You do not have to become one of the 20 million American women with osteoporosis. Osteoporosis is preventable. While some risk factors, such as a family history of the disease, can't be changed, some important ones can be influenced through diet, exercise, and other lifestyle changes or medications.
Are you at risk? Risk factors include:
- Race - Caucasian and Asian women are more at risk than African-Americans
- Family History of Osteoporosis - a family history of osteoporosis is a strong indicator that you may be at risk.
- Menopause prior to age 45 - this factor adds risk because it adds more postmenopausal years to live with estrogen depletion.
- Skeletal size - small-boned women are more at risk. Your body uses the same amount of calcium each day whether you have large or small bones. If your calcium intake is inadequate, your body robs it from your skeleton.
- Low body weight - your body fat composition should be about 20-25 percent fat to avert loss of estrone, a weak form of estrogen produced from body fat.
- Sedentary lifestyle - lack of exercise allows bones to become weak.
- Low calcium intake - low calcium intake in the past or currently could put you at risk.
- Cigarette smoking - nicotine interferes with the body's ability to absorb calcium. Smoking also has an adverse effect on the ovaries and leads to earlier menopause and major estrogen depletion.
- Caffeine - caffeine interferes with calcium absorption. More than two caffeine drinks a day are enough to increase risk.
- Hyperthyroidism or hyperparathyroidism - these conditions both result in calcium loss at the expense of the bones.
- Long term corticosteroid use - Cortisone and prednisone, used in a long-term regimen, can deplete bone mass by 30% in as little as six months.
- Long duration depression - long term studies show that women with depression had a 10-15% lower bone density in their hips than normal for their age. The average women in the studies was age 41 but with a bone density level usually seen in seventy-year-old women. The cause is suspected to be elevated levels of the stress hormone cortisol.
But even if you're in a high risk group, osteoporosis can be prevented. If you don't want to become a statistic, there are common sense steps you can take that will decrease your risk of developing osteoporosis.
- Bone up on calcium. Perimenopausal women and
post menopausal women taking estrogen need 1,000-1,500
milligrams of calcium a day.
- Post menopausal women not taking estrogen need to take at least 1,500-2,000 milligrams of calcium daily to offset the increased risk of osteoporosis.
- Three 8-ounce glasses of low-fat milk a day suffice, as does a diet high in calcium-rich foods like low-fat yogurt, broccoli, kale, pink salmon, canned sardines, and shellfish. Calcium supplements are also an option.
- Vitamin D is needed to boost calcium absorption. If your sun exposure is limited, drink fortified milk or take a vitamin supplement.
- Make exercise a habit. Exercise is crucial for keeping muscles toned and joints limber so that a fall is less likely, or at least less severe. some research suggests that weight-bearing exercise, such as walking, may stimulate bone formation. No matter what exercise it is, stick with it.
- Take estrogen. Although a calcium and Vitamin
D-rich diet and exercise can help slow the rapid bone
loss that occurs after menopause, estrogen can often stop
it altogether. Estrogen slows bone loss by acting
directly on the bone. It also blocks some hormones
responsible for breaking down old bone. Estrogen also
helps activate vitamin D, which enhances calcium
absorption. Estrogen also increases collagen, a substance
that helps form new bone tissue. The "bone-age" of a
woman who take estrogen is on average 10 to 12 years less
than her biological age. For additional information about
estrogen, read about Hormone
Replacement Therapy.
- Add progesterone or testosterone to estrogen. By addiing progesterone to estrogen therapy, research shows that bone loss is not only stopped, but that there is a small increase in bone mass.
- Studies conducted in 1996 demonstrated that small doses of testosterone added to estrogen therapy increased bone formation.
- Consider Alendronate (Fosamax) as an alternative to estrogen. Recently approved by the FDA to both treat and prevent osteoporosis, Alendronate is the best alternative to estrogen, however, unlike estrogen, it doesn't offer any protection against heart disease. On the risk side, Alendronate has the potential to cause gastointestinal problems including severe esophageal inflammation if not taken in prescribed dosages.
- Get a base line bone density scan at about age 40 if you are in a high risk category. The most reliable test is dual energy X-ray absoptiometry (DEXA). Unlike regular x-rays which can't detect osteoporosis until bone mass loss approaches 30%, the 5-minute, low-dose DEXA technique can detect as little as 1 % loss. If the DEXA test shows your bone density to be normal, it can be used as a baseline standard for future comparision after menopause. If the DEXA reveals a lower-than-average bone density, start an aggressive prevention program immediately.
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© 1998 Prairie Public Broadcasting, Inc.