Boning Up on Osteoporosis
Affecting more than 10 million Americans, osteoporosis will likely touch your life, whether it’s you, a family member, a co-worker, or a friend who has to contend with the disease. Osteoporosis occurs when the bones become too porous, causing them to weaken and become more susceptible to fractures, especially those of the hip, wrist and spine. And while loss of bone mass is a normal part of aging—beginning as early as age 20—sometimes the deterioration occurs faster than normal.
While osteoporosis can affect anyone, some people are at a greater risk. Studies show that women are most susceptible to the disease, especially those of European or Asian descent. While the risk for African Americans and Latinos is lower, it is still significant.
“After age 50, one in two Caucasian women will suffer an osteoporosis-related fracture,” says Dr. Felicia Cosman, Clinical Director of the National Osteoporosis Foundation. “This could be attributed to the fact that women lose between 30%-40% of their bone mass within the first 5-10 years after menopause.” Although 80% of osteoporosis sufferers are women, men are not immune: Over two million are affected by the disease each year, and millions more are at vulnerable. In fact, 80,000 American men suffer an osteoporosis-related hip fracture each year, a third of which are fatal.
Individuals with a family history of the disease, a small or thin bone frame, those who smoke or drink excessively, or lead a sedentary lifestyle are also more susceptible. Some health conditions, such as kidney disease, eating disorders, hypothyroidism and Cushing’s syndrome can also increase your risk, as can certain medications, such as anti-seizure treatments, corticosteroids used to treat asthma, and some cancer treatments.
Unfortunately, osteoporosis often goes undetected until a fracture occurs. The good news is that “a bone mineral density test (BMD) is a great way to asses your bone health and risk for fractures,” says Dr. Cosman. “All women over age 65 should definitely get tested, as should those under age 65 who have one or more risk factors.” By measuring the calcium content in your bones, a BMD can quickly diagnose osteoporosis, determine your risk for fractures, measure the effectiveness of osteoporosis medication, and detect osteopenia, a condition marked by low bone mass (but not low enough to be classified as osteoporosis). For some, osteopenia can indicate a predisposition to osteoporosis, but not always; certain individuals are simply born with low bone mass and therefore need to take extra precautions to ward off the disease.
“It’s a completely painless, noninvasive test,” reassures Dr. Cosman. “You don’t even have to get undressed.
Calcium is the key ingredient in strong, healthy bones, and is essential for the prevention of osteoporosis.
“The goal is to get as much calcium as you can into your bones while you’re still young,” says Dr. Michael R. Marks, MD, MBA, President of the Connecticut Orthopedic Society. “The stronger you can build your bones before the age of 20, the longer it will take for their mass to decrease. That’s why it’s so important for children and young adults to get the proper amount of the mineral.
The National Osteoporosis Foundation’s suggested daily calcium intake:
• Pre-adolescents (10-12 years): 1300 mg
• Young adults (13-18 years): 1200 mg
• Adult (25-50 years) men, women, and postmenopausal women on estrogen replacement therapy: 1200 mg
• Pregnant or nursing women: 1600 mg
• Postmenopausal women (NOT on estrogen replacement therapy): 1500 mg
Most research suggests there’s little difference between the benefits of calcium carbonate and calcium citrate supplements, however, some brands are absorbed better than others.
“The best way to test whether a particular brand will be absorbed into your body is to soak a tablet in a glass of vinegar for one 1/2 hour,” says Dr. Marks. “If the pill dissolves, your body will absorb it.” The body cannot absorb more than 500-600 mg of calcium at once, however, so it’s best to stagger your dose throughout the day. A daily vitamin D supplement should also be taken, as it’s needed for all types of calcium to be metabolized.
“It is possible to overdose on vitamin D, though,” says Dr. Marks. “If you’re taking a vitamin D-enriched supplement a few times a day, plus a multivitamin, you should calculate how much of the vitamin you are getting.” The NOF recommends a daily amount of 400 IU for most adults, and between 800-1000 IU for the elderly.
Some foods, such as excessive amounts of caffeine, soft drinks, red meat, alcohol sodium, and antacids containing aluminum can actually interfere with calcium absorption, so they’re best consumed in moderation.
An active lifestyle should be an integral part of everyone’s osteoporosis prevention plan.
“You need at least 20-30 minutes of impact activity three to four times a week to keep your bones strong,” says Dr. Marks. Try walking, jogging, tennis, or dancing. While experts differ on whether weight training increases bone mass and prevents osteoporosis, they do agree it creates muscle strength and coordination—which can prevent falls.
“Swimming doesn’t necessarily increase bone mass, but it can be very beneficial for those who have difficulty walking, says Dr. Cosman. “It exercises your joints and muscles, which can also prevent falls. It’s also wonderful for increasing your overall vigor.”
“A sufficient dose of calcium can easily be attained by eating three calcium-rich foods per day,” says Dr. Cosman, who adds that a standard serving-size of these foods often contains about 300 mg of the mineral. “Calcium-fortified foods, like bread, cereal, and orange juice are a great source.” Children’s juice boxes are often fortified, but only by about 100 mg; it’s best to check the label to see how much they contain. Here are some other calcium-rich foods for thought.
• dairy products (good sources include low fat yogurt and cheese, and skim milk)
• calcium-enriched soymilk
• salmon and sardines
• calcium-enriched foods, such as bread, orange juice, and cereal
• dark, leafy vegetables (collards, bok choy, etc.)
Tips for Preventing Falls
Falling greatly increases your risk for a bone fracture. Follow these simple tips for staying on your feet.
• Wear rubber-soled shoes for traction; avoid wearing socks, stockings, and smooth-soled slippers at home.
• Use caution when walking on highly polished floors, especially when wet.
• Exercise regularly to maintain muscle strength and flexibility.
• Hold onto handrails when climbing stairs.
• Place non-skid pads under rugs to prevent slippage.
• Place nightlights throughout your home.
• Install grip handles in the shower and bathtub.