OSTEOPOROSIS IN YOUNG GIRLS



Abstract

Osteoporosis can happen in any age. It's not an old age disease. This is misconception as the most critical time for building bone mass is the 'Adolescent age'.
The prevalence of osteoporosis increase markedly with age, reflecting the age related decline in bone mass. This gets aggravated by inadequate calcium and vitamin diet (especially vitamin-D), sedentary lifestyle and quest of menopause in females. Females get poor nutrition in childhood and even post pregnancy so, undernourished females eventually become osteoporotic very early. Young women, and even young girls, may also be at risk. Eating disorder such as anorexia nervosa and bulimia can in severe cases not only leaves the sufferer malnourished in terms of such as calcium, but can also lead to a decline in body functions and production of hormones such as estrogen causing menstruation to cease.

Keywords: Osteoporosis, Metabolic bone disease, Adolescent, Young Girls, Calcium intake, Female Athlete Triad.

Osteoporosis in adolescent girls

Teens may not think much about what they eat. Or what they eat today will affect them tomorrow, or twenty years from now. One long-lasting effect of nutritional imbalance during adolescence is osteoporosis. Once recognised primarily as an elderly woman's disease, osteoporosis is now being acknowledged as a partially preventable "adolescent" disease because the occurrence of osteoporosis is influenced by bone mass attained during the first three decades of life, as well as the amount of bone lost after menopause. An optimal calcium intake during adolescence, when 50 percent of adult skeletal mass is formed, decreases the risk of the crippling fractures caused by osteoporosis.

                                                                      Table 1 Showing age wise comparison between male and female calcium influence

Recent studies shows calcium supplementation in the girls of age between 12 to 16 years, produced a 14 percent increase in bone density in comparison to unsupplemented girls. For every 5 percent increase in bone density, the risk of fracture declines by 40 percent. And, by the time adolescents finish their "growth spurt" around the age of 17 to 18 years, approximately 90 percent of their adult bone mass will have been established.
However, a national survey indicates that 85 percent of adolescent females do not consume the Recommended Daily Allowance (RDA) for calcium. Many adolescent females avoid dairy products, the best source of calcium, because of the perception that all dairy products are Fat-laden foods. Other teens replace milk with regular or diet soda, unconcerned about the "Empty calories" or limited nutritional value of soda. Some teens are not aware of the serious, long-lasting implications of inadequate calcium consumption. And most do not think they may become one of the 26 million women that suffer from osteoporosis today.

                                                           Table 2 showing recommended daily allowance of calcium in different age groups

Adolescent Female Athlete Triad

Disordered Eating, Amenorrhea, and Osteoporosis
The competitive adolescent female athlete may often be at risk for developing this trio of medical disorders. The compounded effects of osteopenia (reduced bone mass), amenorrhea (loss of periods), and disordered eating can be debilitating for the female teen athlete. Despite the fact that their weight- bearing exercise acts to increase bone density, this exercise often cannot compensate for the lower estrogen levels associated with menstrual dysfunction and the resultant loss of bone. Many young female athletes may aspire to be "ultra-thin," the loss of 25 percent of total body weight causes serious physiological disturbances, like amenorrhea, which has been linked to increased stress fractures.


Conclusion

                                                                            Figure showing how adequate calcium intake cut down the risk of fractures

Inadequate calcium and vitamin D intake is harmful to bone health. Excessive consumption of other nutrients such as protein and sodium can decrease calcium absorption. Early menopause (<45 yr) occurring naturally or surgically (for example surgical removal of ovaries) cause estrogen deficiency which may increase chances of developing osteoporosis. Excessive use of alcohol increases the risk fractures due to both poor nutrition and increased risk of falling.

References
  1. Physical Medicine Rehabilitation Principle and Practice by Joel A Delisa &Bruce M. Gans (2007), published by Lippincott Williams and Wilkins, fourth edition, Chapter 58 Osteoporosis, page no.1464-1469
  2. Clinical Orthopaedics Rehabilitation,S. Brent Brotzman (2003) and Kelvin E. Wilk, Moshy publication, second edition, chapter 7 special topics, page no 530-538
  3. Clinical Sports medicine,Peter Brukner And Karim Khan with colleagues(reprinted in 2010), published by Tata McGraw Hills, part D chapter 41 Women and activity: related issue across the life span, page no.756-757
  4. Robson BE. Disordered Eating in HighSchool Dance Students,Some Practical Considerations. J Dance Med Sci 6(1): 7-13, 2002.
  5. Internet site reference
http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/calcium- supplements/art-20047097 

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