Method We reviewed articles in the

Method

We reviewed articles in the past 18 years (since 1996). We checked medline using the key words ‘productivity’, ‘osteoporosis’ and ‘preventing’, and limited the search to the English language. We found 10 articles (including four review articles) and focused on the relationship between osteoporosis, productivity and preventing activities.
Material
DEFINITION:
Osteoporosis, a skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to enhanced bone fragility and a consequent increase in the risk of fractures [1], is a problem that is relevant to public health. The condition primarily affects postmenopausal women, although it may also affect elderly men. The most common clinical outcomes of osteoporosis are fractures of the spine, forearm and hip. Of these, hip fractures are the most severe, but are also the most readily diagnosed and the best documented. (Jacob, 2001). At first glance, bones look solid, but that is far from being the case. When they are young, they are hollow and the material of which they are made is full of tiny holes. 315 As we grow older, the holes get bigger, like in a piece Swiss cheese, and the bones become fragile. One can suddenly suffer a broken bone from a fit of coughing, lifting a grandchild or using a vacuum cleaner. One does not have to fall over to sustain a fracture in one's 60s or 70s. When such people fall over, they have a big chance of breaking their ankles, wrists or pelvic girdles. Such fractures can be lethal; 15 per cent. of women who fracture their pelvic girdles—which are not to be confused with hip joints—die of the condition, even though they are operated on. Patching up that part of the body is difficult, because the bones are naturally thin. The quality of life is greatly reduced. (Gorman T. , 1996)
RELEVANCY:
Using the operational definition used by the World Health Organization (WHO) for osteoporosis, which is based upon bone mineral density (BMD) assessment, established osteoporosis affects 30% of postmenopausal white women in the USA (9.4 million women); the proportion rises to 70% in women over the age of 80 yr [2]. Although data on the prevalence of osteoporotic fractures are limited, it is estimated that the number of hip fractures that occurred worldwide in 1990 approached 1.7 million [3]. Hip fractures are extremely serious and are responsible for substantial mortality: the age‐adjusted 5‐yr survival rate for those who suffer a hip fracture has been estimated to be 82% of that of the unaffected population, most of the excess mortality occurring within the first 6 months after the fracture [4]. (Jacob, 2001)
In the past, women over 50 were considered to be over the hill or on the shelf, partly because of the decline in their health. There are many things that such women can do with their talents, but good health is essential. The early treatment of osteoporosis can go a long way towards improving the chances for older women to continue to make an important contribution to our society. (Gorman T., 1996)
In addition to morbidity and mortality, osteoporosis and the subsequent fractures are associated with significant economic costs relating to hospitalization, outpatient care, long‐term care, disability and premature death. Health‐care expenditure attributable to osteoporotic fractures in the USA in 1995 was estimated to be US $13.8 billion [5]. In Belgium, a country of approximately 10 million inhabitants, 13 150 hospital stays for hip fractures yearly have generated an annual cost of BF4.4 billion [6]. Osteoporosis has also been shown to result in significant costs in other countries [7–13]. It is of concern that the worldwide health and economic burden of osteoporosis is likely to increase in the future, as improvements in life expectancy will lead to a growing population of elderly people with a high risk of fracture [3, 14, 15]. (Jacob, 2001)
It’s never too early to invest in bone health. The prevention of osteoporosis begins with optimal bone growth and development in youth. Bones are living tissue, and the skeleton grows continually from birth to the end of the teenage years, reaching a maximum strength and size (peak bone mass) in early adulthood, around the mid-20s. Read about bone development in young people. Children and adolescents should:
• Ensure a nutritious diet with adequate calcium intake
• Avoid protein malnutrition and under-nutrition
• Maintain an adequate supply of vitamin D
• Participate in regular physical activity
• Avoid the effects of second-hand smoking
• It’s estimated a 10% increase of peak bone mass in children reduces the risk of an osteoporotic fracture during adult life by 50%.
Bone mass acquired during youth is an important determinant of the risk of osteoporotic fracture during later life. The higher the peak bone mass, the lower the risk of osteoporosis. Once peak bone mass has been reached, it is maintained by a process called remodelling. This is a continuous process in which old bone is removed (resorption) and new bone is created (formation). The renewal of bone is responsible for bone strength throughout life. During childhood and the beginning of adulthood, bone formation is more important than bone resorption. Later in life, however, the rate of bone resorption is greater than the rate of bone formation and results in net bone loss –a thinning of your bones. Any factor which causes a higher rate of bone remodelling will ultimately lead to a more rapid loss of bone mass and more fragile bones. The nutritional and lifestyle advice for building strong bones in youth is just as applicable to adults to.

Adults should:
• Ensure a nutritious diet and adequate calcium intake
• Avoid under-nutrition, particularly the effects of severe weight-loss diets and eating disorders
• Maintain an adequate supply of vitamin D
• Participate in regular weight-bearing activity
• Avoid smoking and second-hand smoking
• Avoid heavy drinking (Kanis J.A, et al. 2005)

REFERENSI:
M van Laar, Jacob. 2001. On conducting burden‐of‐osteoporosis studies: a review of the core concepts and practical issues. A study carried out under the auspices of a WHO Collaborating Center. Volume 40, Issue 1.
Gorman, T.1996. Osteoporosis, 26th June. Cited in Hansard, pp 314-315. Retrieved 4th April 2008
Kanis JA et al. Smoking and fracture risk: a meta-analysis. Osteoporosis Int. 2005;16:155-62

Results (Indonesian) 1:

