Preventing Osteoporosis: Wisdom from Mahidol University to Maintain Quality of Life

Osteoporosis: A Silent Threat That Comes With Aging

Osteoporosis is one of the most dreaded silent threats that often accompanies the aging process. The fear of brittle bones and the risk of fractures looms, posing a potential loss of quality of life during the later stages. To combat this, it is crucial to stay vigilant and take preventive measures.

Research Contribution from Professor Emeritus Dr. Saranet Waikkul

Professor Emeritus Dr. Saranet Waikkul, a consultant at the Department of Orthopedic Surgery and Physical Therapy of Siriraj Hospital, Mahidol University, has dedicated his time to researching osteoporosis. His invaluable contributions have provided wisdom and information to the community, aligning with the aspirations of Mahidol University.

Dr. Waikkul’s research involved leading a team to survey communities in Bangkok Noi and nearby areas. The results revealed that more than 50% of the population had sufficient knowledge about osteoporosis and were actively taking measures to protect themselves. However, there is still a need to educate the remaining 15% and their families about preventive measures.

The Role of Calcium and Diet

Choosing a diet rich in calcium, specifically 800-1,000 milligrams per day, can help prevent osteoporosis. It is recommended to prioritize calcium-rich foods such as milk, as it is an easily absorbed source of calcium due to its protein content, particularly casein.

While fish bones and grains also contain calcium, they are less easily absorbed due to the presence of phosphorus, calcium oxalate crystals, and phytates. To ensure sufficient calcium intake, it is advised to consume 1-1.5 liters of milk or approximately 2 slices of cheese daily, without the need for synthetic calcium supplements.

Supplementing with Vitamin D and Physical Activity

Vitamin D supplementation is crucial for effective calcium absorption. Dr. Waikkul recommends exposing the body to sunlight between 10:00 am to 2:00 pm for vitamin D synthesis. Vitamin D2 is an accessible and affordable option, with a recommended weekly intake of 20,000 units for the elderly. Other options include Vitamin D3 and Activated Vitamin D, although they are costlier.

Regular physical activity is also essential for stimulating sustainable bone mass. Gentle exercises that focus on isometric contractions, such as sitting and lifting the legs or contracting the neck muscles, can help strengthen the ligament system and bones. Additionally, eccentric exercises, such as slow neck rotations and controlled squats, aid in the development of bone strength and protect against muscle atrophy.

The Importance of Valine and Leucine

A balanced intake of amino acids is crucial in preventing muscle atrophy and promoting strong bones and muscles. Valine and leucine, found in protein sources like milk and eggs, play a significant role. However, it is essential to avoid excessive protein consumption, including low-quality proteins, like collagen, which lack these essential amino acids and have been linked to kidney function issues.

Treatment Options: Anti-Bone Drugs and Prolia

In cases where the risk of fractures is assessed to be high, anti-osteoporosis drugs, such as Prolia, are considered. Oral medications are often the initial choice due to ease of administration and economic factors. However, certain individuals, such as those with kidney dysfunction or severe osteoporosis, may require injectable drugs. Prolia, besides being an anti-bone resorption drug, also has the potential to stimulate bone formation.

It is crucial to note that the use of anti-osteoporosis drugs should be limited to cases with clear indications, as complications or allergic reactions, such as gingivitis, may occur. Before treatment, patients undergo a blood test to assess organ function and vitamin D levels. The injection schedule for Prolia is typically once every six months, with regular follow-up tests and bone density assessments to monitor progress.

Conclusion: Empowering Individuals Against Osteoporosis

Osteoporosis treatment is largely symptomatic, focusing on bone density checks, preventive measures, and appropriate nutrition and exercise. By choosing calcium-rich foods, ensuring vitamin D intake, and engaging in suitable physical activity, individuals can significantly reduce their risk of developing osteoporosis. Ultimately, the aim is to empower all Thai people to lead healthy lives, becoming crucial contributors to society and the nation’s future.

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Among the diseases that often accompany aging “Osteoporosis” is one of the most feared silent threats.

so you should always be prepared to be vigilant In order to prevent cases of fragile bones that are at risk of fracture. This can cause the loss of the opportunity to continue to have a good quality of life during the later stages of life.

Professor Emeritus Dr. Saranet Waikkul, Consultant, Department of Orthopedic Surgery and Physical Therapy, Faculty of Medicine, Siriraj Hospital, Mahidol University has revealed past missions for the community and the nation that have deposited research results to provide information that is “Wisdom of the Land” according to the aspiration of University Mahidol

From leading the team to survey communities in Bangkok Noi and communities in the same neighbourhood. Good visions were found and ensured that osteoporosis can be better managed.

