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Osteoporosis

What is Osteoporosis?

Osteoporosis leads to 1.5 million fractures, or breaks, per year, mostly in the hip, spine and wrist, and costs $14 billion annually, according to the National Osteoporosis Foundation. It threatens 28 million Americans, mostly older women, but older men get it too. One in three women past 50 will suffer a vertebral fracture, according to the foundation. These numbers are predicted to rise as the population ages. Osteoporosis, which means "porous bones," is a condition of excessive skeletal fragility resulting in bones that break easily. A combination of genetic, dietary, hormonal, age-related, and lifestyle factors all contribute to this condition.

Who is at risk to develop osteoporosis?

The greatest risk factor is by far your hormonal status. Women who have gone through menopause, either naturally or by surgical removal of the ovaries, are at risk. Certain other factors may add to your particular risk:

  • Caucasian race or Asian ethnicity
  • Thin or small build
  • Family history of osteoporosis or osteoporotic fracture
  • Early menopause (before age 45)
  • Smoking
  • Inactive lifestyle
  • Chronic use of certain medications such as steroids, excessive thyroid hormone, and certain anticonvulsants
  • Excessive alcohol use

For questions about your particular risk, please ask your Seven Hills practitioner.

How can you detect osteoporosis?

Regular X-rays do not detect osteoporosis until it is in advanced stage, and therefore too late for intervention. A special X-ray test, called a DEXA scan, is used to measure your bone mineral density, or BMD. A DEXA scan is fast, convenient, and painless. You don't even have to undress! It is a precise and sensitive way to measure bone density and detect a weakening of the bones before it is too late.

In a DEXA scan, measurements are taken of the hip and spine and the results are compared to the average BMD of young adult normals of your sex and race at their peak BMD. This information will help your doctor determine if you need to take certain steps to protect your bone health.

For information on scheduling a DEXA scan, call your Seven Hills office.

What are some treatment options for osteoporosis?

Under FDA guidelines, drugs to treat osteoporosis must be shown to preserve or increase bone mass and maintain bone quality in order to reduce the risk of fractures. Before 1996, the only choices were the hormones estrogen and injectable calcitonin, as well as the use of calcium supplements. Several newer agents are now available for use. Among these newer agents, there is a pill called Fosamax, which slows down the rate of bone loss. Another newer agent is an inhaled form of calcitonin. Ask your Seven Hills practitioner which of these methods is appropriate for you.

How can you reduce your chances of getting osteoporosis?

Osteoporosis is preventable. A diet that is rich in calcium and vitamin D and a lifestyle that includes regular weight-bearing exercise are the best ways to prevent osteoporosis.

Getting enough calcium throughout life is important because it helps to build and keep strong bones. Men and women age 25 to 65 should have 1,000 milligrams (mg) of calcium every day. Women near or past menopause should have 1000 mg of calcium daily if they are on estrogen replacement therapy, if not, they need 1500 mg per day. Make foods that are high in calcium part of your diet. Healthy foods that are rich in calcium are:

  • low-fat dairy products such as cheese, yogurt and milk
  • canned fish with bones you can eat, such as salmon and sardines
  • dark green leafy vegetables, such as kale, collard and broccoli
  • breads made with calcium-fortified flour

If you don't get enough calcium from your food, you might think about taking a calcium supplement. Always check with your doctor before taking any dietary supplement. Your body uses vitamin D to absorb calcium. Being out in the sun for even a short time every day gives most people enough vitamin D. You can also get this vitamin from supplements as well as from cereal and milk fortified with vitamin D.

Also, exercise builds bone strength and helps prevent bone loss. It also helps older people stay active and mobile. Weight-bearing exercises, done on a regular basis, are best for preventing osteoporosis. Walking, jogging, and playing tennis are all good weight-bearing exercises. Always check with your doctor before starting an exercise program.

Calcium Intake

What is the optimal calcium intake for women in different stages of their life?

On the basis of the most current information available, optimal calcium intake is estimated to be 1,200 to 1,500 mg/day for adolescents and young adults (11-24 years), 1,000 mg/day for women between 25 and 50 years, 1,200-1,500 mg/day for pregnant or lactating women, and 1,000 mg/day for post menopausal women on estrogen replacement therapy and 1,500 mg/day for post menopausal women not on estrogen therapy. For all women and men over 65, daily intake is recommended to be 1,500 mg/day, although further research is needed in this age group. These guidelines are based upon calcium from the diet plus any calcium taken in supplemental form. Calcium intake up to a total intake of 2,000 mg/day appears to be safe in most individuals. Adequate vitamin D is essential for optimal calcium absorption. Dietary constituents, hormones, drugs, age, and genetic factors influence the amount of calcium required for optimal skeletal health.

If I am lactose intolerant, how can I get the calcium I need?

The preferred source of calcium is through calcium-rich foods such as dairy products. Calcium-fortified foods and calcium supplements are other means by which optimal calcium intake can be reached in those who cannot ingest conventional foods. Furthermore, many food sources such as vegetables and fish contain calcium. There are also products sold in grocery stores and pharmacies that may help people with lactose intolerance better digest dairy products.

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