Osteoporosis in India--the nutritional hypothesis

Area of Science:

• Bone Metabolism and Public Health
• Geriatric Medicine
• Nutritional Epidemiology

Background:

• Osteoporosis is a prevalent metabolic bone disease in India, causing significant morbidity and mortality from fractures.
• Distinctive patterns in Indian populations include earlier onset of hip fractures and a higher male-to-female ratio for fracture risk.
• Increasing life expectancy exacerbates osteoporosis as a public health challenge in India.

Purpose of the Study:

• To review international patterns of osteoporosis and highlight unique clinical features in the Indian population.
• To explore potential etiological factors contributing to earlier onset and higher male fracture risk in India.
• To propose strategies for the prevention and management of osteoporosis in India.

Main Methods:

• Review of international osteoporosis patterns.
• Analysis of clinical features in Indian men and women.
• Exploration of potential contributing factors like calcium and vitamin D deficiencies.

Main Results:

• Indian males and females experience hip fractures at a younger age compared to Western populations.
• Indian males exhibit a higher incidence of hip fractures relative to females.
• Potential contributing factors include early-life dietary calcium deficiency and subclinical vitamin D deficiency leading to malabsorption.

Conclusions:

• Osteoporosis presents unique challenges in India, with earlier onset and higher male risk.
• Suboptimal calcium and vitamin D intake/absorption are likely key etiological factors.
• A multidisciplinary approach involving nutritional strategies (e.g., food fortification), addressing social barriers to therapy, and health education is crucial for bone health promotion and osteoporosis control in India.