Adventist International Institute of Advanced Studies 

Graduate School, Public Health Department 
Lalaan I, P. O. Box 038, Silang, Cavite 4118, Philippines 
Phone: [63] [46] 414‐4300; Fax: [63] [46] 414‐4310 or 4320 
Email: mbakulirahik@aiias;   Web: http://www.aiias.edu  
 

 
Research paper 

OSTEOPOROSIS IN MEXICO 

By

AIME KATSUVA MBAKULIRAHI, MD, MPH candidate

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 INTRODUCTION

WHO (2003) defines osteoporosis as a systemic skeletal disease characterized by low

bone density and micro architectural deterioration of bone tissue with a consequent increase in

bone fragility Osteoporosis is a serious health condition which has been recognized as a global

public health concern in developed countries where its impact has been compared with other

chronic diseases. (Clark P, 2010). It is expected that the number of osteoporotic fractures will

double over the next 50 years (WHO, 2003). Osteoporosis and associated fractures cause

considerable morbidity, mortality and utilize resources all over the world (Jorge Morales-

Torres, 2006).

Osteoporosis is now a growing disease in Latin America because the rates of fractures in

Latin America are almost similar to the ones in southern Europe and slightly lower than USA

and Northern Europe (Riera-Espinoza, 2009). Considering the trends in other regions of the

world, Mexico is now facing an epidemiological transition with its growing number of elderly

people and an increase in life expectancy (Clark P, 2010). The aging process took almost two

centuries to occur in industrialized and developed countries but in Mexico like most of the

transition economies in developing countries, it is taking place very rapidly. (Clark p, 2010).

The purpose of this study is to discuss the etiology, prevalence, impact and risk factors of

the disease in Mexico; find out what measures are being taken at different levels to prevent this

burden. And finally give some effective primary recommendation for better prevention.

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 THE ETIOLOGY OF THE DISEASE

With osteoporosis skeletal weakness leads to fractures with minor or inapparent trauma,

particularly in the thoracic and lumbar spine, wrist, and hip. (Raisz, 2008). Osteoporosis is

classified into two categories; primary osteoporosis: this occur more than 95% in women and

probably about 80% in men. The major mechanism is increased bone resorption. And secondary

osteoporosis. Among the causes of secondary osteoporosis we have cancer, COPE, chronic renal

failure, drugs (corticosteroids, ethanol, phenytoin, tobacco, barbiturates, heparin), Endocrine

disease (eg, hyperparathyroidism, hyperprolacinemia..), hyper avitaminosis A, immobilization,

liver disease…) (Raisz, 2008).

Bones contain minerals such as calcium and phosphorus, which make them hard and

dense. In order to maintain this density the body requires an adequate amount of minerals. Bones

progressively increase in density until a maximum density is reached, around age 30. After that,

bones slowly decrease in density (Berkow R, 1997).

At first osteoporosis produces no symptoms. Usually back pain occurs if vertebrae

collapse. And the most serious fracture is the hip fracture as a major cause of disability and loss

of independence in the elderly. Osteoporosis can be diagnosed before the symptoms occur with

tests that assess bone density. The most accurate test is dual-energy x-ray absorptiometry (DXA)

(Raisz, 2008). In one study Chan (2003) found out that the best way to address osteoporosis is

prevention. However usually drugs are used to treat osteoporosis for example calcium and

vitamin D, estrogen, Bisphosphonates, calcitonin, fluoride supplements and finally fractures

from osteoporosis must be treated.

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 PREVALENCE AND IMPACTS OF THE DISEASE

Osteoporosis affect more than 75 million people in Europe, Japan cause more than 23

million fractures annually in Europe and USA alone. The lifetime risk for hip, vertebral and

forearm fractures has been estimated to be approximately 40%, similar to that for coronary heart

disease (WHO, 2003). According to the International Foundation of Osteoporosis (2003), 1 in 3

women over 50 will suffer a fracture due to osteoporosis; this increases to 1 in 2 over 60. 1 in 5

men over 50 will suffer a fracture due to osteoporosis; this increases to 1 in 3 over 60. In Mexico

Life expectancy at birth has increased almost 39 years on average over the last seven decades

(from 36.2 to 75 years old). The population of 50 years and over is currently 19 million, and it

will increase to 55 million by 2050. By then, the average life expectancy in Mexico will be 82

years of age (Clark P 2010).

Million-dollar

Over US $97 million was reported in 2006 for hip fracture’s direct costs; projection for

2025 range from US $213 to over US $466 million and from US $555 to US $4.088 million for

2050. Only 25% of the available diagnostic tools for osteoporosis (dual-energy X-ray

absorptiometry (DXA) equipment) are found in government health institutions that cover the vast

majority of Mexicans.

