Osteoporosis is a progressive bone disease that is characterized by a decrease in bone mass and density and structural deterioration of bone tissue which then leads to fragile bones and an increased risk of fracture of the spine, wrist and hip. Bone loss is exaggerated by menopause and estrogen deprivation. In the first 5-7 years after menopause, a woman might lose about 20% of her bone, while an average woman loses half her bone by the age of 70 years. Osteoporosis is twice more common in females as compared to males.


Peak bone mass is achieved in men and women by the age of 25 to 30 years. Factors that determine the peak bone mass are genetics, physical activity and diet. Bone loss is highest in small built, fair skinned women. In 1997 alone, the Chinese women in Malaysia accounted for 44.8% of hip fractures in Malaysia.

Risk factors for osteoporosis

Non- modifiable Modifiable
  1. Advancing age
  2. Ethnic group (Oriental/ Caucasian)
  3. Female gender
  4. Premature menopause (< 40 years),
    early menopause (< 45 years) or surgical menopause
  5. Fair skinned
  6. Family history of osteoporosis in first degree relative
  7. Personal history of fracture as an adult
  1. Low calcium and / or Vit D intake
  2. Cigarette smoking
  3. Sedentary lifestyle
  4. Excessive alcohol intake

(> 3 units / day)

  1. Excessive caffeine intake

(> 3drinks / day)

  1. Low BMI (<19 kg/m2)
  2. Impaired vision
  3. Recurrent falls

The common areas of fracture are to the spine, wrist and hip

The Incidence of Hip Fractures in Malaysians above 50 years of age: Variations in different ethnic groups

Age Group Male Female Overall
50-54 10 10 10
55-59 20 30 20
60-64 40 50 40
65-69 60 100 80
70-74 100 230 170
>75 320 640 510

Malaysian data on Osteoporosis has shown that:

  • Chinese women had the highest incidence of hip fractures (44.8%)
  • 20% of men and women die  in the first year after a hip fracture
  • Only 25% of men and women resume normal activity after a hip fracture
  • 25% will always need a walking aid for the future

A Summary of the Malaysian Clinical Guidance on the management of post menopausal and male osteoporosis 2015.

Swan Sim Yeap, Fen Lee Hew, Premitha Damodaran, Winnie Chew, Joon King Lee, Emily Man Lee Goh, Malik Mumtaz, Heng Hing Lim, Siew Pheng Chan.

The above table shows that osteoporosis is clearly an important problem as one gets older. The risks of an osteoporotic fracture is greater than the combined risk of heart attacks, stroke and breast cancer.


The skeleton which holds the body’s frame is 99% calcium. 1000 to 1300 mgs of calcium is needed daily at various stages of one’s life.

Calcium is important for building bone in the first 25 years of one’s life, after which its role is in sustaining bone health until the inevitable age related bone loss occurs.

For more information on Osteoporosis, please click here.