Osteoporosis is a disease of the skeletal system that mainly affects women over 50 years of age. It is characterised by a loss of bone mass, resulting in fractures even after minor injuries. It is often referred to as the 'silent disease' because worryingly few people know they have it until they break a bone. It is worth knowing that there are many ways to avoid this ailment or reduce its severity. Interestingly, a lot can be done with home methods and lifestyle changes. Here are tips on how to deal with bone thinning.

What is osteoporosis?

Osteoporosis is a disease that is characterised by a decrease in bone mass and disruption of its microarchitecture, which increases the risk of fractures. Mechanical resistance is related to bone mineral density (BMD - bone mineral density) and the quality of bone tissue. The disease is often referred to as the illness of women over 50, because it mainly affects them. However, it is worth noting that men can also struggle with it. Although around the age of 60 the ratio of women affected by osteoporosis to affected men is about 6:1, it changes with age - only a decade later it is 2:1 ^[1,2,3,4].

Why is osteoporosis classified as a lifestyle disease?

Osteoporosis is an example of a disease that is associated with the progress of civilisation. Its development is influenced by the extension of life (and thus also the period of bone mass reduction), inadequate diet (with a small amount of calcium), the use of stimulants and a sedentary lifestyle ^[3].

The scale of the problem faced mainly by women is shown by the data according to which osteoporosis 22.1% of women and 6.1% of men over 50 years of age have been diagnosed with osteoporosis. A large number of fractures occur in Europe (40%), and the greatest risk of hip injury due to bone loss is in the countries with the highest development, i.e. in Sweden, Great Britain, Norway, Denmark and Germany ^[6].

What are the symptoms of osteoporosis? How to recognise it?

The diagnosis of osteoporosis usually occurs quite late - often when the bone has already broken (which indicates the advancement of the disease). These injuries most commonly affect the hip, wrist, spine, and femur. The characteristic feature of the so-called osteoporotic (low-energy) fracture is that it occurs during seemingly ordinary activities - e.g. when bending down or falling from a height of the body. This disease develops asymptomatically for a long time, so it is not easy to recognise it in its early stages (then it is called osteopenia). Vigilance should be taken by rapid weight loss or rounded back - these symptoms can be a valuable clue that will encourage diagnostic tests for osteoporosis. It is also worth being careful when there is a familial tendency to bone loss or taking medications for chronic diseases - some may increase the risk of osteoporosis ^[3,6].

What types of this bone disease can be distinguished?

In the main classification of osteoporosis, the division into primary and secondary is most often used. Although this disease is mainly associated with bone loss and fractures, the course and its causes are slightly different. For a better understanding of this condition, three types can be distinguished: 

• postmenopausal osteoporosis  - in this case, the process of bone atrophy is quite fast - then you can lose about 4-5% of your bone mass in a year; this type of disease affects women around 50-60. years of age, and the main source of ailments is oestrogen deficiency; most often wrist fractures occur then
  
  
• age-related osteoporosis - here the loss of bone mass occurs at a slower rate - about 1% per year; both women and men struggle with it, and the most common fractures in this type of disease include hip and vertebral injuries
  
  
• secondary osteoporosis - the least common type of disease, the causes of which can be seen in the action of medications taken (e.g. heparin and glucocorticoids), or chronic diseases (e.g. rheumatoid arthritis, type I diabetes or hyperthyroidism).

Most cases concern osteoporosis primary. About 20% of patients struggle with secondary bone loss ^[3,6].

Where does bone loss come from? Causes of Osteoporosis

Although in general considerations about this disease there is a conviction that there is little that can be done to prevent it, it is worth knowing that the causes of osteoporosis are different - some we can influence, others we cannot. Knowledge of risk factors allows you to implement preventive measures or implement changes that improve the quality of life in time.

The main reasons

for the so-called modifiable causes of osteoporosis - i.e. those over which we have no influence - include: 

• advanced age
• female sex
• Caucasian and Mongolian race
• genetic predisposition (cases of occurrence of this disease and frequent fractures in the family)
• chronic diseases
• low weight and frail physique previously
• dementia
• suffered fractures
• early menopause (end of menstruation before the age of 40) ^[3,4,5,6].
  
  

Lifestyle

reduced by introducing specific changes in lifestyle include: 

• lack of regular physical activity
• deficiency of vitamin D, calcium and protein
• use of stimulants (smoking and excessive alcohol consumption)
• bedrugs (e.g. steroids)
• excess coffee
• prolonged immobilisation ^[3,4,5,6].