From the results of the survey, it was found that more than 50 percent of the population in the area had sufficient knowledge about osteoporosis and had learned how to protect themselves. Until a person in the family and people around them can be introduced around 15 percent

Which “osteoporosis” can be prevented by choosing a diet that contains about 800 – 1,000 milligrams of calcium per day. Which of the food sources should be considered as “milk” first. as it is the best source of calcium food Contains protein group “Casein” (Casein) which is easily absorbed.

When eating fish bones, which are rich in phosphorus (phosphorus), but difficult to absorb. and eating grains It is rich in calcium oxalate crystals (Oxalates) and Phytates (Phytates), but it is also more difficult to absorb.

“Drink 1-1.5 liters of milk or about 2 slices of cheese to get enough calcium to meet your daily needs. without having to consume synthetic calcium

“However, it should be supplemented by vitamin D intake. Ready to allow the body to receive sunlight during the period from 10.00 – 14.00. to stimulate the action of vitamin D Currently available in 3 types, “Vitamin D2” is a vitamin that everyone can access at a price of only 1 – 1.50 baht per tablet, taking only 1 tablet per week (20,000 of units) is essential for the elderly. As well as “Vitamin D3” and “Vitamin D Active” which costs 10 times more than “Professor Emeritus” Dr Saranet Waikkul Says

It should also be supplemented with regular physical activity to stimulate the formation of sustainable bone mass. Where the elderly should exercise with a posture that is not too intense. Because otherwise, it can damage the ligament system and the bone In general, the principle of control by contracting the muscles (Isometric Exercises) is used to contract the muscles. Without having to move, like sitting on a chair and putting your legs up. Create strength on the legs and hips to create good bones.

It can also be administered in the throat. by contracting the neck muscles by using the hands to push the head and contract the neck muscles against the force of the hands Or sit upright and put your hands in the back cover and press. to strengthen the muscles of the spine without relying on movement

Another way to exercise your body is Eccentric Exercises, which train your muscles to contract. while being stretched in order to transfer force to the bone and continue to stimulate the bones to be strong during the head up-down and turning the neck left to right slowly

And another way to control Eccentric Exercises that can be practiced by standing behind a chair. Then grab the top of the chair with your hands before squatting down with your knees bent at 90 degrees so as not to affect your joints. Then try to stand up slowly. which is an exercise position with weight and slow movement to stimulate bone formation and protect against “muscle atrophy,” especially in the elderly

“Amino acids” that prevent muscle atrophy Or good muscle breakdown, including “Valine” (Valine) and “Leucine” (Leucine), which is a protein found in milk and eggs. by Professor Emeritus Dr Saranet Waikkul has observed the inappropriate choice of protein foods at present. from eating too much protein

Including protein foods that are not useful, such as “collagen”, which can be found in general. But there is no Food and Drug Administration (FDA) certification as eating poor quality protein. There is a lack of amino acids “Valine” (Valine) and “Leucine” (Leucine) to make strong bones and muscles. What’s more, it has been reported that it will lead to increased kidney function which could lead to a risk of kidney failure.

If the doctor has assessed that the risk of fracture is high Anti-bone drugs will be considered. Or the anti-osteoporosis drug (Prolia), which, according to the recommendations of the National Essential Medicines List, must start with “oral medicine” for reasons of drug administration and the economic status of the country

Except there is a ban on the use of oral drugs. Finding symptoms of kidney dysfunction and severe osteoporosis Therefore, injectable drugs will be considered, which “Prolia”, in addition to being an “anti-bone resorption drug”, has some information that it can. can “stimulate bone formation”

However, Professor Emeritus Saranetwaikkul Dr. Repeated the use of anti-osteoporosis drugs (Prolia) which will be considered for use in patients with “There is a clear indication” only because there may be complications. or have an allergic reaction to gingivitis

In addition, before receiving treatment the patient must have a blood test to look at the functioning of various internal organs. to prevent complications that can happen to the heart and brain In addition to watching the level of vitamin D (25(OH)D), the doctor will consider injecting Prolia to treat osteoporosis in patients with vitamin D levels (25(OH) D) is greater than 30 micrograms.

A Schedule 1 injection every 6 months, along with follow-up blood tests to see if the bone marker increase is within a normal range or not. as well as having the bone density checked again at the end of 2 years if no complications are examined again in 2 years. After this, the examination will be stopped for the bones to adapt. before re-evaluation

Emeritus Professor Dr. Saranet Waikkul concluded that osteoporosis treatment is “symptomatic treatment”. “Check your bone density” and prevent osteoporosis by choosing foods that contain calcium – vitamin D – exercise appropriately. with the hope that all Thai people will be far away from osteoporosis to have a good quality of life to be an important force for society and the country in the future

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