n World Osteoporosis Day is on October 20:
Nutrition education should be compulsory
- Dr. Renuka Jayatissa
Despite various awareness programs around the country, osteoporosis
still affects 40 percent of Sri Lankan women over the age of 50 years.
Osteoporosis, often called ‘porous bones’, is a disease of bones that
contributes to a high risk of fracture. “During menopause, women are at
a risk of having osteoporosis called postmenopausal osteoporosis because
the bones tend to be weaker with age.
If they get injured or accidentally have a fall, it makes the
condition worse,” said consultant nutritionist at the Medical Research
Institute (MRI), Dr. Renuka Jayatissa. She said that there are many
medical referral cases every day but it is the simple lack of
nutritional education that makes these women become prone to
Dr. Jayatissa said, “It is important that the family physicians and
the GPs themselves educate patients on nutrition without only focusing
on the treatment part alone.” Moreover, she said that about one-fifth of
Sri Lankan women are undernourished but it’s not the lack of food or the
cost of living.
Dr. Jayatissa said, “In a survey we did, even though the cost of
basic essentials is high, only 2 percent of the population actually live
without three meals a day.” According to the doctor, those with low
income managed to live comfortably by eating something but it was the
food decisions that really made the difference.
“Nutrition is a vital factor in preventing not only ailments like
osteoporosis but anything for that matter,” said the doctor. Working for
about ten years in the nutrition sector of the Ministry of Health, Dr.
Jayatissa is the only nutritionist attached to the Government’s health
“In the MRI survey, it was also revealed that a traditional household
would rather spend on their children’s education than a healthy balanced
They don’t understand that if they don’t give proper nutrition for
the child, what use would it be if they can’t attend school or
university?” said Dr.Jayatissa. It was obvious that women who head
households and make food decisions such as this forget about their
nutritional condition due to the best interests of their family.
The doctor said that 20 percent of the total population of women in
Sri Lanka are overweight and 20 percent are underweight. “Underweight
women are more at a risk because they don’t obtain sufficient nutrition
to compensate for the calcium levels in their body.
Hence, bone thinning causes the bones to be fragile and if they have
a fall or injury, the condition would be aggravated,” she said. However,
if a woman is overweight, she is capable of getting ostereo-arthritis
which means that her bones are not strong enough to hold her weight.
The doctor advised that exercising would not only keep weight at a
minimum but strengthen bones to make them resistant to osteoporosis.
Dr. Jayatissa said, “Osteoporosis can be easily prevented if patients
take the doctor’s advice but they shouldn’t overdo it. For example,
calcium supplements can be obtained through a prescription but if anyone
takes more than the recommended dosage, severe adverse effects are
likely to occur.”
Speaking about the link between osteoporosis with pregnant and
lactating mothers, the doctor said that usually a prescription of
calcium tablets are given to them. She said, “A continuous six-month
course is given for women who are breastfeeding and pregnant women and
this is compulsory with the health policies in place by the government.”
The doctor said that the common risk factors of age and family
hereditary brings about ostereoporosis in addition to nutritional
aspects. Furthermore, she said that Vitamin D is very much another
requirement in bone formation.
“In Sri Lanka, we have taken the sunshine for granted but due to a
hectic lifestyle most people don’t even go outside.
It is recommended that we are exposed to at least 10 minutes of
sunlight everyday to produce vitamin D or we will have tragic
complications,”she said. Dr. Jayatissa said that the best times for
going out in the sun is before 10 am and after 2 pm.
Osteoporosis is easily treatable but prevention is better than cure.
Dr. Jayatissa said that there are drugs available to treat the different
stages of osteoporosis.
“However, my advice is to ensure that you have a balanced diet with
plenty of exercise. Also, women should give priority to their health in
order to support the health needs of their families,” she said.
The doctor said that there are some adolescent cases of obesity,
anorexia and bullimia which also can trigger osteoporosis one day so she
advises young adults to take care of their health.