How to reduce the risk of osteoporosis?

The development of osteoporosis is influenced by the risk factors mentioned earlier - both non-modifiable and modifiable. It is the sum of these and the time you are exposed to them, among others, that determines your risk of the disease. It is worth looking at what changes need to be made on a day-to-day basis to keep the skeletal system fit and well for as long as possible. 

The foundation of the optimal functioning of the body is taking care of daily movement and a balanced diet. It turns out that these guidelines are also of great importance in the case of activities protecting against the unpleasant consequences of osteoporosis^[3].

The role of regular physical activity in the prevention of bone loss

Regular physical exercise practised from an early age is one of the key factors that can prevent the development of osteoporosis. It contributes to an increase in peak bone mass at a young age, and in later years it protects against its rapid loss.

The importance of physical exercise in the prevention of osteoporosis can be understood in two ways. Firstly, by loading the skeleton, good conditions are created for the bone formation process in the body. Secondly, the improvement of muscle condition (which occurs thanks to regular physical activity) allows you to protect yourself from falls, which - later in life - can lead to serious fractures ^[4].

Osteoporosis diet. The importance of nutrition for the efficiency of the skeletal system

Although today there is more and more talk about the importance of a balanced diet in the proper functioning of the body, many people still lack conviction in this matter. And yet, mainly along with properly balanced meals, we provide optimal amounts of nutrients, the deficiency of which often causes a number of unpleasant symptoms. What vitamins are crucial for the skeletal system? What diet for osteoporosis will bring the most benefits?

Calcium

Calcium - as a component of bones and teeth - plays an important role in building peak bone mass until the age of 20. The inclusion of dairy products and legumes (soybean and chickpeas) in the daily diet helps to ensure an adequate supply of this element, as well as plant sources: beans, kale, parsley, poppy seeds, sesame, almonds and fortified products - plant drinks and juices fortified with calcium ^[7]. The recommended intake of calcium is specified in nutritional standards and depends on age and sex. It ranges from 700mg to 1300mg ^[4]. It is also important to ensure adequate amounts of calcium in childhood and adolescence, as calcium deficiencies in early life are associated with an increased risk of osteoporosis in old age ^[8].

Vitamin D

The right amount of vitamin D is important for bone mineralisation (it affects the correctness of calcium and phosphate metabolism). Deficiency contributes to its disorders, which can lead to rickets in children, and in adults to the development of osteoporosis. In addition, vitamin D protects against dysfunctions of the nervous system and weakening of muscle strength - and this contributes to better overall performance. Thanks to this, it is possible to reduce the risk of falls, which are so dangerous for people struggling with a decrease in bone mass ^[4].

The source of vitamin D is exposure to sunlight, thanks to which the synthesis of the vitamin in the skin occurs. In our geographic zone, however, it is not easy to obtain it from the sun. Due to the fact that it is also difficult to supplement it with the diet (it is found, among others, in cod liver oil, fish and egg yolk), in many cases it is necessary to include supplementation. What dose of vitamin D3 will be the best for osteoporosis? The recommended daily portions for adults aged 18 to 65 are 800-2000 IU. In some cases (in people particularly at risk of deficiency) the dose is doubled (1600-4000 IU) ^[4]. 

Phosphorus

Phosphorus - like calcium - is a component of bone tissue. Taking care of the proper ratio of calcium to phosphorus affects the proper course of bone formation. It should be 1:1 or 1.3:1. Due to the fact that phosphorus is present in many food products and has good bioavailability, it is not difficult to cover its daily requirement. Excessive supply of this element may hinder the intestinal absorption of calcium, which contributes to the loss of bone mass ^[4,9]. 

Protein

The decrease in bone mass is affected by both insufficient supply and excessive amounts of protein obtained from the diet. Its deficiency may impair the process of collagen synthesis and reduce the absorption of calcium. In turn, excess protein (mainly taken from animal sources) can contribute to the loss of calcium in the urine - which affects the reduction of bone mineral density. It is also important to obtain protein from plant foods (e.g. legumes) - according to data analyses, a high ratio of animal to vegetable protein consumption contributes to an increased risk of fractures. It is recommended to consume protein at the level of 1.0-1.2 g/kg of body weight per day ^[4,9].