Metode Kami memeriksa artikel dalam 18 tahun terakhir (sejak 1996). Kami memeriksa medline menggunakan kata kunci 'produktivitas', 'osteoporosis' dan 'mencegah', dan terbatas pada pencarian untuk bahasa Inggris. Kami menemukan 10 artikel (termasuk empat review artikel) dan berfokus pada hubungan antara osteoporosis, produktivitas dan mencegah aktivitas. BahanDEFINISI:Osteoporosis, a skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to enhanced bone fragility and a consequent increase in the risk of fractures [1], is a problem that is relevant to public health. The condition primarily affects postmenopausal women, although it may also affect elderly men. The most common clinical outcomes of osteoporosis are fractures of the spine, forearm and hip. Of these, hip fractures are the most severe, but are also the most readily diagnosed and the best documented. (Jacob, 2001). At first glance, bones look solid, but that is far from being the case. When they are young, they are hollow and the material of which they are made is full of tiny holes. 315 As we grow older, the holes get bigger, like in a piece Swiss cheese, and the bones become fragile. One can suddenly suffer a broken bone from a fit of coughing, lifting a grandchild or using a vacuum cleaner. One does not have to fall over to sustain a fracture in one's 60s or 70s. When such people fall over, they have a big chance of breaking their ankles, wrists or pelvic girdles. Such fractures can be lethal; 15 per cent. of women who fracture their pelvic girdles—which are not to be confused with hip joints—die of the condition, even though they are operated on. Patching up that part of the body is difficult, because the bones are naturally thin. The quality of life is greatly reduced. (Gorman T. , 1996)RELEVANCY:Using the operational definition used by the World Health Organization (WHO) for osteoporosis, which is based upon bone mineral density (BMD) assessment, established osteoporosis affects 30% of postmenopausal white women in the USA (9.4 million women); the proportion rises to 70% in women over the age of 80 yr [2]. Although data on the prevalence of osteoporotic fractures are limited, it is estimated that the number of hip fractures that occurred worldwide in 1990 approached 1.7 million [3]. Hip fractures are extremely serious and are responsible for substantial mortality: the age‐adjusted 5‐yr survival rate for those who suffer a hip fracture has been estimated to be 82% of that of the unaffected population, most of the excess mortality occurring within the first 6 months after the fracture [4]. (Jacob, 2001) In the past, women over 50 were considered to be over the hill or on the shelf, partly because of the decline in their health. There are many things that such women can do with their talents, but good health is essential. The early treatment of osteoporosis can go a long way towards improving the chances for older women to continue to make an important contribution to our society. (Gorman T., 1996)In addition to morbidity and mortality, osteoporosis and the subsequent fractures are associated with significant economic costs relating to hospitalization, outpatient care, long‐term care, disability and premature death. Health‐care expenditure attributable to osteoporotic fractures in the USA in 1995 was estimated to be US $13.8 billion [5]. In Belgium, a country of approximately 10 million inhabitants, 13 150 hospital stays for hip fractures yearly have generated an annual cost of BF4.4 billion [6]. Osteoporosis has also been shown to result in significant costs in other countries [7–13]. It is of concern that the worldwide health and economic burden of osteoporosis is likely to increase in the future, as improvements in life expectancy will lead to a growing population of elderly people with a high risk of fracture [3, 14, 15]. (Jacob, 2001)It’s never too early to invest in bone health. The prevention of osteoporosis begins with optimal bone growth and development in youth. Bones are living tissue, and the skeleton grows continually from birth to the end of the teenage years, reaching a maximum strength and size (peak bone mass) in early adulthood, around the mid-20s. Read about bone development in young people. Children and adolescents should:• Ensure a nutritious diet with adequate calcium intake • Avoid protein malnutrition and under-nutrition• Maintain an adequate supply of vitamin D• Participate in regular physical activity• Avoid the effects of second-hand smoking• It’s estimated a 10% increase of peak bone mass in children reduces the risk of an osteoporotic fracture during adult life by 50%.Bone mass acquired during youth is an important determinant of the risk of osteoporotic fracture during later life. The higher the peak bone mass, the lower the risk of osteoporosis. Once peak bone mass has been reached, it is maintained by a process called remodelling. This is a continuous process in which old bone is removed (resorption) and new bone is created (formation). The renewal of bone is responsible for bone strength throughout life. During childhood and the beginning of adulthood, bone formation is more important than bone resorption. Later in life, however, the rate of bone resorption is greater than the rate of bone formation and results in net bone loss –a thinning of your bones. Any factor which causes a higher rate of bone remodelling will ultimately lead to a more rapid loss of bone mass and more fragile bones. The nutritional and lifestyle advice for building strong bones in youth is just as applicable to adults to.Adults should:• Ensure a nutritious diet and adequate calcium intake • Avoid under-nutrition, particularly the effects of severe weight-loss diets and eating disorders• Maintain an adequate supply of vitamin D• Participate in regular weight-bearing activity• Hindari Merokok dan bekas Rokok• Hindari berat minum (Kanis J.A, et al. 2005)USEFUL:M van Laar, Yakub. 2001. pada melakukan studi burden‐of‐osteoporosis: Tinjauan konsep inti dan masalah-masalah praktis. Sebuah studi yang dilakukan di bawah naungan Pusat bekerja sama WHO. Volume 40, Terbitan 1.Gorman, T.1996. Osteoporosis, 26 Juni. Dikutip dalam Hansard, pp 314-315. Diakses pada 4 April 2008Risiko Kanis JA et al. Rokok dan fraktur: meta-analisis. Osteoporosis Int. 2005; 16:155-62