Dr. Jayatissa’s recommended calcium-rich food to prevent
1. Green leaves such as gotukola, mukunuwenna and kathurumurunga
2. Salty shrimps called kunissa
3. Milk foods such as milk and yoghurt
A blocked nose?
Dr. Girish Rai and Dr. Usha Chennuru
Blocked nose can lead to chronic problems if not treated separately
A blocked nose is a common symptom faced by many people who have a
cold. It makes breathing difficult and interferes with one’s daily
routine. If this happens during sleep, it is far more distressing.
Chronic, untreated blocked nose leads to problems both in children
Why does your nose get blocked?
When you have a cold, many chemicals are released in the body which
lead to the symptoms of cold - sneezing, blocked nose, runny nose,
watering of eyes, etc. These chemicals act on the tiny blood vessels in
the lining of the nose leading to a feeling of stuffiness and hence the
inability to breathe freely. This is how your nose gets blocked when you
have a cold.
What happens if a blocked nose is left untreated in adults? The nose
performs the important function of filtering the air we breathe. When
the nose is blocked, it cannot filter the air efficiently and this leads
to entry of germs and other foreign particles, which can further
aggravate the cold and lead to infections.
Since the nose, ear, throat and sinuses are all interconnected, an
infection in the nose can travel to these areas and lead to further
infections. Such infections can lead to sinusitis which is bothersome
and needs to be treated with a course of antibiotics.
What happens if a blocked nose is left untreated in children? If a
blocked nose is neglected in children, it leads to breathing through the
A mother will notice that her child is sleeping with her/his mouth
open. Since the mouth cannot filter the air, it leads to entry of
foreign particles and germs into the respiratory tract. A child’s immune
system is not fully developed and hence is prone to infections.
So, a blocked nose can lead to respiratory tract infections which in
turn can lead to ear infections. Also, chronic mouth breathing can lead
What can you do to avoid these complications? Nasal obstruction as a
complaint is on the rise due to increasing nasal allergy.
Treat a blocked nose immediately! Most people believe that a blocked
nose need not be treated separately, and that if the cold is treated,
the blocked nose will be treated simultaneously. This is because people
do not know the complications of a blocked nose.
To prevent the complications of a blocked nose, you must initiate
While this would take care of your congestion and help you breathe
freely again, it would also save you from a lot of other complications
which could be very distressing. Nasal sprays are a good way to relieve
the discomfort and complications of a blocked nose.
Courtesy: The Hindu
It’s always about the heart! Anything remotely related to it has
never been spared of speculation and debates. But there is a thin line
that separates the myths from the facts.
Myth 1: Heart disease affects only the old/middle aged.
Keeping fit: Make an
Many people think that heart disease as a problem of middle and older
age, because that’s when the manifestations of heart disease, such as
angina and heart attack strike.
Although the manifestations of coronary artery disease typically
occur during the middle and later years of life, the roots of coronary
artery disease lie early in life - in childhood.
Heart attacks can even happen to people in their 20’s and 30’s, from
unusually high cholesterol levels that are hereditary. High paced,
stressful lifestyles with irregular eating habits and lack of exercise
are one of the causes of coronary artery disease striking early.
Adopting a healthy lifestyle early in life works much better than
changing one’s lifestyle later in life. Ideally one should have their
cholesterol and blood pressure levels checked in their 30’s and 40’s,
which, if too high, can be early indicators of a heart disease.
Moreover, Indians are genetically more prone to and suffer heart
disease earlier than their western counterparts.
Myth 2: Heart disease doesn’t really affect women.
Heart disease is the leading cause of death in women older than 40,
especially after menopause.
Loss of estrogen is a significant cause of heart disease after
menopause and therefore the risk for heart disease increases after the
age of 50 for women. There are also some unchangeable factors like
family history which make one more prone to heart disease.