Magnesium

Magnesium is a component of bones. Its deficiency contributes to the disorder of bone mineralisation process. People over 50 are recommended to provide more than 300mg of the element per day. The main sources of this ingredient are; oatmeal, almonds, buckwheat, dark chocolate and cocoa ^[4,9].

Vitamin K

The good condition of the skeletal system is also affected by providing the body with adequate amounts of vitamin K. It participates in the synthesis of the most important bone protein (osteocalcin) - vitamin K deficiency disturbs this process, which may lead to a decrease in bone mineral density (BMD) and, consequently, to an increased risk fractures. This ingredient can be found, for example, in Brussels sprouts, white cabbage, broccoli, spinach and kale (K1) as well as in ripening cheeses or fermented products (K2) ^[4,9].

Omega-3 fatty acids

Studies have shown that taking omega-3 fatty acids contributes to an increase in bone mineral density (BMD) in the lumbar spine in people over 60 years of age. It is also possible that omega-3 may prevent sarcopenia, the age-related loss of muscle mass and function, which may help reduce the risk of fractures. The optimal intake of omega-3 fatty acids should be maintained at the level of 250 mg per day ^[4].

A lifestyle that prevents the unpleasant consequences of osteoporosis

Considerable importance in clinical management is attributed to measures to prevent falls. That is why preventive measures of this type (including a balanced diet and physical activity) are, in a way, one of the elements of effective treatment of osteoporosis. Considering the fact that many fractures (mainly of the hips and vertebrae) are associated with the need for surgery, implementation of long rehabilitation and complications, after which it is not uncommon to return to the former fitness, preventing injuries and trying to prevent the first fracture seems to be an obvious choice ^[1,2,3]. 

Can taking collagen improve the condition of bone tissue?

Collagen is a basic structural protein found in many tissues, including in the skin, tendons, ligaments, muscles, bones, teeth, cartilage, cornea of ​​the eye and internal organs. It accounts for 30% of all proteins in the human body. Its basic properties include, for example, maintaining skin tension and good condition of the musculoskeletal system. It increases the flexibility of tendons and ligaments, supports the healing of broken bones and maintains their stability. Collagen synthesis decreases with age. Already around the age of 25, the level of collagen begins to slowly decrease, and its rapid decline can be observed after the age of 50. In turn, in the sixth decade of life, its production is completely stopped.

That is why many people - mainly women after menopause - are exposed to osteoporosis, which has unpleasant consequences for the condition of the body. Collagen synthesis disorders cause decalcification of bones and increase their fragility, which may lead to a tendency to fractures. The importance of collagen for the proper functioning of the skeletal system is illustrated by the fact that the bone skeleton consists of 90% of this youth protein as well as calcium, phosphorus and magnesium ^[10].

Collagen supplementation can have positive effects on the functioning of the musculoskeletal system - it supports, among others, in osteoporosis and degenerative joint diseases. Particular attention is paid to increasing bone mineral density (and thus their strength), cartilage cell growth and protective effect on joints, as well as potential pain relief ^[11]. 

FORTIBONE® - new possibilities to fight osteoporosis

Bioactive collagen peptides have a positive effect on the condition of bones - they have a building effect, supporting calcium absorption and supporting bone formation. FORTIBONE® stimulates osteoblasts (bone-forming cells) to increase the production of extracellular bone matrix, i.e. collagen production, and reduces the activity of osteoclasts (bone-forming cells) responsible for bone tissue resorption. It was developed e.g. to promote the health of the skeletal system - increasing bone density and reducing degradation processes ^{[12, 13]}. Numerous clinical studies confirm its positive properties on the condition of the skeleton. 

A 12-month study of 180 women with low bone mass showed that taking 5 grams of FORTIBONE® per day increased bone mineral density (BMD). Changes in the quality of bone mass were measured in the spine and femoral neck ^[14]. 

A one-year study involving 102 women aged 57 to 71 suffering from osteopenia or osteoporosis showed that daily intake of 5 g of FORTIBONE® stimulated the synthesis of bone collagen matrix. There was an increase in bone mineral density in the femoral neck (6.7%) and spine (3%). It has also been proven that bioactive collagen peptides support bone stability and flexibility ^[15]. A follow-up study involving 31 women with osteopenia or osteoporosis indicated the long-term effects of FORTIBONE®. After 4 years of taking 5g of collagen daily, a further increase in bone density by approx. 7% (taking into account the rate of bone mass loss) was demonstrated, and no fractures were noted during the study ^[16]. 

