Osteoporosis is a devastating disease whereby the bones become brittle and porous and more prone to breakage, which is estimated to affect about 75 million people in Europe, the USA and Japan.
The most widely used supplements for the prevention of the disease and to help strengthen bones after diagnosis are calcium, which is well-known building-block of strong ones, and vitamin D, which has been shown to boost calcium absorption.
There is also a growing body of science linking vitamin K, considerably less well-known than vitamins A to E, to benefiting bone health as it influences the secondary modification of osteocalcin, a protein needed to bind calcium to the bone matrix.
The World Congress on Osteoporosis held in Toronto, Canada, this weekend, coincided with the build-up to World Osteoporosis Day, scheduled to take place on October 20 in 85 countries around the world.
This year the focus will be on the role of nutrition in building bones, and the theme is ‘Bone Appetite'.
Delegates in Toronto heard the results of three surveys designed to assess preventative measures, diagnosis of osteoporosis, and treatment, which were conducted in Belgium, Canada, and Germany.
The Canadian study showed that 61 per cent of 125 patients who suffered a low-trauma fracture of wrist, hip spine or shoulder in 2003 did not receive a bone density scan to test for osteoporosis. The majority were also not told to increase calcium or vitamin D intake, or to undertake exercises to maintain bone strength.
In Germany the rates were even lower: Out of 761 postmenopausal women who suffered a wrist fracture questioned, less than four per cent were offered a scan and less than 10 per cent received supplement advice.
In Belgium, two thirds of post-menopausal female outpatients were offered supplements or drugs – regardless of whether or not they had been diagnosed with osteoporosis. This may, perhaps, be good news for prevention, but Florent Richy of the University of Liege was condemnatory of the public health approach:
“The findings show that while we have the weapons to diagnose and treat osteoporosis, we are not yet able to direct them where they are needed most.”
Health care practitioners are first port of call for most people concerned about osteoporosis susceptibility and certainly for those who have already suffered a fracture, and indeed the weight of responsibility lies with them and government officials.
But given the current situation opportunities exist for others to help communicate the message – including supplement makers, who could step up their own science-based campaigns and boost sales at the same time.
According to the International Osteoporosis Foundation, the total direct cost of osteoporotic fractures is € 31.7 billion in Europe, and 17.5 billion in the US (2002 figure). The total annual cost of osteoporosis in the UK alone is over £1.7 billion (€ 2.5 billion), equivalent to £5 million (€ 7.3 million) each day.
With the ageing of populations around the world as the baby boom generation enters its senior years, there are fears that osteoporosis rates – as well as other age-related illnesses – may skyrocket over the next two decades.
Prevention also came under the spotlight at the conference, with the presentation of study data that indicates the role of material vitamin D consumption on osteoporosis risk of offspring, as poor skeletal growth in infancy was seen to increase the risk of future fractures.
Nicholas Harvey of the MRC Epidemiological Resource Centre in Southampton, UK and colleagues looked at material vitamin D levels taken during late pregnancy, infant bone density in 556 babies soon after the birth, and levels of calcium transporter in the placenta.
They found that baby girls born to women with low vitamin D levels tended to have bones of lower density. Higher levels of calcium transporter were also linked to higher infant bone density.
“What we hypothesise is that the mother's vitamin D levels somehow influence the amount of calcium transporter in circulation,” said Harvey.
In parallel with this, Dr Kassim Javaid, also from the Southampton centre, compared the weight and length data from 13,345 children born in Helsinki, Finland, between 1934 and 1944, at birth and during childhood with later hip fracture incidence. They found that those with a lower weight in infancy and early childhood tended to have more hip fractures in later life.
“Now we have evidence that the bone mass you have at the age of 80 reflects what you started with very early in life,” said Dr Javaid.