Lifestyle plays a crucial role. Smoking and fatal heart diseases go
If a woman smokes, she increases her risk for early heart disease.
There are some differences, though, in how heart disease affects men
For instance, women usually get heart disease 10 years later than
men, but they have a lower chance of surviving a heart attack than men.
They are also more likely to have a second heart attack as compared
Some interesting and educational facts about heart related problems:
Cholesterol deposition in blood vessels begins in the first decade of
life. So, good eating habits and regular physical activity should be
inculcated from early childhood if coronary heart disease is to be
One third of patients with coronary heart disease have normal
cholesterol levels. Low levels of good cholesterol (HDL cholesterol)
increases risk of heart disease even if level of bad (LDL cholesterol)
or total cholesterol is normal.
Blood Pressure : Each blood pressure increment of 20/10 mmHg doubles
the risk of coronary heart disease across the entire BP range starting
from 115/75 mmHg.
High blood pressure originally thought to be a normal occurrence with
increasing age is a misconception. Increased blood pressure is harmful
irrespective of the person’s age.
Risk of heart attack in diabetics with no prior heart attack is
similar to non diabetics with prior heart attack.
Risk of heart disease in “mild” smokers is almost as high as “heavy”
smokers. So, for risk reduction smoking should be completely stopped and
not merely reduced.
“Physical inactivity” or lack of regular physical exercise is as
important and as harmful a risk factor as high blood pressure or
diabetes. Regular physical activity is the best preventive effort for
coronary heart disease as it prevents all its risk factors.
Clinical benefits of blood pressure, diabetes and cholesterol
reduction are similar irrespective of the treatment modality chosen.
The Hindu -
The writer is a Chief Cardiothoracic Surgeon in Gurgaon
Osteoporosis in men
“We used to think that as a result of menopause women were the only
ones who were affected but we have many cases of men having osteoporosis
in Sri Lanka,” said Dr. Jayatissa of the Medical Research Institute.
One in five men over the age of 50 are at a risk of developing
osteoporosis and bad habits like smoking, drinking excessive alcohol and
inadequate exercise contributes to this condition.
“When a man gets drunk, they are prone to accidents and if they fall,
fractures would take a long time to heal due to osteoporosis,” said the
Smoking is also very dangerous to bones because the chemicals in
cigarettes make the bones weak and fragile. “Smoking can also lead to
chronic disease that affects the kidneys, lungs, stomach, and intestines
and alters hormone levels,” said Dr.Jayatissa.
When it comes to osteoporosis in men, testosterone increases bone
density in men with low levels of this male hormone. According to the
doctor, undiagnosed low levels of the sex hormone testosterone leads to
Also, prolonged exposure to certain medications, such as steroids
used to treat asthma or arthritis, anticonvulsants, certain cancer
treatments and aluminum containing antacids.
Dr. Jayatissa said, “Osteoporosis is indeed a silent killer so not
only should we carefully check women but men too, because if it isn’t
detected promptly the consequences would be devastating. The older the
man is, the higher the risk of ostereoporosis.”
What men can do to reduce the risk of fracture - Assess your risks
and seek advice from your doctor.
* Diet: a balanced diet rich in the essential nutrients for bone
health, includes calcium, which strengthens bone, and vitamin D, which
helps the body to absorb calcium.
* Between 25 and 65 years of age, men need at least one gram of
calcium a day, increasing to 1.5 grams daily for the over 65s. Sunlight
is a natural source of vitamin D and exposure to as little as ten
minutes a day can be sufficient or vitamin-rich foods can be
* Physical activity: weight-bearing exercise, such as walking, tennis
and jogging may assist in maintaining bone density and muscle strength,
coordination and flexibility and reduce the risk of falls. Resistance
training and lifting weights may help maintain bone density.
* Diet, exercise, lifestyle and - if osteoporosis is diagnosed, the
use of certain medications - are the major ways of maintaining and
restoring bone health.