After age 50, as many as half of all women will break a bone due to osteoporosis. This is a progressive disease that causes bones to deteriorate and increases the risk of fracture.More than 40 million people in the United States already have osteoporosis or carry a high risk of developing it. Men and women can develop osteoporosis, but it affects twice as many women.Osteoporosis results from an imbalance between the cells that that create bone and those that break it down. Bones are constantly growing and deteriorating, but bone-building cells naturally become less active with age and cannot regenerate bone as quickly as it breaks down.If other risk factors are present—such as a family history of osteoporosis, decreasing estrogen levels or lack of exercise—bones can become even more prone to fracture.
However, osteoporosis is not inevitable. Being aware of the risk factors and taking preventive steps early in life can help keep bones strong and healthy.
Between age 20 and 40, lifestyle plays a major role in bone health. Avoiding tobacco and alcohol can help prevent bone loss. As few as two alcoholic drinks per day significantly increase the risk of developing osteoporosis later in life.
Being underweight is also a risk factor. Women should maintain a healthy weight through a well-balanced diet that includes adequate amounts of calcium as well as vitamin D. Generally, premenopausal women should have 1,000 to 1,200 milligrams of calcium and 800 to 1,000 milligrams of vitamin D daily. Most nutrients should come from diet; supplements should be used only when recommended by a physician.
Weight-bearing exercise such as running or dancing is a must for bone maintenance. Research has found that women who exercised at least four hours per week had a 40 percent lower risk of fracture than those who exercised for less than one hour. Even simply walking jars the body just enough to stimulate bone growth.
Non-lifestyle factors also may boost risk. Chronic use of certain medications, such as some anti-depressants or steroid drugs, may weaken bones. If a woman’s mother or father had a fracture, she may be more likely to develop osteoporosis. Any previous fracture in a woman’s own life, regardless of cause, could indicate a predisposition to the disease.
During the years immediately before menopause, women’s estrogen levels begin to drop, making them more susceptible to osteoporosis. Once menopause begins, all women should have a bone density test; premenopausal women who have any of the risk factors listed above should have the test as well.
If bone density is normal, most women should keep taking preventive measures and continue to get screened every two to three years, starting at menopause. Bone density that is slightly lower than normal indicates a condition called osteopenia. In this case, a specialized fracture risk assessment tool may be used to assess the risk of fracture over the next 10 years. If risk is high, treatment may be recommended. Finally, if the test shows osteoporosis, treatment should be started according to each woman’s individual needs.
“Health Watch” is brought to you by the physicians and staff at Scripps Memorial Hospital Encinitas. For more information or for physician referral, call 1-800-SCRIPPS or visit www.scripps.org.