JEDDAH — As Muslims worldwide celebrate Eid Al-Fitr — a glorious occasion that is followed by rejoicing, giving of alms and a feast of various and delicious foods to mark the end of fasting during the entire holy month of Ramadan — sumptuous meals abound for everyone and the well-wishers, thankful for the whole month of fasting and having another Eid again. This shift to pre-Ramadan food habits may cause a shock to one's body's system and may trigger undesirable side effects such as indigestion, heart burn and the dreaded weight gain that when goes unchecked, may result to developing osteoporosis in the later stage of life when there is an imbalance between new bone formation and old bone resorption. You should also remember that overeating during Eid is very common and in addition to the previous side effects this can also lead to fatigue and the tendency to sleep for longer periods of time. Though osteoporosis is detected only in the adult life, yet recent studies have shown that there is a high prevalence of osteoporosis in Saudi Arabia. At a recently held MSD Osteo Faculty Symposium (MOFS) in Jeddah under the theme “Clinical Aspects on Arthritis & Osteoporosis Management”, Dr. Mohammad Al Sahan, a consultant, orthopedic surgery at Soliman Al Habib Medical Center, Riyadh and the chairman of the symposium, said osteoporosis occurs from 60 years of age in general, though it can be detected as early as 50 years old in the case of women. A separate independent study revealed that in Saudi Arabia, “osteoporosis in men is much more common than previously recognized ” as low bone mineral density occurs with high frequency in Saudi men. Poor oral calcium intake and low level of daily activity were noted. The etiology of osteoporosis including that in men is complex. Many factors appear to play different roles in its pathogenesis. Genetic factors are very important. Other important factors include the hormonal role, degree of physical activity, cigarette smoking, calcium and vitamin D intake and drugs especially corticosteroids. In Saudi females, previous studies have revealed a high prevalence of osteopenia and osteoporosis among post-menopausal women. Nutritional, genetic and environmental factors have been blamed for such trend. The lifestyle of Saudis including Saudi men is different. Their level of physical activity, sun exposure, calcium and vitamin D intake are also variable. Low exposure to the sun and low vitamin D level, have been noted among Saudis, Al Sahan remarked. Hence, he encourages walking under the heat of the sun from 10 a.m. to 2 p.m. for 30 minutes, three times a week, as this is the best time to activate the Vitamin D that is under the skin. It is produced endogenously when ultraviolet rays from sunlight strike the skin and trigger vitamin D synthesis. Vitamin D promotes calcium absorption in the gut and maintains adequate serum calcium and phosphate concentrations to enable normal mineralization of bone and to prevent hypocalcemic tetany. It is also needed for bone growth and bone remodeling by osteoblasts and osteoclasts. Without sufficient vitamin D, bones can become thin, brittle, or misshapen. Together with calcium, vitamin D protects older adults from osteoporosis, he added, noting the urgency of raising awareness of the health benefits of exposure from sunlight as remedy to osteoporosis. Besides, adequate storage levels of vitamin D maintain bone strength and help prevent osteoporosis in older adults, non-ambulatory individuals who have difficulty exercising, postmenopausal women, and individuals on chronic steroid therapy. Moreover, it is time to recognize that osteoporosis does not only affect the elderly. A study by the International Osteoporosis Foundation (IOF) said osteoporosis is a global problem which is increasing in significance as the population of the world both grows and ages. For these reasons, osteoporosis is often referred to as the “silent epidemic”. Osteoporosis affects people at various stages of life, including millions of people who are actively working. These people have been ignored in most studies, but estimates show that osteoporosis in the workplace results in huge economic and human costs, IOF said. In younger people, who are more likely to be economically active, vertebral fractures cause a much more significant impact than hip fractures. Some studies have shown that quality of life following vertebral fractures is reduced much more severely than following hip fractures. Osteoporosis results in significant direct costs for medical care to treat fractures and pay for medication. In addition, osteoporosis results in huge indirect costs that are rarely calculated. For example, a worker with osteoporosis might lose her or his job, incur medical expenses that are never calculated by economists, and suffer other economic losses, the study noted. If the osteoporosis results in a debilitating fracture, the worker is likely to suffer a severe loss of self-esteem, which of course has a huge emotional cost, it added. IOF report further said younger people – those more likely to be working – recover faster than older people and therefore require fewer hospital days following a hip or vertebral fracture. Younger people also are less likely to require long-term hospital or nursing home care. However, “osteoporotic fractures in patients younger than60 lead to higher relative indirect costs: sick leave, loss of job days, unemployment payments, loss of productivity, community expenses, as well as psychological distress.” — SG
