THE shock waves caused by the recent admission by US cigarette manufacturer Liggett that smoking can cause cancer and is addictive could be a foretaste of an evens bigger scandal that will surely rock the food processing industry across the globe. Excess salt is being packed into, processed food in order to extend its shelf life and, according to Prof Austin Darragh, it is causing an intolerable increase in heart disease, strokes and osteoporosis.
Prof Darragh, Consultant in Endocrinology at the Blackrock Clinic in Dublin, believes that, like the tobacco companies before them, food processing companies are fully informed of the risks but are ignoring the clear advice that scientists and doctors are telling them.
Osteoporosis, the disease that makes bones so porous that they become fragile and break easily, is accelerated by excessive salt increase. Salt, says Prof Darragh, causes "leaching of calcium from the body". Incorrectly seen as a woman's disease, as many as one in 12 men suffers from it. Hip fractures in men have risen six fold since the 1950s, an increase that can in no way be explained by increased life expectancy. Nor is osteoporosis any longer to be regarded as, an old person's disease. Men in their 40s can develop it. And, according to Prof, Moira O'Brien of the osteoporosis unit at the Department of Anatomy at Trinity College, young men and adolescents can get it too. She has treated boys aged as young as 13 years who have rare metabolic disorders, do not exercise and are unable to break down protein to strengthen their bones.
Most men don't know that their diet and lifestyle can predispose them to developing osteoporosis. It's a silent disease. The first time many men know they have it is when they fracture their hip, spine or wrist. By this time they can already have lost up to a third of their skeleton. According to the National Osteoporosis Society in Britain, healthy men who have led active, busy lives can suddenly start breaking bones, losing height and suffering severe back pain".
Prof Austin Darragh says that healthy bone is as strong as granite. Bone is a living tissue with new cells constantly replacing old cells. Between the ages of 20 and 70 this huge metabolic process results in the skeleton "turning over" or replacing itself at least three times. However, by the mid 30s less bone is produced than is discarded.
Some, men never develop high bone density in the first place due to deficient calcium and vitamin D intake or smoking, or excessive consumption of salt or alcohol. Sedentary lifestyles predispose men to developing osteoporosis, as cab confinement to bed for extended periods.
Some 20 per cent of male osteoporosis is caused by low levels of testosterone. A further 20 per cent of cases are a consequence of using long term corticosteroids. Five per cent of male osteoporosis cases are caused by excessive alcohol consumption while 10 per cent are due to rare conditions such as the cancer multiple myeloma, gastric surgery, intestinal disease, coeliac disease and genetic conditions such as osteogenesis imperfecta (fragile bone disease). Yet in 45 per cent of cases there is technically "no known cause" for osteoporosis in men. It is this large proportion which Prof Darragh believes is mainly caused by excessive salt intake and has led to the "subtle but pernicious increase" in osteoporosis. But his view is not shared by all his medical colleagues.
He blames manufacturers of convenience foods for their high salt content to extend products' shelf life and he stresses that these are "well recognised today as being a source of excess salt which leads to osteoporosis, heart disease and strokes". Prof Darragh deplores the "cavalier way the manufacturers are doing this, exactly the same as the tobacco industry did, but is now reaping the harvest".
The warning signs for osteoporosis can be a fracture after a slight trauma or minor fall, loss of height and severe back pain. Prof Darragh advises men who have been on steroids for more than six, months to have bone density tests and, suggests that renal patients who have had several kidney stones should do likewise. A GP will arrange a bone density test and X ray to check for any broken bones. Blood and urine tests will detect if there's any other cause for these symptoms.
Consultant Endocrinologist Dr Malachi J. McKenna says that he has seen men shrink in height by as much as seven inches due to osteoporosis. He says, that as many as 25 per cent of hip fracture patients are male. In addition to the gradual decline in bone density with age, some men can lose bone earlier than most if they're deficient in testosterone. This can be due to surgical removal of the testes, congenital malfunctioning and sometimes the result of infections such as mumps. Testosterone levels can be measured by blood tests and, if deficient, hormone replacement therapy can be given by injection into the buttocks or arm every two to four weeks. It can also be given orally, by implant into the abdominal wall or, more recently, by wearing a patch on the arm or buttocks.
Dr McKenna explains that male osteoporosis can result from long term steroid therapy given to men who have chronic lung diseases, chronic arthritis, chronic bowel disease or chronic asthma. Heart, liver or kidney transplants can also give rise to thinning of the bones because of high dose steroids used for immune suppression after transplants.
HEALTHY, cube shaped vertebrae can, with osteoporosis, become wedge shaped and collapse, causing curvature of the spine and sometimes chronic pain by applying pressure on the nerve roots and spinal cord. Various painkillers can be prescribed. Calcitonin, a hormone to increase the absorption of calcium, can be injected under the skin once a day or, given as a snuff.
Biphosphonates are also used. These are tablets that have a direct effect on the skeleton and can help in the reconstruction of bone. Prof Darragh explains that biphosphonates are like replacing the floors in a block of flats - there is no point in putting furniture (calcium) back in until the floors have been replaced. However men with prostate problems, might not be offered biphosphonates anabolic steroids are sometimes an alternative. Physiotherapy can also help in the treatment of osteoporosis. But, ever, prevention is the best medicine.
. Combat a sedentary lifestyle by taking a brisk, 30 minute walk or take other regular weight bearing, exercise at least three times a week:
. Increase calcium intake by consuming at least a pint of low fat or skimmed milk each day, other low fat dairy products and, green leafy vegetables.
. Increase vitamin D intake (sunlight, eggs, cod liver oil, margarine and dairy products)
. Stop smoking
. Keep alcohol consumption within recommended limits (21 units per week for men, a pint being counted as two units).
. Reduce stress (excessive stress reduces, testosterone and increases osteoporosis)
. Get adequate quality sleep because the body replenishes itself during REM sleep.