Osteoporosis

Osteoporosis is the most common bone disease. Characterized by loss of bone density and strength, osteoporosis is associated with debilitating fractures, especially in people age 45 and older. Bone loss develops over a span of many years and is largely symptomless, although some women may experience chronic spinal pain or muscle spasms in the back. Often, the first sign of osteoporosis is a wrist or hip fracture or a compression fracture that causes the vertebrae in the upper back to collapse, curving the spine into the "dowager's hump" that has come to symbolize osteoporosis. Osteoporosis— The most common bone disease, characterized by loss of bone density and strength; it is associated with (debilitating fractures, especially in people 45 and older, due to a tremendous loss of bone tissue in midlife. As many as 10 million Americans, 80 percent of them women, now suffer from the condition, with more than 1.5 million osteoporosis-related fractures occurring annually. A little less than half of all women over 50 will experience an osteoporosis-related fracture in their lifetime. Men are also at risk for the bone-thinning disease. Osteoporosis is seen less often in men because men generally have larger, stronger bones, and because men don't usually experience the abrupt and substantial hormonal changes that women do following menopause. However, the National Institutes of Health says that the problem of osteoporosis in men recently has been recognized as an important public health issue, especially in light of estimates that the number of men above age 70 will double between 1993 and 2050. Today, more than 2 million American men have osteoporosis, and another 3 million are at risk. Each year, men suffer one-third of all hip fractures. In addition to hip fractures, men most often experience fractures of the spine and wrist due to osteoporosis. Luckily, osteoporosis can be prevented, detected, and treated, and it is never too late to do something about it. Although bones seem to be as lifeless as rocks, they are in fact composed of living tissue that is continually being broken down and rebuilt in a process called remodeling. It takes about 90 days for old bone to be broken down and replaced by new bone; then the cycle begins anew. Bones continue to grow in strength and size until a person's early thirties, when peak bone mass is attained. Men achieve more peak bone mass than women. Optimum bone mass and size will be attained only if there has been enough calcium in the diet. After that, bone is broken down faster than it is deposited, resulting in decreased bone mass (about 1 percent per year). In men, bone loss is slow but constant. For women, bone loss speeds up during the five years following menopause due to decreased production of estrogen, and then slows to about the same rate as before menopause. Besides being influenced by age, sex, and estrogen levels, bone health is also influenced by diet and exercise. For maximum bone health, adequate amounts of calcium and vitamin D need to be taken in. Unfortunately, most women (especially teenagers) do not consume the AI for calcium. During the five to ten years after the beginning of menopause, optimum calcium intake is important. Although some bone loss in inevitable, it can be kept to its programmed minimum with adequate calcium from the diet. The Adequate Intake for women and men over 50 is 1200 milligrams of calcium. Exercise also influences bone health, and participation in sports and exercise increases bone density in children. For older adults, exercise helps improve strength and balance, making it less likely they will fall. To benefit bone health, exercise must be weight-bearing or involve strength training. Also, exercise benefits only the bones used, such as the leg bones when biking or walking. The best approach to osteoporosis is prevention-the reason why calcium intake is so important. Starting in childhood through young adulthood (when bones are forming), adequate calcium intake is vital to having more bone mass at maturity. Adequate intake of calcium is also important after early adulthood. Individuals who are aware of the problems of osteoporosis sometimes take calcium supplements. Many calcium supplements include calcium carbonate, a good source of calcium. There are also powdered forms of calcium-rich substances, such as bone meal and dolomite (a rock mineral). These are dangerous because they may contain lead and other elements in amounts that constitute a risk. Choose a calcium supplement with the USP seal of approval. Excessive intake of calcium can cause problems such as urinary stone formation, constipation, and decreased absorption of iron and other nutrients. Other ways to prevent osteoporosis include regular weight-bearing or strength-training exercise (as already mentioned), consumption of adequate milk for vitamin D, exposure to the sun (for more vitamin D), estrogen therapy for women, moderate consumption of alcohol and caffeine, and avoiding smoking. Although estrogen decreases the risk of osteoporosis, with long-term use it may increase the risk of breast and endometrial cancers and blood clotting. Although it cannot be cured, osteoporosis can be slowed down. A special kind of X-ray, the bone mineral density test, is a safe, accurate, quick, painless, and noninvasive way to detect low bone density, monitor the effectiveness of treatments, and predict the risk for future fractures. Some patients who have low bone density are prescribed a medication called Fosamax (alendronate). Fosamax is approved for use in men and women to increase bone mass. It works by reducing the activity of the cells that cause bone loss. The best approach to osteoporosis is prevention—taking in the Al for calcium, regular exercise, consuming milk for adequate vitamin D, consuming moderate amounts of alcohol, and avoiding smoking. Medications, such as Fosamax, can increase bone density.