Bone-a-fide

Careful attention to your body’s indicators can save you

By M. Natalie Achong, MD

Have you considered your bone health lately? Perhaps it’s time to think more about one of the most common diseases in the u.s.—osteoporosis, which is often considered “the silent disease.” While the bone loss and weakening that characterizes osteoporosis can occur without symptoms, a bone fracture is often the first indication of the disease’s onset.

Approximately 10 million Americans over age 50 have osteoporosis, and another 34 million are at risk for this disease. Osteoporosis is not necessarily a disease of the elderly; it can occur in younger ages as well. Proper prevention and treatment should actually start in early childhood. t Osteoporosis is a major health concern for women; 80 percent of those affected are female. A woman’s lifetime risk of having an osteoporosis fracture is estimated to be 40-50 percent. Most women don’t realize that fractures due to osteoporosis are more common than the incidence of heart attack, stroke and breast cancer combined. t As the American population ages, it is expected that even more women and men will be diagnosed with osteoporosis. For now, the rates of hip, wrist, spine and repeat fractures—clinical signs of this disease—are on the rise.

It is a common misconception that osteoporosis only affects white women. While it is most commonly seen in white and Asian women, the latest data from a report from the Surgeon General indicates that the prevalence of osteoporosis in Hispanic women is similar to that in white women. According to the National Institutes of Health (nih), 10 percent of Hispanic women and 5 percent of non-Hispanic African-American women over the age of 50 are estimated to have this disease. Scientific data on women of color and osteoporosis is limited, although it appears that women of color may be at a lower risk it is a reality they cannot ignore. Hip fractures are one of the most serious threats of osteoporosis, and it is established that minorities face a higher risk of death and more serious health complications due to hip fractures.

Generally, our bones reach their peak density and strength by the time we get to our 30s. In other words, our skeletons do not get any better with age. Risk factors for developing osteoporosis include: age (being 50 and older), low body weight, having a first-degree relative—like a sister or mother—who has had the disease, smoking, and low dietary intake of calcium and Vitamin D. Certain chronic medical conditions, such as thyroid disease and long term use of medications like steroids and heparin, can contribute to the development of osteoporosis.

Bone mineral density (bmd) testing is commonly used to diagnose osteoporosis. Basically, it is a simple and painless radiology study. For most, a bmd score less than -2.0 is considered abnormal.

Prevention is critically important because the microscopic changes associated with bone loss are largely irreversible. If diagnosed, treatment may stabilize or even increase bmd, but is unlikely to fully restore bones.

The importance of a balanced diet, with adequate calcium and Vitamin D for bone integrity, cannot be overstated. The majority of people do not get the recommended amount of Vitamin D. Depending on their age, women should get a minimum of 1000-1500 milligrams of calcium per day. Prevention of all falls is often an underappreciated strategy to prevent osteoporosis. If you smoke, make your best effort to stop for good.

Many studies have demonstrated the positive effects of exercise and physical activity on bone health. So here’s another great reason to get out on the links, tennis courts, or walking trails—often. And always, be proactive about your health. If you have questions or concerns about osteoporosis, take the lead and talk to your physician.