The National Heart, Lung, and Blood Institute state that asthma is a chronic disease that affects more than 22 million Americans (an estimated 6 million of whom are children). On World Asthma Day, we want to remind people living with asthma that they may also be at increased risk for osteoporosis. Though asthma itself does not threaten your bone health, asthma medications and behavioural practices may affect your bones.
An asthma attack can be triggered by everyday activities, such as air pollution, dust, allergens, exercise, infections, emotional upset, or certain foods. Symptoms include coughing, wheezing, tightness in the chest, difficulty breathing, increased and rapid heart rate, and sweating. Children may experience itchy upper chest and get dry coughs.
Osteoporosis is a process where bones become less dense and more likely to fracture. Often, a bone fracture is the first symptom that you may have osteoporosis. Bone fractures may result in pain and disability. In Canada, 1.4 million people have osteoporosis – 1 in 4 are women over the age of 50 and 1 in 8 are men over the age of 50.
According to the National Institute of Health’s Osteoporosis and Related Bone Diseases National Resource Center, people with asthma tend to be at increased risk for osteoporosis, especially in the spine. Reasons why this may be include:
- The anti-inflammatory medication glucocorticoid prescribed for asthma, when taken by mouth, can decrease the amount of calcium absorbed from food, increase calcium lost from the kidneys, and decrease bone formation. A dose of more than 7.5mg each day can cause significant bone loss.
- Another medication known as corticosteroids affects the production of sex hormones, which leads to bone loss and muscle weakness.
- People with asthma avoid milk and other dairy products in fear they may trigger an asthma attack – which is likely to be true only for those who also have a dairy allergy. Avoiding calcium-rich dairy products can hinder children’s bone development.
- Exercise can often trigger an asthma attack; therefore, people avoid weight-bearing exercises that can help strengthen bones.
Below are some management strategies to prevent and treat osteoporosis in people with asthma:
- Nutrition – Include food rich in calcium and vitamin D. Calcium rich food includes low-fat dairy products, dark green and leafy vegetables, and calcium-fortified foods and beverages. Vitamin D helps with calcium absorption and bone health, and includes food like egg yolks, saltwater fish, and liver.
- Exercise – Include weight-bearing exercise that forces you to work against gravity. Activities can include walking, climbing stairs, weight training, and dancing
- Smoking has a negative effect on bones, hearts, and lungs. Women who smoke may start menopause earlier, meaning bone loss at a younger age. Smoking may affect how much calcium you absorb from your diet.
- Alcohol consumption can lead to increased bone loss and fracture because of poor nutrition and an increased risk of falls.
- Talk to your doctor about having a bone density test if you are concerned about osteoporosis.
- Talk to your doctor about medications that can prevent and treat osteoporosis.