UC HEALTH LINE: What You Do Now Affects Your Bones Later

CINCINNATI—People often think of osteoporosis as “an old person’s disease.” While the possibility of osteoporosis does increase as you age (65 years and up), there are steps you can take now to decrease your risk and strengthen your bones.

“Many people don’t even realize they have osteoporosis until they break a bone,” says Nelson Watts, MD, director of the University of Cincinnati Bone and Osteoporosis Center. “Osteoporosis, or weak bones, can really affect a person’s ability to do everyday things like walking and picking up objects.”

Dr. Watts stresses that it’s important for people to realize that their bones are not a hard, lifeless structure, but complex living tissue. “Bones are constantly changing, and you build and store bone tissue efficiently until age 30. After that, bones begin to break down faster than new bone is formed because of the aging process. That’s why it’s so important to do what you can to build a healthy bone mass.”

Several factors increase the risk of developing osteoporosis, says Dr. Watts. They are:

• Age: Bones become weaker and less dense as you age.

• Gender: Women have a greater chance of developing osteoporosis. They have less bone tissue than men to start with and loss of estrogen due to menopause causes them to lose bone more rapidly.

• Race: Caucasians and Asians are at highest risk. African-Americans and Hispanics are also at significant risk.

• Bone structure and body weight: Small-boned and thin people (women under 127 pounds) are most vulnerable.

• Family and personal history of fractures:  Women who have a first degree relative with a hip fracture are at increased risk of fracture themselves. Personal history of fractures as an adult also increases your fracture risk.

• Menstrual history/menopause: Normal or early menopause, abnormal absence of menstrual periods, as experienced by women with eating disorders, or excessive physical exercise can cause bone loss.

• Lifestyle: Smoking, drinking too much alcohol, getting little or no weight-bearing exercise, and inadequate calcium intake increase the risk.

• Medications: Long-term use of some medications has been linked to bone loss. These include glucocorticoids, used to suppress various allergic, inflammatory and autoimmune disorders and as an immunosuppressant; anti-epilepsy drugs and the anti-clotting agent heparin. Ask your physician if a medication you’re taking carries an increased risk of developing osteoporosis.

• Low testosterone levels in men: “While osteoporosis largely affects women, it’s important for men to realize they can it develop it too,” says Dr. Watts. According to the U.S. Department of Health and Human Services, one in four men over age 50 will suffer a fracture caused by osteoporosis.

Whether you’re male or female, here are some steps you can take to reduce bone loss and the risk of developing osteoporosis:

• Take a bone mineral density (BMD) test: This is recommended for healthy women 65 and older, men 70 and older and those with increased risk. Talk to your doctor about your risk factors for developing osteoporosis.

• Get enough calcium and vitamin D: “Bones are made of calcium,” Dr. Watts points out. The recommended daily allowance of calcium is 1300 milligrams (mg) per day for ages 9–18, 1,000 mg for ages 19–50 and 1,200 mg for those aged 51 and older. Calcium rich foods include low or non-fat dairy, kale, broccoli and oranges.
  
  From birth to age 50, people should get 200 IU of vitamin D a day. Adults 51–69 require 400 IU daily, and those over 70 require 600 IU. Dr. Watts recommends patients with osteoporosis get at least 800–1,000 IU of vitamin D a day.
  
  Multivitamins usually contain only 400 IU of vitamin D, says Dr. Watts, so most people will need an additional supplement.

• Build and protect strong bones: Weight-bearing exercises stimulate your bones, especially the hips and spine, and help you build stronger bones. Dr. Watts cautions that weight-bearing exercises that involve high impact and can be hard on joints or weak bones.

• Live healthily: Don’t smoke or abuse alcohol. Excessive alcohol consumption and smoking rob the bones of hard-earned calcium and mineral content, making them weak and fragile.

Dr. Watts chairs the FDA’s Advisory Committee for Endocrine and Metabolic Drugs and is on the editorial boards of Osteoporosis International and the Journal of Clinical Densitometry. He is past president of the International Society of Clinical Densitometry and past president of the American College of Endocrinology (ACE).

May is National Osteoporosis Awareness Month.

According to the National Osteoporosis Foundation, osteoporosis is a major public health threat for an estimated 44 million Americans, or 55 percent of people 50 years of age and older. In the United States,10 million people are estimated to already have the disease, and almost 34 million more are estimated to have low bone mass (osteopenia), which places them at increased risk for osteoporosis.