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Make No BONES about It!

June 2007
Make No BONES about It!

Without our bones, where would we be? They hold up our bodies and, along with our muscles. Yes, they are heroes—but it is our job to keep the heroes strong. Otherwise, the result can be osteoporosis, a disease that causes bones to become full of holes, making the body like a house attacked by termites. And just like termites, osteoporosis can be stealthy and sneaky as there are not many indications of its progression within the body. Not surprisingly, the consequences of the disease can be grave. Weakened bones cause falls. Consider this: twenty percent of elders who suffer a broken hip die within a year.

Not just a disease of older women, osteoporosis also strikes men, and in fact begins its course in children as well. According to the 2004 Surgeon General's Report on Bone Health and Osteoporosis, half of all Americans over 50 will have weak bones by the year 2020 if they don't adopt lifestyle changes. Already, 10 million individuals have osteoporosis, and 34 million more are believed to have low-bone mass.

When we're young, more bone tissue is added than removed. However, we reach maximum bone density and strength by age 25. After that, it's a constant game of catch-up.

Many things—some of which are beyond our control—weaken our bones. A family history of fractures or osteoporosis puts one at greater risk. So does being a Caucasian or Asian woman with a small bone structure. Risks increase with age: women can lose up to 20 percent of their bone mass in the five to seven years following menopause. Certain medications weaken bones. For example, when asthmatics take corticosteroids, the drugs can interfere with calcium absorption, facilitate calcium loss, and decrease bone formation. Medications can also impede the production of hormones, thus facilitating bone loss, and cause muscle weakness, leading to falls.

Lifestyle factors, on the other hand, are more within our control. Being underweight increases risk of fracture and bone loss, partially because less padding of muscle and fat exists to protect bones. Both smoking and excessive alcohol affect the health of bones in many ways: vitamin absorption is impaired; hormone levels are affected along with the bones' ability to heal and there is an overall reduction of bone mass.

Bone Savers

Diet and exercise go a long way in prevention of osteoporosis. Calcium plays a vital role in building and maintaining bones, yet most Americans don't get enough of it. Between ages 9 and 18, we need a calcium intake of 1,300 mg per day; an adult of age 18 to 50 needs 1,000 mg; and after age 50, it's 1,200 mg. However, only one in five girls ages 9 to 19, and about half of boys, get enough calcium! The Mayo Clinic reports an alarming rise in children's forearm fractures, compared with 30 years ago. Children today drink more sugary sodas, not only packing on the pounds but also substituting for vital water and calcium-rich milk. Replace sodas with three to five servings daily of bone builders: dairy products, sardines and canned salmon with bones, dark green leafy vegetables, soybeans, and calcium-fortified foods. Calcium supplements may be advisable (check with your pharmacist for drug interactions). Try taking half in the morning and half at night, since calcium is best absorbed in amounts of 500 mg or less at a time.

Vitamin D, made by your skin when you're in the sun, helps your body absorb calcium. The daily requirement increases as you get older: 200 IU until age 50; 400 IU from ages 51 to 70; and 600 IU from age 70 on. Milk and other foods are fortified, but consider supplementation, with caution, for example in winter and for the elderly.

Being physically active is also crucial for children and adults. Weight-bearing exercises such as walking, racquet sports, or aerobics are particularly helpful—so are strength and balance training, such as lifting weights, yoga and Tai Chi. If you've been sedentary, see your doctor before beginning any exercise program.

When the Bone Breaks

While osteoporosis provides no early symptoms, the following signs often indicate its progression: low back pain, neck pain, bone pain or tenderness, loss of height, stooped posture, and, of course, fractures.

How can you learn the health of your bones before you break one? Talk to your doctor and evaluate your risks. If you've already experienced a fracture, particularly after age 50, that's a "red flag." Then let your bones talk to you: consider a bone mineral density (BMD) Test, which uses X-rays or sound waves to measure bone strength. It's quick, safe, painless, and precise.

The Surgeon General's Report advises all women 65 and older to have a BMD test. If you're at increased risk for osteoporosis, asthmatic or menopausal, for example, have one sooner. If you're diagnosed with osteoporosis, your doctor may recommend one of many available treatment agents. However, calcium and vitamin D must still be consumed along with prescribed medications.

It's never too early or too late to build up your bones so they don't fall prey to osteoporosis.

This article was compiled and partly written by guest writer, Mayuri Mulji, a Certified Personal Trainer (AFFA) and a Personal Wellness and Weight Management Consultant.

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