If osteoporosis, a condition that weakens bones making the patients susceptible to fractures, was not controlled through proper treatment and public awareness, it would assume epidemic proportions in India, according to Dr Ambarish Mittal, president of the Indian Society for Bone and Mineral Research (ISBMR) and senior endocrinologist, Indraprastha Apollo Hospitals, New Delhi.

Addressing a symposium-cum-CME programme for doctors on osteoporosis at Hotel Viceroy, Dr Mittal said India was one of the countries most affected by the disorder due to poor calcium intake, vitamin D deficiency, premature menopause, drug abuse, low body weight, smoking and alcoholism. Though osteoporosis was prevalent in both sexes, it was more common in women.

About 40 to 50 per cent of post-menopausal women were susceptible to this disorder and one-third would actually develop bone fractures. As estrogen levels went down at menopause, there could be break down of the bone tissue and leeching of calcium from the bone, Dr Mittal said.

Terming it as a silent disease, because there were no symptoms till the bones became weak and started to break, Dr Mittal said osteoporosis could be diagnosed by using DXA Scanner, which was now available at all major hospitals, especially in the metros. He said the Society was exploring the introduction of a cheaper option in the rural areas by taking X-ray pictures of the patients and using them to measure bone density. Ideally, all persons over 65 and all post-menopausal women should undergo bone density tests.

Dr Mittal said osteoporosis could be prevented to a large extent by an awareness campaign about the risk factors and preventive measures of the disorder. Use of estrogen by women in low doses would reduce the risk of fractures as the female hormone level declined at menopause, resulting in breakdown of the bone tissue.

He said currently ISBMR was conducting a nationwide campaign to generate public awareness about the disease as it felt that calcium and vitamin D deficiencies had not been addressed at the community level. The Society had plans to educate physicians and promote research in osteoporosis.

Though the disorder could be cured by proper medication, change in life styles, regular exercise and exposure to sunshine, Dr Mittal suggested a three-pronged approach involving calcium intake, vitamin D supplements and physical exercises like walking to prevent osteoporosis.

Speakers at the symposium included two USA-based professors, Dr Sudhakar Rao, Director, Bone and Mineral Research Laboratory, Dept of Medicine, Henry Ford Hospital, Detroit and Dr Sunil Wimlavansa, Professor, General Internal Medicine and Endocrinology, University of Texas. They said osteoporosis fractures were four times more common than stroke and the risk from hip fractures was equivalent that from breast cancer. Yet, it was still undiagnosed and untreated in over 15 million women in America.

Describing osteoporosis as a paediatric disease with geriatric manifestations, they said bone development during the 10-15 age group was important. Children's diet must include milk, a source of calcium, green vegetables and seafood. Besides, they must be exposed to sunlight for vitamin D.

With the increase in life expectancy, more and more of people would be afflicted by the disabling disease. The symposium, therefore, suggested a nationwide campaign to create public awareness about the disease and its prevention.

The Menopause Clinic of CDR Hospital in Hyderguda on Sunday observed the World Menopause Day and Osteoporosis Day by conducting free BMD screening and a free health awareness programme. The programme was attended by about 100 people and Sixty-four women underwent the screening.

Senior gynecologist Dr Gowri Jayaram spoke about the importance of ageing gracefully and with a positive attitude towards life. Dr Jayashree Reddy, senior gynecologist, talked about osteoporosis and how to deal with it. The free BMD screening would be available till October 25.