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What is osteoporosis?
Osteoporosis, or porous bone, is a disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an increased susceptibility to fractures, especially of the hip, spine and wrist, although any bone can be affected. It is a disease where bones become more likely to break. Until the age of 30, bodies build and store bone efficiently. As part of the natural aging process bones begin to break down faster than new bones can form. For women, bone loss speeds up after menopause, when the body loses estrogen, the hormones that protects against bone loss.
Who is at risk?
"So many women tell me they are frightened they will get osteoporosis. They are scared of the pain that broken bones cause. They are worried about how it will impact their physical appearance and their lifestyle. Instead of being caught up by fear, I encourage people to take action. Osteoporosis is a largely preventable and treatable disease. We also need to remind men, this is not just a woman's concern. Osteoporosis affects men too!" - Judith Cranford
Chances are … it could be you. One in two women and one in four men age 50 and older will have an osteoporosis-related fracture in their lifetime. Ten million Americans already have osteoporosis and 34 million more have low bone mass placing them at increased risk for developing osteoporosis. Caucasian and Asian women have the highest risk but osteoporosis affects men and women of all races. Though it is often thought of as a disease that only affects the elderly, osteoporosis can strike at any age. Known as "the silent thief," osteoporosis progresses without symptoms or pain until bones start to break, generally in the hip, spine or wrist. Every year, roughly 1.5 million people suffer from a bone fracture related to osteoporosis.
What are the risk factors of osteoporosis?
Osteoporosis is a complex disease and not all of its causes are known. However, when certain risk factors are present, your likelihood of developing osteoporosis is increased. Therefore, it is important for you to determine your risk of developing osteoporosis and take action to prevent it now. Certain people are more likely to develop osteoporosis than others. The risk factors include:
• Personal history of fracture after age 50
• Current low bone mass
• History of fracture in a first degree relative
• Being female
• Being thin and/or having a small frame
• Advanced age
• A family history of osteoporosis
• Estrogen deficiency as a result of menopause, especially early or surgically induced
• Abnormal absence of menstrual periods (amenorrhea)
• Anorexia nervosa
• Low lifetime calcium intake
• Vitamin D deficiency
• Use of certain medications, such as corticosteroids and anticonvulsants
• Presence of certain chronic medical conditions
• Low testosterone levels in men
• An inactive lifestyle
• Current cigarette smoking
• Excessive use of alcohol
• Being Caucasian or Asian, although African Americans and Hispanic Americans are at significant risk as well
How can I protect myself against osteoporosis?
It is important to understand that bone is not a hard and lifeless structure; it is, in fact, complex, living tissue. Our bones provide structural support for muscles, protect vital organs, and store the calcium essential for bone density and strength. Think of your bones as a savings account. There is only as much bone mass in your account as you deposit. The critical years for building bone mass are from prior to adolescence to about age 30. Some experts believe that young women can increase their bone mass by as much as 20 percent - a critical factor in protecting against osteoporosis. There are ways to prevent developing osteoporosis. Building strong bones during childhood and adolescence can be the best defense against developing osteoporosis later. There are six steps, which together, can optimize bone health and help prevent osteoporosis. They are:
• A balanced diet rich in calcium and vitamin D
• Weight-bearing exercise
• A healthy lifestyle with no smoking or excessive alcohol intake
• Maintain a healthy weight throughout your life
• Bone density testing and medication when appropriate
• Take steps to minimize the risks of falling, including regular vision tests.
Encourage children to do these things, so they can avoid developing this devastating disease.
How much calcium and vitamin D do I have to take?
Calcium plays an important role in maintaining bone. However muscles and nerves must also have calcium to work. If your body is not getting enough calcium from the food you eat your body simply takes it from your bones. Calcium alone cannot prevent or cure osteoporosis, but it is an important part of an overall prevention or treatment program. Yet, national surveys have shown that many Americans are not consuming enough calcium. Many women, in fact, consume less than half of the daily-recommended amount of calcium. The average adult, under 50 needs about 1000 mg of calcium per day.
One way to increase the amount of calcium in your diet is to eat calcium-rich foods like low-fat milk, cheese, broccoli and others. Many foods are fortified with calcium and are readily available and affordable. Foods like orange juice, cereals and breakfast bars have calcium added to them, so it is easier than ever before to consume the recommended level of calcium for every age. Having extra calcium in a variety of foods also makes it easier for parents who are trying to ensure that their adolescent children are getting enough calcium.
