These exercises, also called resistance training or strength training. They strengthen muscles and bones in the arms, chest and upper spine. They can work directly on the bones to slow minerals loss.  Get adequate vitamin K: This vitamin may be helpful in enhancing bone strength. Green leafy vegetables are the best sources of vitamin K. If one is taking a blood thinner, he or she should check with the doctor.  Avoid excessive alcohol: Women should limit alcohol consumption to less than one ounce a day and men should limit it to less than two ounces.  Limit cola drinks: People who have high cola intake often have lower bone density.