Your bone is constantly changing. New bone is being made and old bone is being broken down. When you're young, your body makes new bone faster than it breaks down old bone and your bone mass increases. But you reach your peak bone mass around age 30. After that, your bone is still changing, but you lose slightly more than you gain.
The strength of your bones depends on their size and density. Bone density is determined, in part, on the amount of calcium, phosphorus and other minerals in your bones. When your bones contain fewer minerals than normal, they're less strong and eventually lose their internal supporting structure. This loss could lead to a disease called osteoporosis.
WHAT IS OSTEOPOROSIS:
Osteoporosis means "porous bones" and is the most common type of bone disease. It occurs when calcium is deposited into bones too slowly or reabsorbed from bones too quickly. This disease reduces our bone mass, gradually stealing calcium and other minerals from our bones, until a fracture suddenly occurs. Preventable but NOT curable, osteoporosis strikes with great force when it hits, making it very hard to perform even the simplest of tasks. Osteporosis is a worldwide epidemic.
Not long ago, conventional medical wisdom held that osteporosis was an age-related disease caused by the sudden reduction of estrogen in postmenopausal women and the consequent loss of calcium from the bone. It was also believed to be irreversible.
Today, we know that osteoporosis is a chronic degenerative disease that starts in childhood and that will attack BOTH men and women. The onslaught of this disease is largely of our own making, due to poor diet, a lack of regular exercise, poor lifestyle habits like smoking, and exposure to pharmaceutical drugs used in the treatment of other diseases. Simple lifestyle choices could have prevented up to 90% of current cases of osteporosis, saving people from the agony of osteoporosis.
Once osteoporosis hits, the first evidence of it usually shows up in the form of a bone fracture. Most of these fractures occur in the spine, hip or wrist. Although it's often thought of as a women's disease, osteoporosis affects men too. And aside from people who actually have osteoporosis, many others have low bone density, putting them at risk of developing osteoporosis.
Researchers estimate that about 1 out of 5 American women over the age of 50 have osteoporosis. About half of all women over the age of 50 will have a fracture of the hip, wrist, or vertebra (bones of the spine).
Although most people do relatively well with modern surgical treatment, hip fractures can result in disability and even death from postoperative complications, especially in older adults. Wrist fractures from falls also are common.
In some cases, spinal fractures can occur even if you haven't fallen or injured yourself. The bones in your back (vertebrae) can simply become so weakened that they begin to compress or collapse. Compression fractures can cause severe pain and require a long recovery. If you have many such fractures, you can lose height as your posture becomes stooped.
How likely you are to develop osteoporosis depends on how much bone mass you attained in your 20's and early 30's and how rapidly you lose it later. The higher your peak bone mass, the more bone you have "in the bank" and the less likely you are to develop osteoporosis as you age.
A number of factors can increase the likelihood that you'll develop osteoporosis .
HERE ARE RISK FACTORS YOU CAN CHANGE:
* Calcium deficiency: Low calcium intake reduces bone density, leads to early bone loss, and increases the risk of fractures.
* Tobacco use: Contributes to weak bones.
* Eating disorders: Those with anorexia or bulimia are at higher risk of lower bone density.
* Sedentary lifestyle: Those who sit often have a higher risk of osteoporosis than those who are more active. Weight-bearing exercises such as walking, running, jumping, dancing, and weightlifting are particularly helpful for creating healthy bones.
* Excessive alcohol consumption: Regularly consuming more than two drinks a day increases your risk of osteoporosis.
* Corticosteroid medications: Examples include prednisone, cortisone, prednisolone and dexamethasone. Long-term use of these medications is damaging to bone.
NOTE: These medications are common treatments for chronic conditions, such as asthma, rheumatoid arthritis and lupus, and you may not be able to stop taking them to lessen your risk of osteoporosis.
* Other medications: Examples include aromatase inhibitors (breast cancer drug), selective serotonin reuptake inhibitors (antidepressant medications), methotrexate (cancer treatment drug), some anti-seizure medications, proton pump inhibitors (acid-blocking drugs), and aluminum-containing antacids. Long-term use of these medications can increase your risk of osteoporosis.
HERE ARE RISK FACTORS YOU CAN'T CHANGE:
* Being a woman: Women have double the chance of men of incurring a fracture from osteoporosis.
* Getting older: Osteoporosis risk increases with age.
* Race: Osteoporosis risk increases if you're white or of Asian descent.
* Family history: Osteoporosis risk increases if you have a parent or sibling with osteoporosis (especially if you also have a family history of fractures).
* Frame size: Osteoporosis risk increases in both men and women who are exceptionally thin (Body Mass Index < 19) or who have small body frames.
* Thyroid hormone: Too much thyroid hormone can cause bone loss. This can occur either because your thyroid is overactive (hyperthyroidism) or because you take excess amounts of thyroid hormone medication to treat an underactive thyroid (hypothyroidism).
* Medical conditions and procedures that affect bone health: Stomach surgery (gastrectomy) and weight-loss surgery can affect your body's ability to absorb calcium. Crohn's disease, celiac disease, hyperparathyroidism and Cushing's disease can affect your body's ability to absorb calcium as well.
WHO SHOULD GET TESTED?
Now that you understand the risk factors involved, here are some guidelines on who should get tested.
