Osteoporosis

Osteoporosis is often called a "silent disease" because bone loss occurs without symptoms.

What is osteoporosis?

An estimated 1.5 million fractures a year are attributed to osteoporosis. Learning about the causes of osteoporosis can help you take important preventative steps. Osteoporosis is the most common bone disease in America today. It is characterized by low bone mass, which causes the bones to become fragile, making them susceptible to fractures, usually of the spine, hip or wrist.

What are the symptoms of osteoporosis?

Osteoporosis is known as the "silent disease" because there are no signs or symptoms until a fracture occurs. Oftentimes a patient with osteoporosis will turn over in bed and fracture a vertebra in the spine, fracture a hip while out walking or fracture a wrist while lifting a bag of groceries.

Who is affected?

Osteoporosis usually affects people who are 50 years of age or older. Eighty percent of the people affected are women. The risk factors, as noted by the National Osteoporosis Foundation (NOF), are as follows:

Personal history of fracture after age 50
Current low bone mass
History of fractures in a relative
Female
Having a thin and/or small frame
Advanced age
Family history of osteoporosis
Estrogen deficiency as a result of menopause, especially if early or surgically induced. Women can lose up to 20 percent of their bone mass in thefive to seven years following menopause, making them susceptible to osteoporosis.
Abnormal absence of menstrual periods (amenorrhea)
Anorexia nervosa
Low calcium intake over a lifetime
Use of certain medications, such as corticosteroids and anticonvulsants
Low testosterone levels in men
An inactive lifestyle
Cigarette smoking
Excessive use of alcohol

How is osteoporosis diagnosed?

Osteoporosis is diagnosed by a DEXA (Dual Energy X-ray Absorptiometry) scan. The patient lies on an X-ray table and is subjected to a pencil-thin ray of radiation that measures the density of the lumbar spine and the nondominant hip. The DEXA scan gives a T-score reading to determine the patient's bone density. T-scores ranging from -1.0 to -2.5 are indicative of low bone mass, while T-scores below than -2.5 are indicative of osteoporosis, according to the World Health Organization.

A bone density test is recommended for the following people: postmenopausal women under the age of 65 with one or more of the risk factors for osteoporosis; all women age 65 and older; and postmenopausal women who have fractured a bone (usually a diagnosis of osteoporosis. In this case, the test is used to determine the severity of the disease and the patient's risk for additional fractures).

How can diet help prevent osteoporosis?

According to a survey conducted by National Academy of Sciences, a number of women consume less than half of the daily recommended amount of calcium. Women ages 19 to 50 should take 1,000 mg of calcium per day, and women ages 51 and older should receive 1,200 mg per day. During menopause, women should increase their daily calcium intake to 1,500 mg per day. The simplest way to increase the amount of calcium in one's diet is to eat calcium-rich foods such as low-fat milk, cheese and broccoli.

An important rule of thumb is that the body is only able to absorb 500 mg of calcium at a time. So, whether you are eating a calcium-rich diet or taking calcium supplements, it's important to to spread it throughout each day to maximize calcium absorption. Vitamin D is important because it helps the body absorb and use calcium. Four hundred to 800 IUs (International Units) of vitamin D3 should be taken each day, either as part of one's diet or in the form of a dietary supplement. Sunlight is a natural source of vitamin D. 10 to 15 minutes of sun exposure to the face, hands and arms two to three times a week is usually sufficient to meet vitamin D requirements.

How can exercising help prevent osteoporosis?

While diet is important to ensure proper intake of calcium and vitamin D, exercise also plays a key role in the prevention of osteoporosis. Weight-bearing exercise such as walking, jogging, racket sports and stair climbing helps minimize bone loss, as they force the body to bear weight and hence strengthen bones. It is recommended individuals do 20 to 30 minutes of weight-bearing exercises three to four times per week.

Exercises that increase balance, flexibility, and stamina - such as swimming, water aerobics, rowing, bike riding and lifting weights - are also important for the prevention of osteoporosis. While they have no effect on bone loss, these exercises help decrease the risk of a fall. Please consult a physician before starting any exercise program!

How is osteoporosis treated?

Since bone loss cannot be replaced, the main focus in treating osteoporosis is prevention. However, certain medications and therapies are being used to help prevent and treat osteoporosis. Bisphosphonates, such as Fosamax and Actonel, have been approved for the prevention and treatment of postmenopausal osteoporosis; both medications now are available in tablet form, to be taken once a week.

Hormone replacement therapy for postmenopausal women has been used for many years as a preventative for osteoporosis. The therapy has been shown to reduce bone loss, thus cutting the risk of fractures related to osteoporosis. However, the safety of these medications is currently under question.

How can the risk of falls, possibly resulting in fractures, be reduced?

It is important to safeguard your home against falls that might result in life-altering fractures to the hip or spine.

Minimize clutter on floors and check for loose cords and wires that could cause a fall. Avoid throw rugs.
In bathrooms, install hand bars in the bathtub or shower. Place nonskid pads in the tub and on the floor.
Make sure all areas of your house are well lit. Install nightlights.
In the kitchen, clean up any spills immediately. Use a rubber mat in front of the stove and sink.
Install a handrail to assist in going up and down stairs. If there are rugs on the steps, be sure they are secure.
Wear rubber-soled shoes that fit properly. Avoid slip-on shoes.
Use alcohol in moderation.
If taking any medications, check with the doctor or pharmacist to see if they could cause dizziness or alter mental status.

Kids and osteoporosis

We often think of osteoporosis as a condition that affects older women and the elderly population. Poor nutrition and lifestyle habits are creating situations such that children are now more vulnerable to the disease and have an increased risk of it later in life. Higher percentages of boys and girls are failing to get the recommended daily allowance of calcium in their diets, putting them at risk from very young ages. In this article, we are going to look at some of the causes and also look at some solutions for the youth of today.

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