2. OSTEOPOROSIS : A DISEASE THAT SHOULD BE PREVENTED
a. What is prevention ?
Prevention is constituted of a set of actions that aim to avoid the occurrence of the disease (primary prevention), but also to avoid the occurrence of the consequences of the disease (secondary prevention).
Focusing on osteoporosis, actions for a primary prevention are targeting the maintenance of optimal bone mass as well as bone tissue quality, while for the secondary prevention, the goals will focus on the protection against fracture event.
b. What kind of interventions could be offered for the primary intervention ?
The goals are:

i) either to optimize the gain in bone mass during childhood
ii) either to slow down at best the process of bone degradation with age in terms of mineral content and of bone quality.

General recommendations underline the importance of a sufficient intake in calcium (1'000 mg / d) as well as a sufficient daily intake in vitamin D (at least 800 UI). But, in addition, the diet should bring sufficient protein intake (at least 1 g / kg body weight), the life style should include regular physical activity and personal actions should be set up in order to avoid risk of falls, to avoid excess in alcool consumption as well as tobacco consumption.
c. How do I know what is necessary for me ?
The overall medical community and dedicated medical officials at the national as well as at the international level have underlined to importance to perform an appropriate diagnostic approach with your personal physician. Search for specific clinical risk factors and ultimately the quantification of the fracture risk, will enable you to appreciate your bone state, and possibly to justify the appropriateness of further investigations by means of bone densitometry measurement (DXA), radiological search for silent vertebral deformities as well as blood and urinary biological lab.
This overall evaluation enables to assess your personal fracture risk as compared to the general population and will support the discussion with your physician for the need of introducing new actions or treatment.
d. Does it exist efficient drugs to fight osteoporosis ?
Over last two decades, we have seen an extraordinary development in the medical treatment of osteoporosis.
Thus in addition to the previously discussed preventive actions, introduction of drug treatment is not systematic. It will depend in particular on the clinical history (previous occurrence of osteoporotic frature) as well as on the presence and the nature of risk factors for osteoporosis.
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