Volume 14, Number 4: Augusts 2006
Ask Dr. Nancy
Q: Ads for osteoporosis medicine are a TV staple. Could you advise about managing osteoporosis- and preventing it? I'd like to know for my daughter as well as myself.
A: I'm glad you asked the question about prevention, because girls and women can take definite steps to strengthen bones. "Steps" in fact-walking and other exercise-are one strategy to do it!
FIRST, SOME FACTS AND DEFINITIONS. Bone thinning is a natural process after age 30 and cannot be stopped completely. Osteoporosis is dangerous loss of bone. Bones become so porous that they fracture easily and heal slowly. The spine may also curve unnaturally.
Osteoporosis has no symptoms until a bone breaks or a person loses height. Factors in developing osteoporosis include bone thickness early in life (thicker bones reduce risk); health, diet, and physical activity at all ages; and heredity.
Women are more at risk than men because of smaller skeletons and at risk earlier because of menopause. Lack of estrogen accelerates bone loss. However, men do develop osteoporosis.
PREVENTION SHOULD START EARLY AND NEVER STOP. The steps below slow bone loss. To build bone, preteen and teen girls especially should be very active and get adequate calcium.
Exercise: Do weight-bearing exercises to work muscles and bones against gravity: walking, dancing, jogging, weights, resistance bands. Muscle strength supports the skeleton and aids balance.
Calcium and vitamin D: Calcium builds bone; vitamin D helps the body absorb calcium and improves muscle strength. Dairy products, fortified orange juice, and many vegetables are good sources of calcium. Sunlight is the best source of vitamin D. However, most people's diets provide half the calcium needed, so calcium plus D supplements are recommended. Adults 19-50 need 1000 mg. of calcium daily; those 51 and over need 1200.
Smoking: Don't do it. Smoking increases osteoporosis risk and makes bones thin faster.
Alcohol: More than one drink a day increases risk.
Falls: This is a prevention step against fractures. Older people should have frequent vision checks, wear nonslip shoes, and continue exercises that help balance.
OTHER INHERITED RISKS MAY EXIST. People of European and Asian background and of thin build have higher incidence of osteoporosis. Consider these factors as you assess risk with your physician.
DIAGNOSIS AND TREATMENT ARE BETTER THAN EVER. The definitive test for porous bones is painless DEXA scanning (dual-energy x-ray absorptiometry). Capital Health Plan offers a state-of-the-art DEXA instrument in our new Imaging Center at the Governor's Square Health Center. The U.S. Preventive Services Task Force recommends routine testing at age 65 or at 60 if high risk exists. Today's medications are able not only to stop bone thinning but to rebuild bone.
HOW TO DECIDE: HEALTHWISE® AND YOUR DOCTOR. Osteoporosis, or its prospect, raises many questions: Are my diet and activity sufficient? Which calcium supplement? Should I get a DEXA scan? Does the medicine have risks? If you haven't read HealthLine's cover story, I urge you to. The Healthwise® Knowledgebase is an excellent source for deeper information, for weighing your personal situation, and for making the most of an appointment with your physician.