Keeping Bones Strong for Life

http://www.thejakartaglobe.com/health/keeping-bones-strong-for-life/459764


Sylviana Hamdani | 
August 17, 2011


Accountant George Sembiring had always been a kind and dutiful husband and an attentive father to his five children. But a minor accident in 2005 changed all that. 

“He didn’t see a hole in the road one rainy night and fell off his motorbike,” said Paulus, his youngest son. 

After that night, George never walked again. He fractured his hips at five different points. His doctors discovered that the 55-year-old’s bones had been weakened over the course of years by osteoporosis. Yet with no pain or any other symptoms, George had never realized it. 

Osteoporosis is a disease that robs bones of their density, leaving them porous, brittle, thin and prone to breaking. 

George underwent a number of costly hip reconstruction operations, burning through his family’s savings. After the third unsuccessful operation, the family took him out of the hospital and decided to care for him at home. 


“My father changed. He became a bitter and angry person because of his disability,” Paulus said. 

Paulus had to quit university and get a job at a computer shop to pay for his father’s medical bills. George remained bedridden until he died a couple of years ago. 

In Indonesia, osteoporosis has become a serious health problem. According to the Indonesian Osteoporosis Association (Perosi), in 2006, the most recent year for which figures are available, 29 percent of men and 32 percent of Indonesian women suffered from the disease. 

“That’s why osteoporosis is nicknamed the ‘Silent Thief,’ ” said Fiastuti Wicaksono, a nutritionist and lecturer at the University of Indonesia’s medical school. “The disease silently eats away your bones and robs you of your active life.” 

Contrary to what many people believe, bones are alive and continue to die and regrow within your body throughout your life. In a healthy person’s body, it takes about three months for an old bone to degenerate and be replaced by a new one. 

For people with osteoporosis, bone loss outpaces growth, causing bones to thin and become frail. 

“But the good news is that the disease can be prevented,” Fiastuti said. “With a well-balanced diet and healthy lifestyle, we can maintain our bone mass.”

Preventive measures should be taken at the earliest opportunity. Bones start to grow while we are still in the womb. If an expectant mother eats a healthy diet high in calcium, it can help to ensure her baby is born with strong bones. 

“Pregnant women also need a diet that is high in calcium to protect their own bones,” Fiastuti said. “Babies derive the calcium they need from their mothers. If a baby doesn’t get it from the mother’s food intake, then it will take it from her bones, leaving her prone to osteoporosis.” 

Children who do not get enough calcium when they are babies can still catch up. 

Toddlers aged between 1 and 3 need 500 milligrams of calcium per day, which can be obtained from drinking two glasses of milk. Children aged between 4 and 8 need about 800 milligrams of calcium daily, or about three glasses of milk. Those between 9 and 18 need about 1,300 milligrams of calcium, or about four glasses of milk. 

“It’s like a savings account at the bank,” Fiastuti said. “We should all start saving calcium in our bones to prepare for future losses.” 

Adults need to about 1,200 milligrams of calcium per day. Human bone mass reaches its peak between the ages of 30 and 35. 

“After bone mass reaches its peak, it will start to lose more than it builds,” Fiastuti said. 

Besides age, other risk factors that nothing can be done about include gender and race. 


“Research has revealed that women are more likely to suffer from osteoporosis than men,” Fiastuti said. “It’s largely because women give away the calcium in their bones during pregnancy and breast-feeding.” 

Women can also suffer from osteoporosis post-menopause. 

Asians and Caucasians, as well as people with smaller physiques, are more likely to suffer from osteoporosis. 

According to Fiastuti, milk is one of the best sources of calcium. 

“Milk contains lactose, which enhances calcium absorption by our bones,” she said. 

However, for lactose-intolerant people, there are other food sources that are high in calcium such as tempeh, tofu, dark green vegetables and anchovies. 

“You can also eat milk-derived products, such as yogurt and cheese, or dishes that contain milk, such as, lasagna,” she said. “When the milk is processed, it doesn’t usually trigger any bad reactions in the body.” 

You should also watch your diet. Junk foods, which are high in fat, salt and seasoning, will impair calcium absorption. You should also stay away from alcohol and cigarettes to protect your bones. 

“Nicotine has a direct toxic effect on the body,” Fiastuti said. “It hampers the body’s ability to utilize growth hormones, calcium and vitamin D to build new bones.” 

Alcohol, coffee and carbonated drinks also deplete calcium and hamper bone growth. 

Besides calcium, you also need vitamin D to fortify your bones. People between the ages of 20 and 50 need 400 international units of vitamin D. Those older than 50, need between 600 and 800. Food sources with vitamin D include salmon, liver, cod liver oil and egg yolks. 

“But, actually the skin can produce vitamin D for the body when it’s exposed to sunlight,” Fiastuti said. 

Between 10 and 15 minutes of sunlight three times a week will help to satisfy the body’s need for vitamin D.

Protein is a major building block for the body. Thus, to repair bone structure, you will need a steady stream. The suggested amount is 55 grams per day for women and 65 grams per day for men. Good sources of protein include eggs, fish, poultry, soy products and milk. 

Exercise is also necessary to maintain bone mass. So, get off the couch and start exercising regularly, at least three times a week for about 30 minutes each time. Brisk walking, jogging, light aerobics and moderate weight-lifting are all good for your bones. 

“The stamping movements when you walk or jog will help to solidify your bones, while weight-training helps maintain strong muscles to keep up your balance and coordination, which prevents you from falling and getting fractured bones,” Fiastuti said. 

As for Paulus, the 24-year-old drinks milk every day with his breakfast. He also walks to the store where he works, which takes about 30 minutes, rather than riding his motorbike. 

“The accident [with my father] has taught me a lot,” he said. “I want to have a long, meaningful life for my family and myself. And maintaining a healthy lifestyle is just a small investment for the future.”