It’s always good to go to granny’s for Sunday dinner – home cooked is what you get, tasty and nutritious. And no guessing on pudding – from apple pie to melktert, you knew you were getting the best; recipes honed to perfection and passed down through the family generations. And if granny was hale and hearty, moving with ease and agility around her kitchen, likely you were getting her bones as well!

Life rolls the dice unfairly on many different boards – and no more so than when it comes to the DNA of the skeletal structure. If granny’s looking good, and most of your family members show little in the way of bone density decline or joint discomfort – retaining strong stature, posture and muscular strength well into their old age, it stands to reason that you will be less likely to suffer from the difficulties of osteoporosis, arthritis or rheumatism.

Bones and genes

Bones are made up of a mineral and protein scaffolding filled with bone cells. Bone is continually broken down and replaced. When the rate of bone loss outpaces the rate of replacement, bones weaken, eventually leading to osteoporosis and therefore an increased risk of fracture. Past studies suggest that genetic differences may account for more than half the variance in bone mineral density between people.

“In reality, there may be 500 or more gene variants regulating osteoporosis,” says Dr. John Ioannidis, Stanford University School of Medicine. “Each variant conveys a small quantum of risk or benefit. We can’t predict exactly who will or won’t get a fracture.”

The ultimate goal of genetic studies is to better identify those at high risk for the disease and devise personal treatments for osteoporosis based on your genetic blueprint. A number of aspects of bone physiology are controlled by genetic factors, including peak bone mass, bone shape, and composition – a key measurement however is that of bone density which gives a clear warning should bone thinning be taking place, leaving one individual more vulnerable to osteoporosis than another.

What is osteoporosis?

Osteoporosis is a bone disease where there is a gradual decrease in the bone density, which can cause risk of bone fractures as you age. Even though there is progressive decrease in bone density – symptoms may not show for years. Such patients are at a high risk of suffering bone fractures. Many factors other than age affect osteoporosis: genetics, lifestyle, diet, smoking.

While many people are at risk through the aging process, the most vulnerable group remains post-menopausal women – but a low-calcium diet can be detrimental to even the most genetically-robust bones. Age is something we can’t help – neither are the genes we inherit. And while these are the chief culprits for bone thinning, we often manage to compromise our bones through unhealthy diets, lack of exercise, poor lifestyle habits such as smoking and drinking, and sometimes too many medications.

Heredity as a risk factor

Over time and many studies, it has become an accepted fact that a person with a family history of bone fracture or loss of bone density issue, has a greater risk of developing the condition. People with a family history of osteoporosis, especially those with a small and frail body structure, are at the greatest risk of suffering from decreased bone density even at an early age.

Finding the exact gene culprit however, is complex because there are around 56 genetic variants that can be linked to osteoporosis. But it is these very links which confirms hereditary as a key player in osteoporosis.

Treatment for hereditary osteoporosis

The problem lies in the fact that symptoms of reduced bone density are similar. It is difficult to differentiate whether genetics alone are to blame, or a host of other possibilities such as medications, disease conditions, or lack of physical activities. Not all of the genetic factors involved have been fully identified. Genetics are believed to play a role as high as 85% of causality.

However, awareness is key – and even before one displays symptoms of osteoporosis, precautionary measures should be taken. If a family history of the disease is highlighted, then these measures should be taken sooner rather than later. If you believe that your family has a history of bone fracture or any other symptoms of reduced bone density, consult your doctor for action to counter this increased risk of chronic bone disease.

Here are your defense mechanisms, no matter your family lineage or how well granny manages to move around a kitchen:

  • Regular bone density tests should be undertaken from at least 50 years old and/or anyone with high-risk factors (no matter the age).
  • Regular exercise that does not stress the joints, such as swimming, walking, cycling, stretching and weight-bearing exercises.
  • Ensuring you get enough calcium from the right foods, such as dairy, nuts, leafy greens, etc.
  • Making sure to keep to the correct weight for your height – the heavier you weigh on your bone structure, the greater the stress you put on your bones.
  • And if you’re a smoker, you know the answer… a greater bodily destructive habit you cannot imagine.
  • So, lose the smoking, curtail the alcohol, and keep an eye on those meds.

NOFSA (National Osteoporosis Foundation South Africa)

NOFSA is the only nonprofit, voluntary health organisation dedicated to promoting lifelong bone health. We focus on reducing the widespread prevalence of osteoporosis while working to find a cure for the disease, and by supporting research and developing programmes of education and advocacy.

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