Deterioration in the quality of life

Fractures due to osteoporosis don’t just cost a lot of the health system but also have an

impact on the quality of life of individuals. In older adults, from 12% to 20% die within the first

year after a fracture. Of the remaining elderly who do not die 30% left with permanent disability,

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40% have difficulty walking and 80% with some difficulty performing everyday activities

(partial disability). Furthers more a fracture is a major factor for having a second. (Tonka, 2010)

RISK FACTORS ASSOCIATED WITH THE DISEASE

The risk factors of developing osteoporosis are: immobilization, being thin, insufficient

dietary intake of calcium, phosphor and vitamin D; cigarette smoking (Kanis, the director of the

WHO collaborating Centre of Metabolic Bone Disease at England’s Sheffield university, stated

that smoking can be considered a major predictor of fracture risk); excessive caffeine or alcohol

use; whites and Asians are at higher risk; a family history of osteoporosis increases risk;

decreasing amounts of sex hormones; a high protein diet (Pickering, 2004) (Raisz, 2008)

MEASURE TAKEN AT DIFFERENT LEVELS OF PREVENTION

Primary prevention of osteoporosis should focus on adolescents, young women and

perimenopausal women. To ensure that women reach their maximal peak bone mass and

minimize bone loss through their early adult years. Secondary prevention will focus on women

who have osteopenia or osteoporosis. This encompasses lifestyle modification, pharmacologic

therapy and fall prevention. Tertiary prevention of osteoporosis is a strategy to prevent future

fractures in women with osteoporosis who have already sustained a fracture. (Schrager S, 2003)

National nutritional programs for osteoporosis prevention

Unfortunately there are no official programs for prevention of osteoporosis in Mexico

this time. Only the milk industry is marketing program to increase the consumption of milk and

dairy product in the population. The fact is that in Mexico, people drink instead of milk,

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carbonated soft drinks, making it the second highest country in consumption per capita of soft

drinks and cola. Vitamin D can be found in any pharmacy in Mexico.

In October 2008 the Ministry of Health through the National Commission of the

Institutes of Health and high level specialty hospitals in Mexico convened a group of

osteoporosis experts to develop a national program for prevention, treatment and education that

will bring awareness to health professionals and the general public regarding osteoporosis and

fragility fractures.

Several organizations like The Mexican Association of Bone and Mineral Metabolism

AMMOM, the Mexican Committee for Study of Osteoporosis Prevention (COMMOP) and local

societies organize activities in different provinces of Mexico for the World Osteoporosis Day in

October. Several courses sponsored by the pharmaceutical industry are offered for continuing

education to different health care professionals, mostly clinicians.

RECOMMENDATIONS TO PREVENT OSTEOPOROSIS

The government should reinforce primary prevention in the population buy developing

national proms for prevention. This includes to increase awareness and education programs for

consumers and health professionals using media and key opinion leaders in different sectors help

the population to adopt healthy lifestyle early in life so they can reach the pick mass bone. This

is the only way osteoporosis can be controlled. The government should improve the insurance

system so that everybody should be covered when sick. Facilitate better detection, treatment

opportunities and education programs for primary physicians. Increase the number of DXA

machines to cover the needs of the elderly and distribute them wisely within the governmental

institutions.

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 REFERENCES

Clark, P. (2010). Epidemiology, costs and burden of osteoporosis in Mexico. Conference on

Diagnosis and Treatment of Osteoporosis in 2003 [21]. Consenso Mexicano de
Osteoporosis (2001) Rev Invest Clin 53. (5):469–495. Retrieved from:
www.iofbonehealth.org/download/osteofound/.../WhitePaper_Mexico.pdf

Morales, J. ( 2006). Fragility and fractures. Retrieved April 11, 2011, from the International
Society for Fracture Repair: http://www.fractures.com/osteoporosis-international-
perspectives-mexico.html

Pickering, K. (2004, August). Osteoporosis incidence rising in Latin America . Retrieved April
14, 2011, from ORTHOSupersite: http://www.orthosupersite.com/view.aspx?rid=1661

Raisz, L. G. (2008, February). Osteoporosis. Retrieved April 11, 2011, from Merck:
http://www.merckmanuals.com/professional/sec04/ch036/ch036a.html

Riera-Espinoza, G. (2009). Epidemiology of osteoporosis in Latin America 2008. Retrieved April

11, 2011, from Salud Pública de México:
http://www.scielo.org.mx/scielo.php?pid=S0036-
36342009000700009&script=sci_arttext

Shea, B., Wells, G., Cranney, A., Zytaruk, N., Robinson, V., Griffith, L., Hamel, C., Ortiz,G.
(2002). In a meta-analysis of calcium supplementation in the prevention. Meta-analyses
of therapies for postmenopausal osteoporosis. VII. prevention of postmenopausal
osteoporosis. Endocr Rev 23, 552-559. Retrieved from:
www.osteoporosis.org.au/files/.../Calcium_Supplements_evidence.pdf -

Schrager S, (2003). Osteoporosis prevention in Primary care. Wisconsin medical journal 2003.
Volume 102, No. 3. Retrieved from
http://www.wisconsinmedicalsociety.org/_WMS/publications/wmj/issues/wmj_v102n3/s
chrager.pdf 

Tonka. (2010, October 21). Mexico-Osteoporosis: a problem about to turn into a nightmare.
Retrieved April 13, 2011, from MEDPEDIA ( flutrackers.com/ forum/:
http://www.flutrackers.com/forum/showthread.php?p=375498 

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