Bone status of Indian women from a low-income group and its relationship to the nutritional status

Abstract

Indian women from low-income groups consume diets that have inadequate calcium coupled with too few calories, proteins and micronutrients. Hospital-based data suggest that these women have osteoporotic hip fractures at a much earlier age than Western women. Studies reporting bone parameters of the Indian population involving large sample sizes are not available. This study was therefore carried out with 289 women in the 30-60-year age group to estimate the prevalence of osteoporosis and measure the bone parameters by dual energy X-ray absorptiometry (DXA). Their mean (+/- SD) age was 41.0+/-8.60 years. Their mean (+/- SD) height, weight and body mass index (BMI) were 149.1+/-5.49 cm, 49.2+/-9.85 kg and 22.1+/-3.99, respectively. Dietary intake of calcium was estimated to be 270+/-57 mg/day. The prevalence of osteoporosis at the femoral neck was around 29%. Bone mineral density (BMD) and T scores at all the skeletal sites were much lower than the values reported from the developed countries and were indicative of a high prevalence of osteopenia and osteoporosis. BMD showed a decline after the age of 35 years in cases of the lumbar spine and femoral neck. This was largely due to a decrease of bone mineral content (BMC). The nutritional status of women appears to be an important determinant of bone parameters. BMD and BMC at all the skeletal sites and whole body increased significantly with increasing body weight and BMI of women (P<0.05). However, bone area (BA) did not change with an increase in BMI. In the multiple regression analysis, apart from body weight, age, menopause and calcium intake were the other important determinants of BMD (P<0.05). In addition to these, height was also an important determinant of WB-BMC. This study highlights the urgent need for measures to improve the nutritional status, dietary calcium intake and thus the bone health of this population.

Dietary diversity among women in the reproductive age group in a rural field practice area of a medical college in Mandya district, Karnataka, India

“…This finding is similar to the one in our study except the fact that urban slum population is a mixture of people from different locality thus showing the minor variations. 7 In a report published by Vinay Kumar et al, in the year 2012, the nutritional status of Indian women is inadequate: 33% of married women (aged 15-49 years) are too thin (i.e., BMI <18·5 kg/m 2 ). This is in contrast to the findings from our study which found 14.3% of women in the reproductive age group having BMI below 18.5kg/mt 2 .…”

Prevalence and determinants of osteoporosis in women aged 40-60 years

“…However, the RDA for calcium has not been established for menopausal women in India subsisting on a cereal-pulse diet, and therefore 400 mg/day of RDA for calcium is indicated. 12 The major part of this calcium intake came from plant sources, which are known to have low bioavailability. The foods rich in calcium such as milk, spices and dry fruits are expensive and not well available for majority of this population.…”

Preliminary screening of osteoporosis and osteopenia in middle aged urban women from Hyderabad (INDIA) using calcaneal QUS

“…The variations from the present study in incidence of osteoporosis and osteopenia by both calcaneal QUS and DEXA methods have been shown in Table 4. (11) Digital X-ray radiogrammetry 50% -Above age 50 years Shatrugna et al (12) DEXA Prevalence 29% -…”

“…[8][9][10][11][12][13] but still the data is scanty, particularly from this region. Hence, the present pilot study was planned to screen bone status of healthy urban women above age of 25 years (when peak bone mass is formed) from this region utilizing calcaneal QUS (Hologic Sahara 0058 USG) as a diagnostic tool.…”