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Osteoporosis

Osteoporosis Facts

Osteoporosis is characterized by low bone mass. It is a condition that makes the bones weak and brittle, thus making them more prone to fractures. In advanced osteoporosis, something as innocuous as bending over or coughing can cause a fracture. Fractures often occur in the spine, hip or wrist. Osteoporosis affects about 8 million American women and 2 million American men. About 18 million Americans may have low bone density, the underlying cause of full-blown osteoporosis.

Symptoms

Often, the first sign of osteoporosis is a bone fracture. There are no signs in the early stages of bone loss, but once osteoporosis develops, a person they may experience one of more of the following:

  • Back pain- A regular or persistent backache occurs in people with osteoporosis because small sections of their spine collapse over time.
  • Loss of height over time - A loss of more than 2 inches may mean a person is experiencing spinal crush fractures brought on by osteoporosis.
  • Stooped posture, known as Dowager's hump - This is a protrusion in the upper back. The collapse of vertebrae causes your head to move forward, shortening the chest area and reducing lung capacity.
  • Stooped posture and other spinal deformities.
  • Recurrent bone fractures, especially of the vertebrae, wrists, hips or other bones

Who Gets Osteoporosis?

About 10 million Americans have full-blown osteoporisis, and some 18 million have low bone density, the major risk factor for developing osteoporosis. Although, both men and women may get osteoporosis as they age, it is most common in post-menopausal women. Women have less bone mass than men and lose it at a much faster rate than men do. Caucasian or Asian women also are more likely to have osteoporosis than African American or Hispanic women. One out of every two women and one in eight men over 50 will have an osteoporosis-related fracture in her or his lifetime.

Osteoporosis is responsible for more than 1.5 million fractures annually, including 300,000 hip fractures, approximately 700,000 vertebral (spinal) fractures, 250,000 wrist fractures, and more than 300,000 fractures at other sites, according to the National Institute of Arthritis and Muscloskeletal and Skin Diseases (NIAMS).In the presence of osteoporosis, fractures can occur from normal lifting and bending, as well as from falls. Osteoporosis is genetic, so children of parents with osteoporosis are more likely to have it.

People who smoke or drink excessively are more prone to osteoporosis. Also, people who use steroids for longer than six months have an increased risk of developing osteoporosis. Most men who develop it had a long-term treatment with steroids.

Who Gets Osteoporosis?

About 10 million Americans have full-blown osteoporisis, and some 18 million have low bone density, the major risk factor for developing osteoporosis. Although, both men and women may get osteoporosis as they age, it is most common in post-menopausal women. Women have less bone mass than men and lose it at a much faster rate than men do. Caucasian or Asian women also are more likely to have osteoporosis than African American or Hispanic women. One out of every two women and one in eight men over 50 will have an osteoporosis-related fracture in her or his lifetime.

Osteoporosis is responsible for more than 1.5 million fractures annually, including 300,000 hip fractures, approximately 700,000 vertebral (spinal) fractures, 250,000 wrist fractures, and more than 300,000 fractures at other sites, according to the National Institute of Arthritis and Muscloskeletal and Skin Diseases (NIAMS).In the presence of osteoporosis, fractures can occur from normal lifting and bending, as well as from falls. Osteoporosis is genetic, so children of parents with osteoporosis are more likely to have it.

People who smoke or drink excessively are more prone to osteoporosis. Also, people who use steroids for longer than six months have an increased risk of developing osteoporosis. Most men who develop it had a long-term treatment with steroids.

Diagnosis

Osteoporosis is detected through a bone-density test. There are two common tests for bone density, a Dual Energy Absorptiometry or a Sonometer test. The first is an X-ray test that can show thinning bones, but by the time osteoporosis is evident in X-rays, bones are weak and the disease is at an advanced stage. The Sonometer sends sound waves through the bones to detect density.

The less dense a bone is, the faster the waves will pass through it. The National Osteoporosis Foundation recommends screening for all women who have risk factors for osteoporosis. Some of these risk factors include a family history of osteoporosis, taking certain medications like corticosteroids and postmenopausal women older than 65 who have never had a bone density test before.

Treatment

Treatment of osteoporosis requires both medication and lifestyle changes.

  • Calcium, vitamin D, and protein Calcium supplements and low doses of vitamin D have been shown to reduce the risk of hip fracture in elderly women living in nursing homes (who are often vitamin D deficient). In addition, calcium and vitamin D supplementation is often part of the treatment regimen for osteoporosis in younger patients. Sufficient protein intake is mandatory to help maintain muscle function and bone mass.
  • Exercise Regular strength training has been shown to help maintain and build up bone mass. Exercise helps develop stronger muscles, better balance and agility, which can help in fall prevention. The type of exercise should be tailored to the individual's needs and abilities. People with osteoporosis must take special care when exercising to reduce the risk of fracture due to impact or falls.

Antiresorptive Drugs Hormone replacement therapy (HRT) is the one of the best ways to prevent osteoporosis in women. The approach, however, can have considerable side effects, which include increased risk for stroke and heart attack. Before recommending HRT, a doctor must carefully evaluate the potential benefits against the possible side effects for each patient.

Many Women Unaware of Their Low BMD

FUNCTION: Bones give our bodies shape, act as levers against which our muscles work and serve as reservoirs for calcium needed in other parts of our body. As such, bones must be kept strong and resupplied with calcium

FORM: Human bones are strong but relatively light. Bones are made up of a compact outer layer and a more porous inner area. This inner area is commonly described as spongy bone because it is made up of a network of canals ringed by bone cells with spaces in between. The outer layer is what makes bones strong, while the inner layer serves to keep them relatively light. Bones contain both living tissue and minerals, mainly calcium and phosphate; they are alive, changing with our body over time and undergoing continuous remodeling throughout life. Calcium and phosphate must be part of a healthy diet in order to keep bones strong.