The National Osteoporosis Foundation recommends a bone density test (which is how osteoporosis is usually diagnosed) if you are:
* A woman older than age 65 or a man older than age 70, regardless of risk factors
* A postmenopausal woman with at least one risk factor for osteoporosis
* A man between age 50 and 70 who has at least one osteoporosis risk factor
* Older than age 50 with a history of a broken bone
* Taking medications (as mentioned above)
* A postmenopausal woman who has recently stopped taking hormone therapy
* A woman who experienced early menopause
NOTE: Osteoporosis rarely causes signs or symptoms until it's advanced, so if you fall within the criteria above, GET TESTED!
The BEST screening test is called dual energy X-ray absorptiometry. This procedure is quick, simple and gives accurate results. It measures the density of bones in your spine, hip and wrist (which are the areas most likely to be affected by osteoporosis) and it's used to follow changes in these bones over time.
Other tests that can accurately measure bone density include ultrasound, quantitative computerized tomography (CT) scanning, and single-photon absorptiometry.
Once you've been tested, if you discover you have osteoporosis, or are on your way to developing osteporosis, or even if your bones are healthy, you should take the following steps.
TREATING or PREVENTING OSTEOPOROSIS:
These steps will keep your bones strong and healthy throughout life, or help your bones become healthier.
* DIET - OBTAIN KEY NUTRIENTS: (for those with and without osteoporosis)
There are three simple things you can, and should, do to improve the health of your bones. Ramp up your CALCIUM intake daily to an optimal level, ramp up your VITAMIN D intake daily to an optimal level, and start EXERCISING regularly.
NOTE: Doing this throughout your life will put you at an even greater advantage.
Let's spend a little time discussing calcium in more detail.
The amount of calcium you need to stay healthy changes over your lifetime. The Institute of Medicine recommends the following amounts of calcium DAILY from food and supplements:
Up to 1 year old — 210 to 270 milligrams (mgs)
Age 1 to 3 years — 500 mgs
Age 4 to 8 years — 800 mgs
Age 9 to 18 years — 1,300 mgs
Age 19 to 50 years — 1,000 mgs
Age 51 and older (and pregnant and lactating women) — 1,200 mgs
Good sources of calcium from food can be found in broccoli, spinach, cooked kale, legumes, fortified orange juice, almonds, fish, canned salmon with the bones, sardines, and soy products (such as tofu).
You might be wondering why I left out dairy products, since you have probably heard they provide good sources of calcium. While that might be true, leafy green vegetables and legumes are a richer and more balanced source of calcium and minerals than milk and dairy products. In fact, recent evidence suggests that a high consumption of dairy products during adulthood may lead to an increase in the prevalence of osteoporosis.
Nevertheless, many people find it difficult to get enough calcium in their diet (and many studies actually support this statement), which is why supplementation has become critical in filling in the missing gap. Just make sure you are taking a high quality, pharmaceutical-grade, calcium supplement. Better yet, get on a complete, broad-spectrum, pharmaceutical-grade multivitamin that includes all of the essential nutrients, including calcium. Getting the right level of all of the key nutrients is critical to optimizing overall health. The Institute of Medicine recommends taking no more than 2,500 mgs of calcium daily as it could have adverse effects.
Now let's turn our attention to vitamin D.
Getting optimal levels of vitamin D is just as important for bone health as getting adequate amounts of calcium. As matter of fact, our bodies have a hard time absorbing calcium without the presence of vitamin D, so in reality, they are equally important. For more information on vitamin D, read my blog articles The Importance of Vitamin D & the Dangers of Vitamin D Deficiency - Part 1, The Importance of Vitamin D & the Dangers of Vitamin D Deficiency - Part 2, and The Importance of Vitamin D and the Dangers of Vitamin D Deficiency - Part 3.
And lastly, let's discuss the importance of exercising regularly.
* EXERCISE REGULARLY: (for those with and without osteoporosis)
Exercise can help you build strong bones and slow bone loss. Exercise will benefit your bones no matter when you start, but you'll gain the most benefit if you start exercising regularly when you're young and then continue to exercise throughout your life.
When I mention "exercising regularly", I specifically mean to combine strength training exercises with weight-bearing exercises regularly.
Strength training exercises help strengthen muscles and bones in your arms and upper spine. It involves the use of free weights, weight machines, or exercise bands.
Weight-bearing exercises, on the other hand, mainly affect the bones in your legs, hips and lower spine. Examples of weight-bearing exercises include walking, jogging, running, stair climbing, skipping rope, skiing and impact-producing sports. Swimming, cycling and exercising on machines such as elliptical trainers can provide a good cardiovascular workout, but because such exercises are low impact, they're not as helpful for improving bone health as weight-bearing exercises.
* OTHER LIFESTYLE CHANGES: (for those with and without osteoporosis)
In addition to increasing calcium and vitamin D intake daily, as well as exercising regularly, there are several other things you can do to help prevent bone loss. Reduce your consumption of salt and caffeine since they negatively affect calcium status. In addition, eliminate smoking and reduce alcohol intake. Smoking and/or consuming more than two alcoholic drinks a day may decrease bone formation and reduce your body's ability to absorb calcium.
* DRUG TREATMENT & HORMONE THERAPY (for those with osteoporosis):
Some treatment options include taking medications (such as bisphosphonates, raloxifene, calcitonin, and teriparatid), or initiating hormone therapy to reduce the loss of minerals from bone that is the cause of osteporosis.
WARNING: If your doctor recommends intervention with a drug therapy program or hormone replacement, seek a second opinion, and FAST!
* PHYSICAL THERAPY (for those with osteoporosis):
Also keep in mind that physical therapy may help you build bone strength and improve your posture, balance and muscle strength, making falls less likely.
But just remember, you are usually better off focusing on some serious lifestyle changes to slow bone loss and maintain bone mass than resorting to drugs or hormone replacement.
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