If you avoid dairy products because of concerns about fat intake, remember that skim milk, fat-free yogurt, and ice milk retain 100% of their calcium while sparing you the fat and extra calories. If you are lactose intolerant, you may want to try reduced-lactose or lactose-free dairy products, which are also rich in calcium. Calcium supplements in tablet or capsule form can help you ensure that you're getting enough of this vital mineral. While it is preferable to obtain calcium from food, supplements are a viable way to satisfy average daily calcium requirements. Since there are several different types of calcium and a variety of supplements available, you should discuss the choice of calcium with your doctor.
Vitamin D is produced by the skin by exposure to the sun and is found in fortified milk and other foods. It plays a major role in calcium absorption and bone health. The relationship between calcium absorption and vitamin D is similar to that of a locked door and a key. Vitamin D is the key that unlocks the door and allows calcium to leave the intestine and enter the bloodstream. Vitamin D also works in the kidneys to help reabsorb calcium that otherwise would be excreted. The major food sources of vitamin D are vitamin D-fortified dairy products, egg yolks, saltwater fish and liver. Some calcium supplements and most multivitamins contain vitamin D, so it is important to check the labels to determine how much each contains. The average adult, under 50 needs about 200 International Units (IU) of Vitamin D per day.
What kind of exercise should I do?
Bone is living tissue that responds to exercise by becoming stronger. When you put stress on your bones your body reacts by adding new cells to help make your bones stronger. Two types of exercises are important for building and maintaining bone mass and density: weight-bearing and resistance exercises. Weight-bearing exercises are those in which your bones and muscles work against gravity. This is any exercise in which your feet and legs are bearing your weight. Jogging, walking, stair climbing, dancing and soccer are examples of weight-bearing exercise with different degrees of impact. Swimming and bicycling are not weight-bearing.
The second type of exercise is resistance exercise or activity that use muscular strength to improve muscle mass and strengthen bone. These activities include weight lifting, such as using free weights and weight machines found at gyms and health clubs.
How can I minimize my risks of falling?
You can minimize your risk of falling by removing items such as small rugs that may cause tripping. Use non-slip mats in the bathtub and shower and have grab bars installed. Improving the lighting around your home, regular vision tests and other medical assessments are easy ways to make sure that impaired vision does not lead to falls. In addition regular exercise can improve coordination and balance and help prevent falls.
Are there symptoms of osteoporosis?
"Osteoporosis is a disease that one is unaware of until it makes a sound. And that sound is not really an audible sound. To me that sound was the sound of pain experienced when a bone breaks," said Linda, a patient.
Osteoporosis is often called the "silent disease" because bone loss occurs without symptoms. People may not know that they have osteoporosis until their bones become so weak that a sudden strain, bump or fall causes a fracture or a vertebra to collapse. Collapsed vertebrae may initially be felt or seen in the form of severe back pain, loss of height, or spinal deformities such as kyphosis or stooped posture.
How do I know if I have osteoporosis?
The Surgeon General recommends a bone density test for all women over the age of 65 and for any man or women who suffers even a minor fracture after the age of 50. To determine if you have osteoporosis or may be at risk for the disease, your doctor will ask you a variety of questions about your lifestyle and medical history. Be sure to share with your doctor all of the medications you take as some can cause bone loss. Your doctor will want to know if anyone in your family has suffered from osteoporosis or if they have fractured any bones. Based on a comprehensive medical assessment, your doctor may recommend that you have your bone mass measured. This test will safely and accurately measure your bone density and reliably predict your risk of future fracture. Specialized tests called bone density tests can measure bone density in various sites of the body. A bone density test is safe, quick and painless and uses x-rays or sound waves to measure the strength of the bones. It can:
• Detect osteoporosis before a fracture occurs
• Predict your chances of fracturing in the future
• Determine your rate of bone loss and/or monitor the effects of treatment if the test is conducted at intervals of a year or more.
What if I already have osteoporosis?
You can live actively and comfortably by seeking proper medical care and making some adjustments to your lifestyle. Your physician may prescribe a diet rich in calcium and vitamin D, a regular program of weight-bearing exercise and medical treatment. In addition you and your doctor should discuss ways you can reduce your risk of falling.
What is a bone fracture?
As a result of low bone mass, bones become weak and can break or fracture more easily. Bone fractures often occur from falling or other common accidents. Spine fractures can occur without trauma. The most typical sites of fractures related to osteoporosis are the hip, spine, wrist and ribs, although the disease can affect any bone in the body. The rate of hip fractures is two to three times higher in women than men; however the one year mortality following a hip fracture is nearly twice as high for men as for women. An average of 24% of hip fracture patients aged 50 and over die in the year following their fracture. At six months after a hip fracture, only 15% of hip fracture patients can walk across a room unaided. A woman's risk of hip fracture is equal to her combined risk of breast, uterine and ovarian cancer.
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