Interview on the Management of osteoporosis through physical exercise with Prof. Carlina Veneranda Albanese, medical surgeon, specialist in internal medicine and radiodiagnostics

Interview on the Management of Osteoporosis through Physical Exercise with Prof. Carlina Veneranda Albanese | UPMC Italy

Osteoporosis is a medical condition that makes bones more fragile, increasing the risk of fractures, particularly of the vertebrae, wrist and femur. Unfortunately, fragility fractures can lead to significant consequences in terms of both mortality and motor disability. In Italy, according to estimates by the Ministry of Health, this pathology affects about 5 million people, with a prevalence of 80% in menopausal women. These figures are set to increase in the coming years due to the ageing of the population. To explore this issue in detail, we have the honour to interview Prof. Carlina Veneranda Albanese, a surgeon with extensive experience in the clinical-diagnostic management of osteoporosis.

Prof. Albanese, could you kindly explain how to identify the signs of osteoporosis?

Bone density loss is usually asymptomatic and is often due to hormonal changes, incorrect nutrition, vitamin D and calcium deficiency, taking drugs that interfere with bone metabolism, or predisposing diseases. The first warning could be an unexpected fracture following an accidental fall, lifting a weight, or during physical activity. Laboratory tests and MOC with DXA method can confirm the clinical diagnosis of osteoporosis and assess the individual's risk of fracture.

Is it possible to prevent osteoporosis?

To be effective, prevention should start at a young age, with the adoption of a healthy lifestyle, which is crucial for maintaining strong bones. This includes regular exercise, a balanced Mediterranean diet, abstinence from smoking and moderate alcohol consumption. It should be remembered that both calcium and vitamin D are essential nutrients for healthy bones and are found in good quantities in milk, cheese and dairy products. After the menopause, all women should follow this lifestyle and undergo regular check-ups by performing an MOC in specialised centres to catch the first signs of bone density loss and thus prevent fragility fractures.

Speaking about physical exercise, many people may be reluctant to do it for fear of fractures. Is it safe to exercise when you have osteoporosis?

In contrast to the common fear, exercise is a valuable ally in the management of osteoporosis. Not only does it help increase muscle and bone mass, but an adequate and regular training programme also improves mobility, coordination, balance and musculoskeletal flexibility. A solid muscle mass reduces the risk of falls and provides additional support in avoiding the risk of vertebral and femoral fractures.

What exercises are recommended for people with osteoporosis?

Numerous studies indicate that the optimal training plan for people with osteoporosis includes a combination of aerobic and resistance exercises. The choice of exercise should be based on age, physical condition and personal aptitudes. Low-impact activities such as walking or tai chi are excellent, as is yoga to improve the body's flexibility, gradually increasing the intensity at first following a professional's instructions to ensure an effective and safe workout.

In conclusion, what can we say about drug therapies for osteoporosis?

It is important to note that vitamin D and calcium alone may not be sufficient to prevent osteoporosis fractures.  Drug therapies vary from individual to individual depending on predisposing diseases, risk factors and laboratory tests and diagnostic results. They commonly include bisphosphonates, monoclonal antibodies and hormonal therapies, as well as calcium and vitamin D.

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