Osteoporosis is a major health problem for Americans. Seven to 8 million Americans have the disease. Seventeen million are at an increased risk for developing it. Eighty percent of those affected are women. Persons with osteoporosis suffer from a loss in bone mass and bone strength. Their bones become weak and brittle, which makes them more prone to fracture. Any bone can be affected by osteoporosis, but the hips, wrists, and spine are the most common sites. Peak bone mass is reached between the ages of 25 and 35. After age 35, everyone's bones lose density.
Causes
The actual causes of osteoporosis are unknown. Certain risk factors increase the
likelihood of developing osteoporosis, however:
Being female. Women are 4 times
more likely to develop osteoporosis than men. The reasons are as follows:
Female bones are generally thinner and lighter
Women live longer on average than men
Women have rapid bone loss at menopause due to a sharp decline of estrogen.
The risk also increases for women who:
Go through menopause before age 45. This could
be natural menopause or one
that results from surgical removal of both ovaries.
Experience a lack of or irregular menstrual
flow
Having a thin, small-framed body
Being Caucasian or Asian, although African
Americans and Hispanic Americans are at significant risk as well.
Lack of physical activity, especially
activities such as walking, running, tennis, and other weight-bearing exercises. Or,
exercising too much to the point where menstrual periods cease.
Lack of calcium. Adequate calcium intake
throughout life helps to insure that calcium deficiency does not contribute to a weakening
of bone mass.
Heredity factors. The risk increases if
there is a history of osteoporosis and/or bone fractures in your family.
Smoking cigarettes
Alcohol consumption. Regularly consuming
alcoholic beverages may be damaging to bones. Heavy drinkers often have poor nutrition and
may be more prone to fractures because they are more prone to falls.
Taking certain medications such as:
corticosteroids (anti-inflammatory medicines used to treat a variety of conditions such as
asthma, arthritis, lupus, etc.); some antiseizure medicines; overuse of thyroid hormones;
and aluminum-containing antacids
Other disorders such as hyperthyroidism,
hyperparathyroidism, and certain forms of bone cancer.
Prevention
To prevent or slow osteoporosis, take these steps now:
Be sure to eat a balanced diet.
Plan to get your recommended Adequate Intake (AI) for calcium every day. AIs are the
Dietary Reference Intakes that have been set by the Food and Nutrition Board of National
Academy of Sciences. These are the set intakes of calcium that appear to provide the
amount of calcium needed for good health for different ages.
| AIs (Adequate Intakes) for Calcium: |
| Age | Milligrams (Mgs.) Calcium/Day |
| 0-6 months | 210 |
| 6 months - 1 year | 270 |
| 1 year - 3 years | 500 |
| 4 - 8 years | 800 |
| 9 - 18 years | 1,300 |
| Pregnant and breast feeding women: |
|
| 18 years and younger |
1,300 |
| Over 18 years |
1,000 |
| 19 - 50 years | 1,000 |
| 51+ years | 1,200 |
To get your recommended calcium:
Choose high-calcium foods daily:
Soft-boned fish and shellfish, such as salmon, sardines, or shrimp
Skim and low-fat milks, yogurts, and cheeses. {Note: If you are
lactose intolerant, you may
need to use dairy products that are treated
with the enzyme lactase, or you can add this enzyme
using over-the-counter drops or tablets.}
Vegetables, especially broccoli, kale, and collard greens
Beans and bean sprouts as well as tofu (soybean curd), if processed with calcium
Calcium-fortified foods such as some orange juices, apple juices, and ready-to-eat cereals
Take calcium supplements, if necessary and
advised by your doctor
Follow a program of regular, weight-bearing
exercise at least 3 or 4 times a week. Examples include walking, jogging or low-impact or
non-impact aerobics. (A person with osteoporosis should follow the exercise program
outlined by his or her doctor.)
Do not smoke. Smoking makes osteoporosis
worse and may negate the beneficial effects of estrogen replacement therapy.
Limit alcohol consumption.
Check with your doctor regarding medical
management to prevent further bone loss and/or osteoporosis fractures, especially if you
are at high risk for getting these. He or she may prescribe:
Estrogen replacement therapy, if you are female
Calcitonin
Alendronate sodium (Fosamax)
Signs and Symptoms
Osteoporosis is a "silent disease" because it can progress
without any noticeable signs or symptoms. Often the first sign is when a bone fracture of
the hip, wrist, or spine occurs. Symptoms include:
Gradual loss of height
Rounding of the shoulders
Back pain
Stooped posture or dowager's humps
Treatment and Care
Special X-rays, such as dual energy X-ray absorptiometry (DEXA) can
measure bone mass in various sites of the body. They are safe and painless. These tests
can help doctors decide if and what kind of treatment is needed. Treatment for
osteoporosis includes:
Medication therapy: Estrogen replacement
therapy (ERT), calcitonin, or alendronate sodium (Fosamax)
Dietary measures: A balanced diet rich in
calcium, and calcium supplementation if necessary
Daily exercises approved by your doctor
Proper posture
Fall-prevention strategies:
Use grab bars and safety mats or nonskid tape on your tub or shower.
Use handrails on stairways.
Don't stoop to pick up things. Pick things up by bending your knees and keeping your back
straight.
Wear flat, sturdy, nonskid shoes.
If you use throw rugs, make sure they have nonskid backs.
Use a cane or walker if necessary.
See that halls, stairways, and entrances are well lit. Use night lights in hallways,
bathrooms, etc.
There is no cure for osteoporosis. The focus of treatment is to prevent the disease (see prevention measures above), prevent further bone loss, and build new bone.
(See "Places to Get Information & Help" under Osteoporosis.)
HEALTH AT HOME - Your Complete Guide to Symptoms, Solutions, and Self-Care © 1999 by Don R. Powell. American Institute for Preventive Medicine.
Date updated 04/21/99