'Boning Up' on Osteoporosis to See if You're at Risk

By Leigh Kirchner, MPH, CHES, Senior Health Educator

Osteoporosis affects more than 28 million Americans, including (any statistics for Maine?) It is a disease that weakens bones and often leads to fractures, a stooped posture and sometimes disability. Although it is mostly women who are afflicted, men are also at risk –more than 2 million are affected.

The good news is that osteoporosis is largely preventable, especially if patients who are at risk are identified early and take steps to reverse the process of bone loss. May is Osteoporosis Awareness and Prevention Month so we thought it would be a good time to take a look at this potentially disabling disease.

Regardless of your age and gender, use the following information to assess your risk and learn what you can do to prevent osteoporosis.

Bones are constantly in the process of being broken down and re-formed in a process called ‘remodeling.’ Bone cells called osteoclasts are responsible for dissolving portions of old bones, while cells called osteoblasts take on the job of rebuilding new bone. As we age, the activity of breaking down bones overwhelms the activity of repairing bones, causing them to become more brittle. If you are at risk of developing osteoporosis, there are lifestyle changes you can make to keep your bones healthy.

Here is a checklist to see if you are at risk and what to do about it.

Factors You Cannot Control

1. Gender—Women are at increased risk, especially if menstruation began later than normal and/or menopause started early (before age 45). The hormone estrogen protects women from bone loss, but in the five years right after menopause, the rate of bone loss speeds up. Men are protected by the hormone testosterone, which promotes muscle and bone growth.

2. Family history—Peak bone mass is determined 60–70% by genetics.

3. Racial heritage—The lighter your skin, the greater your risk for osteoporosis.

4. Body type—Thin individuals tend to have less bone mass.

5. Medical history—Medical conditions such as rheumatoid arthritis, thyroid disorders, lactose intolerance, and chronic digestive disorders increase your risk.

6. Medications—Medications such as steroids, thyroid hormones, and anticonvulsants may lead to bone loss. However, these medications may be critical in controlling another condition, so check with your doctor or pharmacist before discontinuing their use. Antacids that contain aluminum interfere with calcium absorption when taken in high doses.

Factors You Can Control

1. Activity level—People who get little exercise are at greater risk for osteoporosis. Weight-bearing exercises such as walking and weight training are recommended to reduce this risk.

2. Dietary calcium—Lifetime calcium intake strongly predicts peak bone mass. Four daily servings of calcium-rich food are recommended.

3. Vitamin D—Because this vitamin is required for calcium metabolism, some daily sun exposure and vitamin D–rich foods or supplements are recommended. As we age, the body does not produce vitamin D as well as when we were younger, so further supplementation may be required.

4. Daily intake of fruits and vegetables—Citrus fruits that are high in vitamin C and green leafy vegetables that provide vitamin K are especially beneficial to your bones. Five or more servings a day are recommended.

5. Alcohol consumption—More than seven drinks a week increases your risk.

6. Caffeine consumption—Four or more cups of coffee (or caffeinated sodas), per day, doubles your risk for developing osteoporosis.

7. Smoking—Female smokers, and even former smokers, have greatly reduced bone density because smoking decreases estrogen levels.

If you have several of these risk factors, the National Osteoporosis Foundation recommends that you speak to your doctor about a bone density test.

Who Else Should Be Tested?

Talk to your doctor about being tested if you
¡ have symptoms of osteoporosis, such as a broken bone not related to severe trauma, loss of height or curvature of the spine, or sharp or recurring pain in the middle to upper back area.
¡ are trying to decide about treatment for bone loss.
¡ are approaching menopause and have several risk factors.
¡ are postmenopausal and have never been tested.

Sadly, osteoporosis can be severely disabling. For patients with hip fractures, one in five dies within a year and half are never able to live independently again. The good news is that treatment is available, and you can greatly reduce your risk by making some of the lifestyle changes mentioned above. “Boning up” on osteoporosis means getting started today to protect your healthy bones.

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Leigh Kirchner, MPH, CHES, is a Senior Health Educator at Martin’s Point Health Care. The organization has facilities in Portland, Windham, Brunswick and Portsmouth, N.H., and offers classes, books, videos and other helpful information on health topics and prevention. For additional information, visit Martin’s Point online at www.martinspoint.org.