Not only does it poison the air we breathe in cities: Smog can also hurt your bones. And the 'antidote' seems to be green. Living in lush areas, near gardens or parks, can increase bone density and reduce the risk of osteoporosis. This effect is highlighted by research published online in the 'Annals of the Rheumatic Diseases'. And according to the authors, it is precisely the lower levels of air pollution in green spaces that represent a significant factor contributing to the associations found. The work was signed by Chinese researchers from the Central South University of Changsha (Hunan) and the Huazhong University of Science and Technology in Wuhan.
Osteoporosis, a condition that makes bones fragile and prone to fractures, caused by genetic, hormonal and environmental factors, can lead to chronic pain, reduced mobility and poorer quality of life. It is already a global health problem – experts highlight – but its global prevalence is destined to increase with the rapid aging of the population and changes in lifestyle. Starting from the fact that exposure to green spaces has been linked to lower risks of poor health, the authors wanted to investigate whether this also extends to the risk of osteoporosthe. To understand this, they analyzed the data stored in the UK Biobank on 391,298 people, average age 56, just over half of whom (53%) were women. All had recorded information on bone mineral density and potentially influential factors including ethnicity, annual household income, education level, employment status, residential area, alcohol consumption, physical activity levels, smoking status, diet.
Their genetic risk of osteoporosis was calculated using a score and then the amount of green space in their residential area was determined using a widely used measurement method. Average annual exposures to the pollutants nitrogen oxide (NO2) and particulate matter PM2.5 were estimated based on residential postcode and data from the Escape project, which is examining the long-term health effects of smog exposure in Europe . Each participant was monitored and during an average period of 12 years, new cases of osteoporosis occurred in 9,307 people. They were more likely to be older, female, smokers and retired, and were also more likely to have a lower level of education and be more economically disadvantaged. But it also emerged a consistent association between the amount of green spaces and new cases of osteoporosis.
The authors estimated the vegetation index by calculating the distance from available residential greenery in a range between 300 and 1,500 meters. With increases in this index, an increase in bone mineral density and a 5% lower risk of developing osteoporosis were found. The main factors in the observed association between green space and reduced risk of developing osteoporosis were lower levels of the pollutants NO2 and Pm2.5.
Several studies – experts reason – have shown that Exposure to smog can produce oxidative stress and inflammation and alter hormones, phenomena that increase the risk of osteoporosis. People living in greener areas will be exposed to less risk because trees and plants act as natural filters, removing pollutants from the air. Being physically active has also been associated with a lower risk of osteoporosis, perhaps because living in areas with green spaces offers more opportunities for exercisethe researchers still suggest.
This is an observational study, the authors point out, and as such cannot be conclusive on the causes. The researchers also acknowledge several limitations, including that the vegetation index calculation was based on residential addresses, so it may not have accurately defined the actual amount of green space. And the study participants were generally healthy, so the potential for selection bias cannot be ruled out. But the results, the scientists conclude, “present the first evidence indicating that residential greenery is associated with greater bone density and at a reduced risk of developing osteoporosis. And they provide valuable information on the potential” of plants and trees “in preventing the onset of the condition, underlining the importance of urban greenery in the development of effective strategies.”
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