The incidence of Osteoporosis in Singapore for those over the age of 65 is projected to increase approximately 3-fold from 6% to 19% during the period of 1990 to 2030. In the 3 decades since the 1960s, the number of osteoporotic hip fractures in Singapore has increased 5-fold to 403 cases per 100,000 in women over the age of 50. The number of osteoporotic hip fractures in women over the age of 50 is 8-fold more than the number of breast cancer cases. There were 402 cases of osteoporotic hip fractures vs 53 cases of breast cancer per 100,000 people.

Worldwide approximately 200 million women worldwide suffer from osteoporosis in Europe and the United States, it is estimated that one third of all women over 50 will suffer an osteoporosis-related fracture at some point in their lives. Approximately 1.7 million hip fractures annually are attributed to osteoporosis. A woman’s risk of hip fracture is equivalent to her combined risk of developing breast, uterine and ovarian cancer.

Osteoporosis has become an epidemic in the United States. About 10 million people—80 percent of them women—suffer from the chronic condition that leads to debilitating and life-threatening fractures. What’s worse, the number of people with low bone mass— high risk for osteoporosis development— keeps growing. While 34 million people now have low bone mass, by 2010, the number is expected to climb to 52 million. The reasons for the increase are not yet clear, but research points to lifestyle and diet.

The bony structure is built in childhood, when weight-bearing physical activity and proper nutrition are essential. Today’s children, however, spend most of their time sitting in front of TV sets or computer monitors and drink calcium robbing sodas, instead of calcium-rich milk. The combination of inactivity and calcium imbalance makes them more likely to develop osteoporosis. One of the most common bone diseases, osteoporosis is also one of the most preventable. Because osteoporosis is painless until a fracture actually occurs, bone density screening should be used to help diagnose the disease early on.

Risk factors for Osteoporosis
• Female
• Menopausal
• Small frame
• Ovary removal
• Early enopause by age 45
• Prolonged hormonal imbalances
• Calcium and vitamin D deficiencies
• Insufficient physical activity
• White or Asian ancestry
• Smoker
• Excess caffeine/soda intake
• More than 2 alcoholic drinks per day
• Regular use of certain medications (glucocorticoids, thyroid hormone, anticonvulsants, and aluminum-containing antacids) •
• History of eating disorders.

Osteoporosis screening should be done every 2 years. Osteoporosis screening and prevention are especially important because bone loss must be stabilized.

We recommend the following tips for preventing and managing osteoporosis: Exercise – Start a regular exercise program. Exercise puts stress on the bone and helps it strengthen and remodel. Exercise for at least 20 minutes 3 times a week. However, if you have had a fracture, fall frequently, or have osteoporosis, consult your health care provider before starting any exercise program. Tai Chi and other weight-bearing activities, such as jogging, walking, stair climbing, playing racquet sports, aerobics, and dancing, can be beneficial. These exercises improve flexibility and balance, reducing the risk of falling and fractures. Resistance exercises that increase muscle mass and strengthen bones, such as weight lifting, are generally recommended.

Spend time outdoors. Exposure to sunlight increases your level of vitamin D—a necessary element for absorption of calcium, which prevents osteoporosis development. Low dose supplemental Vitamin D of 1000IU may be used if your sun exposure is minimal.

Additional tips for people with Osteoporosis: Be careful when bending and lifting heavy objects, including children. When lifting, bend from the knees, not the waist, and try to avoid hunching over while sitting or standing. Remove throw rugs, electrical cords, and other objects you may trip on from the areas where you normally walk. Falls from a standing position for an osteoporosis patient may often result in fractures.
Decrease consumption of foods high in phosphorus, such as soda, potato chips, hot dogs, bacon, beer, biscuits, crackers, white rice, liver, bologna and peanuts. Too much phosphorus decreases absorption of calcium and other minerals and weakens the bone. Calcium is essential to building and protecting the bones.

Good sources of calcium are milk, cheese, yogurt, broccoli, kale, spinach, and rhubarb. A glass of milk and a cup of yogurt add 600 mg of calcium to your daily diet. If you are looking for a calcium supplement, try one that’s highly absorbable, such as microcrystalline hydroxyapatite concentrate (MCHC), or one of the malates, fumarates, succinates, glutarates, or citrates. But don’t overdo it. Excess calcium may cause kidney stones, so ask your health care provider about your individual supplement amount. Check with your doctor if you are getting enough vitamin D. Without vitamin D, the body won’t absorb calcium.

Distraction (redirecting your attention away from chronic pain), imagery (going to your “happy place”), and dissociation (detaching yourself from the chronic pain) can be useful. Involving your family with your recovery may be quite helpful, according to recent scientific evidence. 

Feel free to discuss these or other techniques with your doctor. He or she may suggest some simple techniques that may work for you or may refer you to another health care provider for more in-depth training in these techniques.