“Every day, I had 3 liters of soda and 1 liter of coffee, plus energy drinks. I even replaced the water to drink soda. I needed it to stay awake and play for 18 hours to stay in the top 1 global Free Fire”, says gamer and streamer José Neto, 21 years old, better known as Neto Silva.
The influencer from Minas Gerais, who earned more than R$ 1 million just with the game, just didn’t count that such adaptations in the routine would influence his health and that they would cause an unusual situation for his age: osteoporosis.
According to the MSD Manual of Diagnosis and Treatment, osteoporosis is a condition in which there is a reduction in bone density, which makes bones weaker and therefore more susceptible to fractures.
Neto explains that, before starting his career as a gamer, he practiced exercises and always took care of his health. But, with the change in routine, he exchanged such habits for sedentary lifestyle, poor diet and even lack of exposure to sunlight.
“I started to feel a lot of pain in my body, I couldn’t find a very good position [confortável] to sleep, I felt the bone aching. One day, I decided to go out for a run and started to twist my feet in the first few steps. I already felt a lot of pain in my ribs before going to sleep, but I thought it was due to bad posture, from spending many hours sitting in the chair. But when that happened, during the race, I went to the hospital the same day,” he reports.
Bone densitometry [exame para avaliar a densidade dos ossos] found that the young man had type 2 primary osteoporosis, also called senile osteoporosis, which consists of calcium deficiency. Neto, however, had no history of the problem in his family.
Endocrinologist Vívian Simões, from BP – A Beneficência Portuguesa de São Paulo, explains that the occurrence of osteoporosis among young people is small, with few reports in the medical literature, with prevalence in post-menopause and among the elderly. However, for young people, it would be more common to find cases of bone fragility.
Such a condition in younger people would normally be associated with underlying diseases, generally rheumatic, such as lupus or rheumatoid arthritis; eating disorders such as anorexia and bulimia; bowel diseases such as Crohn’s and IBD (inflammatory bowel disease); to treatments with corticosteroids; or in people with dietary restrictions, such as vegetarians or vegans, which interfere with calcium intake. These situations would be linked to loss of bone mass or malabsorption of calcium and vitamin D.
“Initially, we were surprised with a patient with osteoporosis at that age, as it is not what we routinely expect. But, due to their lifestyle and habits, it was possible to establish a connection that would lead to osteoporosis”, says orthopedist Guilherme Chohfi de Miguel, the physician responsible for diagnosing and monitoring gamers.
Influence of habits
Both experts claim that habits have a direct influence on bone health and that there is an increase in risk when the diet is not healthy, with the lack of consumption of foods with calcium, and the lack of sun exposure, which decreases the absorption of vitamin D by the body.
The lack of physical exercise also ends up influencing the absorption of such nutrients, as well as muscle strengthening to reduce the chances of fractures.
Chohfi explains that habits like those of his patient, where there is a high intake of drinks rich in caffeine, there is an increase in the excretion of calcium in the urine, given the higher speed of absorption of the drinks when compared to the absorption of calcium.
“The amount of caffeine consumed per day should be up to 400 mg. When we reach more than 800 mg, we already have proof that we will have harm to the body. – workouts or any other product that may contain caffeine. When we consume 100 ml of filtered coffee, we are consuming about 85 mg of caffeine; 250 ml of energy drink, between 80 and 90 mg, 350 ml of cola-type soda are around 35 mg of caffeine”, warns the orthopedist.
The lack of physical activity, especially those of impact, ends up reducing the stimulus for bone formation, and the patient should always seek to practice physical activity as a routine, explains the specialist.
As for the lack of sun exposure, there ends up being a decrease in the conversion of vitamin D, which helps the absorption of calcium from food and also in bone quality.
Adequate sleep is responsible for stimulating the restoration of functions, as well as helping to produce hormones that stimulate growth.
Due to current eating habits and the increase in sedentary rates, the doctor expresses concern that, eventually, more cases of osteoporosis are registered at increasingly younger ages.
Prognosis
From the diagnosis, Chohfi alleges that it is necessary to correct the risk factors capable of modification, with changes in the diet and adequate nutritional monitoring, insertion of physical activities in the routine, and calculating the risks of fracture. This calculation is essential to define the best therapeutic option and choice of medication to be used.
The adoption of healthy habits should occur from childhood, a time when bone density is produced, reaching a higher concentration soon after 20 years of age.
In addition, the doctor advises not to smoke or consume alcoholic beverages in excess.
Neto says that, after the diagnosis, he started drug treatment, replacing calcium and vitamin D. He even noticed clinical improvement after starting a routine of physical activities, adopting a healthy diet and improving the quality of sleep.
Vitamin D: when to take a supplement and what is the safe dose