Osteoporosis, which is defined as "porous bone," is a chronic condition that affects approximately 10 million Americans.  Another 34 million Americans are thought to have a condition called osteopenia (low bone mass) which puts them at risk for developing osteoporosis.  Osteoporosis is a disease in which the bones have become less dense, thin, and weak making them susceptible to fractures.  Under a microscope, healthy bone resembles a honeycomb.  With osteoporosis, structural changes have occurred in the bone that make the holes and spaces of the honeycomb structure much larger.  As a result, the bone becomes less dense, weaker and more susceptible to fracture.

     Bone is living tissue that constantly breaks down and rebuilds throughout life.  This process involves calcium to be withdrawn from and deposited into your bones daily.  The strength of your bones depends upon the amount of calcium stored in them.  In children and teenagers, new bone is formed faster than it is broken down.  Thus, the bones continue to become more dense until peak bone mass (the greatest amount of bone that you will have in your lifetime) is achieved.  

     Your body is efficient at depositing calcium into your bones until you are about the age of 30.  At this point, the rate of bone loss is greater than the rate of new bone formation.  This is why it is important to concentrate on optimizing calcium stores and building up bone tissue at a young age.  If you can optimize your peak bone mass as a youth, your bones will be stronger and less susceptible to osteoporosis when your body starts to lose bone faster than it can make it.

     Osteoporosis is a major public health problem.  It is estimated that in adults 50 years and older, one in two women and one in four men will suffer an osteoporosis-related fracture in their lifetime.  Each year it leads to fractures in 1.5 million people.  Fractures typically occur in the hip, spine, and wrist.

     Fractures of the hip are of particular concern.  Approximately 24% of adults over the age of 50 who have suffered a hip fracture will die within a year of the incident.  For those who survive a hip fracture, quality of life can be greatly reduced by functional limitations.  One in five sufferers will need long-term aid (nursing home care) afterward.  And, only 15% of hip fracture sufferers can walk unaided across the room six months post-incident. 

     Fractures of the vertebrae (spine) are also of special concern.  They can lead to death as well.  In addition, they are associated with physical deformity and a decrease in height.  These physical changes can affect self-esteem and lead to anxiety and depression.

     There are certain lifestyle habits and traits that can increase your risk for developing osteoporosis.  They are listed below.

Risk Factors for Osteoporosis:

• Female gender - 80% of those affected are women
• Small/thin body frame
• Low body weight
• Ethnicity - Caucasian and Asian races are at a greater risk
• Older age
• Family history of osteoporosis and broken bones
• Personal history of broken bones
• Physical inactivity
• Smoking
• Low levels of sex hormones - Estrogen protects bones.  Women who have low levels, such as from menopause, are at a greater risk.  The risk is also greater for those women who have amenorrhea (absence of periods).  Testosterone protects bone in men, therefore, low levels can lead to bone loss.
• Poor diet - Low intake of calcium and vitamin D as well as excessive consumption of caffeine, alcohol, protein, and sodium can increase risk.
• History of steroid and anticonvulsant medication use 
• History of anorexia nervosa, rheumatoid arthritis, and gastrointestinal disease

     Osteoporosis is known as a "silent" disease.  You cannot feel your bones becoming less dense and weak.  Many times, the first sign that osteoporosis is present is a bone fracture.  Kyphosis (a stooped posture) or a loss of height also can be an indication of the presence of osteoporosis. 

     Fortunately, osteoporosis is preventable and can be treated.  You can take action to promote bone health by following the healthy lifestyle habits listed below.

Tips to Promote Bone Health:

• Engage in regular exercise that is weight-bearing and uses the major muscle groups of the body. 
• Participate in resistance training activities at least 2-3 days/week.
• Perform balance exercises at least 1 day/week.
• Consume adequate levels of calcium and vitamin D.  Foods that are high in calcium include dairy products, fortified oatmeal, soybeans, canned salmon with edible bones, and broccoli.  The best way to get vitamin D is by sun exposure, about 15 minutes per day.  Vitamin D-fortified cow's milk and soy milk are other sources of the vitamin.
• Avoid smoking and excessive alcohol consumption.
• Discuss your bone health and risk for developing osteoporosis with your physician.  He/She may suggest a bone density test, supplementation, and/or medication.

Note:  Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for or who currently have chronic health conditions.

Resources:

The 2004 Surgeon General's Report on Bone Health and Osteoporosis

The National Osteoporosis Foundation (www.nof.org)