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Dear
Doctor: I am a woman in my forties and have heard that I am at risk for
osteoporosis. Is this true? M.S. Columbus
Osteoporosis, a systemic disorder
characterized by abnormal rarefaction of bone, has fast become a major
public health concern. Over 25 million women in the United States
alone have osteoporosis, and the numbers are growing, due to the increase
in the average age of our population. The cost of health care for this
disorder alone is estimated at almost $14 billion dollars. Though this
condition affects both men and women, your chances of developing
osteoporosis are greater if you are a woman. Women have less bone tissue
and lose bone more rapidly than men because of the changes involved in
menopause.
Our bones continue to grow throughout
childhood and adolescence, and usually by the time we’re 30, we’ve reached
peak bone mass. Though we tend to think of bone as inert and immobile, it
is a dynamic living tissue composed of inorganic minerals and a “non-mineral
protein collagen matrix.” As such, it requires appropriate high-quality
nutrients for healthy growth in addition to repeated stimulation from
weight-bearing exercises. Our bones continue to change throughout our lives
through a process known as “remodeling”. This is a continuous process which
involves two major types of bone cells: osteoclasts,
which break down and dissolve old or weakened bone, creating cracks and
spaces in our bone, and “osteoblasts”, the bone-creating cells which fill
in these spaces. When the osteoblasts cannot keep up the repair of the
damage, bones become weaker and more brittle. Bone loss gradually occurs as
we continue to age, however certain factors can influence this process.
Estrogen plays a critical role in regulating bone matrix synthesis. Reduced
estrogen levels cause the rate of bone absorption (demineralization) to
exceed the rate of bone formation, which can lead to osteoporosis.
The bones of a person with osteoporosis
become thin and fragile making them vulnerable to fractures of the hip,
spine and wrists. Though bone loss involves the entire skeleton, these
areas are most susceptible to fracture. Fracture is the principle
consequence of osteoporosis. Post menopausal women are therefore at a
higher risk of breaking wrists, hips and bones in the spine, as there is an
increase in the rate of bone loss during the first three to five years
after menopause. After that, the rate of bone loss continues at a slower
but steady rate. Fractures of the spine, also known as “vertebral
compression fractures” are the most common type of osteoporotic
fracture. These fractures generally do not cause noticeable symptoms.
However, recent, multiple or severe fractures may cause chronic back pain.
Though not as common as spine fractures, hip fractures related to
osteoporosis are more serious, for they can have potentially devastating
effects. It is estimated that there
are over 250,000 hip fractures per year as a direct consequence of
osteoporosis.
Intervention is most effective before
bone density falls into the range of osteopenia. Osteopenia is a pre-osteoporosis
condition characterized by reduced bone density and increased risk for
osteoporosis.
Early detection of osteoporosis can
result in treatment which can recondition compromised bone mass and
decrease the likelihood of fracture. Bone mineral density (BMD) is now used
as a common indicator of bone health, and can be measured through special
types of x-ray scan, such as DXA scan. These scans can assess bone health,
and even forecast the likelihood of fracture risk. However it should be remembered that BMD is only one component of
bone tissue strength, and there is no absolute marker for determining
fracture risk.
As mentioned, the likelihood of
developing osteoporosis is far greater for women, for the reasons outlined
above. Family history of
osteoporosis with particular emphasis on a previous hip fracture in the
mother increases the risk. Caucasian and Asian ethnicity has proven to be at
higher risk, followed closely by African American and Hispanic women.
Though these risk factors are certainly uncompromising, there are lifestyle
factors over which we have control and are modifiable. These include
sedentary or active lifestyle choices, cigarette smoking (research
indicates there is a definitive link between smoking and bone health, and
that smoking can affect the body’s response to treatment), alcohol and
caffeine consumption, diet and lack of adequate supplementation.
Ideally, intervention should begin as
early as possible but it is never too late to make a difference. Lifestyle
modifications should include a regular exercise program such as walking,
swimming or biking, as exercise is a critical factor in maintaining and
building bone mass. Dietary goals should include high calcium-rich foods
such as dark leafy greens, as studies have shown that calcium intake can
increase bone mineral density and reduce risk of fracture. Other vitamins
to consider include Vitamin D, which is required by the body to process
calcium. Vitamin C is a key factor in the formation of collagen, and
collagen encompasses the greater part of bone matrix. Vitamin K has also
recently been identified as a key player in bone metabolism, and is found
in dark, leafy greens. Avoiding or minimizing certain foods such as
caffeine, refined carbohydrates and sugars is strongly advised, as these
products increase calcium excretion from the body.
It’s never too late to improve the
integrity of your bones. If you feel you may be at risk for osteoporosis,
talk to your health care provider. Get nutritional advice from a licensed
professional. Respect the bone you have. Keep your bones as strong as
possible when you are young, and maintain their health as you age. The
course you take can change the quality of your life.
Yellowstone Naturopathic
Clinic
720 N. 30th St.
Billings, MT 59101
PHONE 406·259·5096/FAX 406·248·5655
ync@180com.net
Dispensary
406·254·9682
dispensary@yncnaturally.com
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