Another clinical study shows the positive effect of FORTIBONE® on the acceleration of bone fracture healing. It involved 28 people with various fractures (humerus, radius, fibula, metatarsal, coccyx and toe) aged 17 to 87 years. They took 10 g of collagen for 30-90 days. The results were evident in improving clinical outcomes regardless of fracture type. According to the doctors, 36% of the patients had good healing results, and 43% had very good healing results. Compared to the placebo group, patients taking FORTIBONE® 30% better healing of fractures ^[17]. 

Taking bioactive collagen peptides also contributes to reducing the risk of fractures. The use of 5 g of collagen in combination with 500 mg of calcium and 400 IU of vitamin D for a period of 3 months in a group of 51 postmenopausal women with osteopenia showed a reduction in increased bone turnover. There was also a 13% decrease in bone turnover markers and no changes in the placebo group ^[18].

The above clinical studies have shown that supplementing with FORTIBONE® supports the functioning of the skeletal system. Their main properties include:

• stimulating the synthesis of bone collagen matrix
• increasing bone density
• limiting collagen degradation processes
• supporting bone stability and flexibility [14].

Taking bioactive collagen peptides FORTIBONE® allows you to take care of the skeletal system. It works well both in the elderly and in those who train a lot ^[14]. 

For people looking for effective ways to support the skeletal system, OSAVI offers a dietary supplement Collagen Joints and Bones - 153 grams, which contains patented and clinically tested bioactive collagen peptides FORTIBONE® and wild rose extract standardised to min. 70% of vitamin C. Rosehip helps maintain healthy and flexible joints and supports their mobility and strength - vitamin C contained in it contributes to the proper production of collagen, which improves the functioning of bones and cartilage. 

OSAVI collagen is a powdered product that can be used as a food additive or dissolved in water or your favourite beverage. It has a neutral taste and smell, which makes it a good accompaniment to any meal. It has the so-called clean label, no additives. The package contains 30 daily servings. It is recommended to take 5.1 grams of collagen per day - this amount can be easily measured thanks to the measuring cup placed inside. 

The supplement works well for men and women who want to comprehensively take care of their joints and bones. It is especially recommended for people actively training and looking for new and effective ways to support the musculoskeletal system.

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[10] Zuchowski, A., Nowicka-Zuchowska, A. (2019). Kolagen – rola w organizmie i skutki niedoboru. Katedra i Zakład Technologii Leków. Uniwersytet Medyczny we Wrocławiu, 29(11/12), 342-343.
[11] Porfírio E,  Fanaro G. B. 2016. Collagen supplementation as a complementary therapy for the prevention and treatment of osteoporosis and osteoarthritis: a systematic review. Revista Brasileira de Geriatria e Gerontologia [online], 19(1), https://doi.org/10.1590/1809-9823.2016.14145.
[12] Ohr L. M. (2018, lipiec 1). Active Aging. Food Technology Magazine. 72(7), Pobrano 14.12.2022 z https://www.ift.org/news-and-publications/food-technology-magazine/issues/2018/july/columns/nutraceuticals-formulating-products-that-address-healthy-aging.
[13] Ohr L. M. (2015, maj 1). Solutions for Stronger Skeletons. Food Technology Magazine. 69(5), Pobrano 14.12.2022 z https://www.ift.org/news-and-publications/food-technology-magazine/issues/2015/may/columns/nutraceuticals.
[14] FORTIBONE® – The missing piece in bone health management. Pobrano 25.11.2022 z https://www.gelita.com/en/products/collagen-peptides/fortibone. 
[15] König D. 2018. Specific Collagen Peptides Improve Bone Mineral Density and Bone Markers in Postmenopausal Women-A Randomized Controlled Study. Nutrients. 16;10(1):97. doi: 10.3390/nu10010097. PMID: 29337906; PMCID: PMC5793325. 
[16] Zdzieblik D. 2021. Specific Bioactive Collagen Peptides in Osteopenia and Osteoporosis: Long-Term Observation in Postmenopausal Women. J Bone Metab, 28(3):207-213. doi: 10.11005/jbm.2021.28.3.207. 
[17] Knefeli H.C., Mueller-Autz M. 2018. Improved bone healing after oral application of specific bioactive collagen peptides. Nutrafoods, 17:185-188. doi: 10.17470/NF-018-1022-4. 
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