Shahnai Basharat et al. Int. j. med. appl. health. Vol. 1, No. 2, 2013 36 COMBINATION THERAPY OF DIET AND PHYSICAL THERAPY IS HANDY TO COMBAT THE OSTEOPOROSIS Shahnai Basharat 1* , Muhammad Mustafa Qamar*, Akhtar Rasul* and Ayesha Basharat 2 1 Institute of Diet & Nutritional Sciences, University of Lahore 2 Department of Physical Therapy, Sargodha Medical College Campus, University of Sargodha Corresponding author e-mail: shahnaibhatti@gmail.com ABSTRACT Osteoporosis is a skeletal disorder, frequently common especially in postmenopausal women above age of 50 years. Evidence suggests that life modification can prevent or delay development of osteoporosis. A study was carried out in order to determine the effects of di et along with physical therapy in female patients with osteoporosis. In this causal comparative study, an osteoporosis knowledge based assessment questionnaire including diet frequency, anthropometric measurements, clinical signs and symptoms, including the prevalence of pain and intensity of pain in joints, biochemical evaluation and physical activity record were taken from sample of 50 female patients of osteoporosis between age ranges of 50-60 years. These subjects were randomly assigned two groups. The 1 st group consists of osteoporotic female patients who were on di et along with physical therapy and 2 nd group consists of other osteoporotic female patients who were on estrogen hormone replacement therapy. Chi-square was used to determine the effects of two treatments. Current study results indicated that di et along with physical therapy is more effective in the management of osteoporosis than the hormone replacement therapy. There was a significant improvement in the BMI, BMD-t score, the relief of pain and decrease in the intensity of pain, improved level of serum calcium, vitamin D and phosphorous level in the patients group who were seeking diet along with physical therapy treatment as compare to the group receiving hormone replacement therapy. We concluded that the patients having balanced intake of appropriate diet, caloric intake ranging from 1801-2200 KCals, supplementary calcium intake 1400 mg/day, including dairy products, green leafy vegetables, fruits and soybeans and the supplementation of vitamin D, soy-isoflavon along with physical therapy is best non- pharmacological interventional strategy to prevent, manage or treat the osteoporosis. KEY WORDS: Balanced diet, Physiotherapy, Hormone replacement therapy, Osteoporosis INTRODUCTION Osteoporosis is a sileŶt ĐoŶditioŶ iŶ ǁhiĐh the rate of bone loss exceeds the rate of new bone formation (Misner & Vanessa, 2006; Bauman, et al, 2008). It affects approximately 200 million women throughout the world. Osteoporosis affects an estimated 75 million people in Europe, US and Japan. In the US about 8 million women and 2 million men have osteopenia over the age of 50, are at greatest risk of developing osteoporosis and suffering related fractures with ratio of One in every two women and one in every six men will suffer an osteoporosis related fracture at some point in their life (Adachi, et al., 2001). In developed countries the spinal osteoporosis is about 4-6 times, and hip fractures 2-3 times more common in women than in men (Garnerov et al. 2000 ; Hough, 2006). According to the statistics from the International Osteoporosis Foundation, 30 to 50% of women and 15-30% of men in Pakistan were likely to suffer a fracture related to osteoporosis in their lifetime (AtKinson et al., 2004). According to one survey, 72% of people lead a sedentary lifestyle, and vitamin D and calcium deficiency among Pakistani women has been reported to be as high as 83% which place them at a higher risk of having and developing osteoporosis (Fatima et al, 2009). A low calcium intake during the groǁiŶg LJears liŵits the ďoŶe’s aďilitLJ to aĐhieǀe aŶ optimal mass and density. Most people achieve a peak ďoŶe ŵass ďLJ their late 20’s aŶd deŶse ďoŶes best protect against age-related bone loss and fractures. All adults lose bone as they grow older, it begins before they are 40 (Whitney & Rolfes, 2002; Heaney, 2009). Optimum balanced nutritional practices in the youth is required to achieve high peak bone mass. Bone health is influenced by three major interacting factors; diet, exercise, and estrogen. It is neither too early nor too late to prevent the onset and severity of osteoporosis by ensuring adequate intake of vitamin D, engaging in regular weight-bearing exercises (Miggiano & Gagliardi, 2005; Mahan & Stump, 2008; Farrell, et al., 2009). Weight-bearing and strengthening exercises are essential in the