BONE MASS: Bone mass is the total amount of bone in a body. A person's bone mass depends on sex, race, nutrition, exercise and overall health, and peaks sometime during the third decade of life. Continued calcium intake throughout life and exercise maintain and build bone mass.

BONE LOSS: Bone loss refers to the decline of bone mass after its peak, which for most people comes after the age of 30. Bones lose both mineral and living tissue. Though a certain amount of bone loss is a normal part of natural aging, life habits (such as smoking and drinking), diseases and space flight can accelerate bone loss and result in an increased susceptibility to fracture. We strengthen our bones with vitamins and minerals, the most important of which are vitamin D and the mineral calcium. Vitamins and minerals come from the food we eat.

VITAMINS: Vitamins are organic compounds required for regulation of metabolism and the healthy growth and functioning of the body. They can be loosely organized into two categories:

WATER SOLUBLE: Water-soluble vitamins travel through your bloodstream. Because the body does not store these vitamins, your body only uses what it needs, and they need to be replaced often. Watersoluble vitamins include vitamin C, thiamin (B1), riboflavin (B2), cobalamine (B12), pyridoxine (B6), niacin, folic acid, biotin and pantothenic acid.

FAT SOLUBLE: Fat-soluble vitamins are stored in the fat tissue and liver of your body. They remain in your body fat and are used as your body needs them. Fat-soluble vitamins include vitamins A, D, E, and K.

MINERALS: Minerals are inorganic compounds that fall into two categories, macrominerals and trace minerals.

MACROMINERALS: Your body needs large amounts of macrominerals, which include calcium, phosphorous, magnesium, sodium, potassium, chloride, and sulfur.

TRACE MINERALS: The body requires only a small amount of trace minerals, which include iron, manganese, copper, iodine, zinc, cobalt, fluoride, and selenium. Calcium is a mineral that helps maintain bone. Foods that are rich in this important dietary requirement include milk, cheese, broccoli, cauliflower, and calcium-fortified foods.

OSTEOPOROSIS

A healthy diet provides active bones with the raw materials they need to stay strong and healthy. Exercise causes bones to use more calcium and increases skeletal mass. If any part of this cycle breaks down, bone loss is more likely to occur. Vitamin D enables the body to use and absorb calcium and phosphorus. This vitamin is essential for the body to make use of available minerals. Weight-bearing activities, such as brisk walking, stair climbing, hiking and dancing, put weight on the bones and help increase skeletal mass.

Women have approximately 30 percent less bone mass than men at peak. Bone loss in women increases rapidly after menopause due to a reduction in estrogen production. Among those who live to be 90, 32 percent of women and 17 percent of men will fracture their hip, mostly due to osteoporosis.

FOODS WITH CALCIUM

- Food Amount Milligrams
- low-fat or nonfat plain yogurt 1 cup 415 mg
- orange juice (calcium fortified) 8 oz 350 mg
- skim or low-fat milk 1 cup 300 mg
- cheese 1 oz 200 mg
- tofu 4 oz 108 mg
- ice cream 1/2 cup 88 mg
- collard greens, cooked 1/2 cup 145 mg
- cottage cheese 1 cup 116 mg
- spinach, cooked 1/2 cup 106 mg
- orange 1 medium 54 mg
- broccoli, cooked 1/2 cup 49 mg
- dried beans, cooked 1/2 cup 45 mg
- tangerine 1 medium 34 mg
- cabbage 1/2 cup 32 mg
- green beans 1/2 cup 32 mg
- squash, winter 1/2 cup 29 mg
- squash, summer 1/2 cup 26 mg
- whole wheat bread 1 slice 25 mg
- brussel sprouts 1/2 cup 25 mg
- white bread 1 slice 21 mg
- rye bread 1 slice 19 mg
- asparagus, cooked 1/2 cup 15 mg
- fast food hamburger 1 sandwich 140 mg
- fast food cheeseburger 1 sandwich 199 mg
- fast food french fries reg. size 14 mg
- fast food taco 1 medium 69 mg
- fast food bean burrito 1 medium 139 mg
- restaurant cheese pizza 1 slice 104 mg

HOW MUCH CALCIUM DO YOU NEED EVERY DAY?

At this life stage, you need this much calcium:

- child (age 1 to 10) = 800 milligrams
- young adult (age 11 to29) = 1,200 milligrams
- adult (age 30 to 50) = 1,000 milligrams
- adult (age 51 to 64)* = 1,200 milligrams
- adult (age 65 and over)** = 1,500 milligrams
- * also includes pregnant and lactating females and postmenopausal females on estrogen

Nearly half of postmenopausal American women do not know their bone-mineral density (BMD) is low according to the National Osteoporosis Risk Assessment (NORA) study. When you have low BMD, you are more at risk of bone fracture. Based on the studyís results, lead investigator Dr. Ethel S. Siris and colleagues concluded that healthcare providers should pay more attention.

The researchers examined more than 200,000 women from 34 states over a 2-year period in the largest research study of osteoporosis ever conducted among postmenopausal American women. None of the women

The researchers also found the following:

The likelihood of developing osteoporosis increases with age. About 7% of study participants with low BMD also had osteoporosis.

According to the study, certain women are at greater risk of osteoporosis

- Women of Asian or Hispanic descent
- Smokers
- Those who use cortisone medications
- Those with a personal or family history of fractures
- Women with a significantly lower risk of developing osteoporosis include:Women of African-American descent
- Users of estrogen or diuretic medications
- Those who exercise regularly
- Those who consume alcohol

NORA was funded and managed in large part by Merck & Co., Inc,

Journal of the American Medical Association. 2001;286:2815-2822.

American Journal of Epidemiology. 2002;155:72-79.