Best defense against osteoporosis

Bone up
Knowledge of how to build calcium and an action plan of diet and exercise are your best defense against osteoporosis

Throbbing hip and knee pain are signs your bones are starting to weaken. True or false?

Answer: False. Osteoporosis is a debilitating disease in which bones become fragile and more likely to break. It’s often called the “silent thief,” because it sneaks up on you with no symptoms. Especially in the early stages, there is no pain, aching or inflammation.

“For many people, the first they know they have osteoporosis is when they get a fracture,” says Dr. Enass Rickards, chief of orthopedic surgery at Scripps Memorial Hospital in La Jolla.

Other than waiting until you break a bone, how can you determine if you have osteoporosis or are at risk of the disease?

A. There is no way to know for sure.

B. MRI

C. Bone density test

D. FRAX online questionnaire.

Answer: C and D. A bone density test (also called densitometry or DXA scan) uses special X-rays to measure how many grams of calcium and other bone minerals are packed into a segment of bone. The higher the mineral content, the denser your bones. The test is easy, fast and painless, with no preparation needed. The bones tested are those most likely to break because of osteoporosis, including the lower spine, leg, hip, wrist and forearm. Your doctor will interpret your test results which are presented in T-scores, the number of units that your bone density is above or below what’s expected in a young, healthy adult of your sex.

The U.S. Preventive Service Task Force recommends a bone density test for women 65 and older; men, 70 or older, and anyone over 50 with an increased risk of osteoporosis.

You and your doctor can also assess your risk by using an online tool developed by the World Health Organization called FRAX (Fracture Assessment Risk Tool). It asks your age, sex, weight and height, along with some other information and computes your chances of suffering a major bone fracture in the next 10 years. Check it out at shef.ac.uk/frax

Who is considered at increased risk for osteoporosis?

A. Anyone with a family history of osteoporosis.

B. Anyone who has broken a bone after age 50.

C. Women who went through an early menopause.

D. People taking medications such as prednisone (a steroid), heparin (a blood thinner) and anti-seizure drugs.

E. All of the above.

Answer: E. Besides these risk factors, there are other things that can increase your chances of developing osteoporosis. These include: People with a very small and thin frame, particularly those of Caucasian or Asian race; cigarette smoking and excessive alcohol and caffeine consumption; men with low testosterone; being physically inactive; and poor nutrition and conditions that may cause malabsorption, such as celiac or Crohn’s disease.

Although about one out of every two women will experience an osteoporosis-related fracture at some point in her lifetime, osteoporosis is not just a woman’s disease. How many men are expected to suffer a broken bone due to osteoporosis?

A. One in three men.

B. One in four men.

C. One in five men.

D. One in 10 men.

Answer: C. Twenty percent of osteoporosis cases in this country are men. Men who are at higher risk for the disease include those who smoke, abuse alcohol or take steroids or are past andropause, the age when testosterone levels decline.

Approximately 90 percent of bone mass is acquired by what age?

A. By 14 in girls and 18 in boys.

B. By 18 in girls and 20 in boys.

C. By 24 in both women and men.

D. By 25 in women and 30 in men.

Answer: B. Building strong bones during childhood and adolescence can help to prevent osteoporosis later in life.

“It’s important to encourage children to be as physically active as possible for the development of bone mass, along with agility and coordination,” Einhorn says.

Parents also need to make sure children get a balanced diet with adequate amounts of calcium and vitamin D.

“Young girls are so worried about getting fat that they don’t get anywhere near the appropriate level of (calcium food products),” says Rickert, explaining that we’re constantly making bone and breaking it down. “As we get older, we’re breaking it down faster than we’re making it, and we need increased amounts of calcium.”

After age 35, you stand to lose 1 percent of your bone density a year.

Women at menopause may lose even more as estrogen levels drop.

How much calcium do we need to keep our bones strong?

A. 600 milligrams per day

B. 1,000 to 1,200 milligrams per day for people under 50; 1,200 to 1,500 for anyone older than 50.

C. 2,000 milligrams per day

D. At least three 8-ounce glasses of fat-free milk per day

Answer: B. Calcium needs increase with age. With 99 percent of the body’s calcium stored in the skeleton and teeth, the main role of calcium is to help build bones and increase bone density. When the body is short on calcium, it steals the mineral from your bones.

Foods that are rich in calcium include dairy products, green leafy vegetables, broccoli, bok choy, mustard greens and collards. Also, almonds and hazelnuts are a good source of the mineral. Calcium-fortified foods, including orange juice, cereal, ice cream and soy milk, are also a good source. Supplements can help make up for the calcium you’re not getting in your diet. Calcium intake, in both food and supplements, should be divided up during the day, because the body can’t absorb large amounts of the mineral all at once.

What other natural bone-builder are many people deficient in that’s necessary for bone health?

A. Vitamin A

B. Vitamin B

C. Vitamin D

D. Antioxidants

Answer: C. Although vitamin D is produced in the skin as a result of sun exposure, a deficiency exists even here in sunny Southern California. You can get some of your vitamin D by exposing your arms and legs (not your face) sans sunscreen to the sun for about 15 minutes a day. But, an easier and dermatologically safer way of getting enough vitamin D is to take a supplement.

“We are much more vitamin D deficient than we realized, and we need higher levels (than originally thought),” says Einhorn, who recommends taking 2,000 to 5,000 international units of vitamin D-3 every day. “Vitamin D does more than just help with calcium absorption. It improves bone density, which is a direct effect of the vitamin D itself.”

Besides vitamin D and calcium, make sure your diet has sufficient amounts of some other vitamins and minerals, including: vitamin C, which boosts collagen production and helps calcium absorption; vitamin K, which activates osteocalcin, a protein critical to bone density; and magnesium, which directs calcium to the bones.

Which of these exercises is not especially beneficial to building healthy bones.

A. Walking

B. Swimming

C. Dancing

D. Strength training

Answer: B. While swimming and water aerobics have many benefits, they don’t provide the impact your bones need to slow mineral loss. Weight-bearing exercises, or performing activities with your bones supporting your weight, work directly on the bones in your legs, hips and lower spine to slow mineral loss. Because swimming is not a weight-bearing exercise, it does little to improve bone density or strength.

When you run or jump or lift weights, bones respond to the stress by producing more osteoblasts or cells that fill in bone cavities. The result is improved bone density.

Although balance training doesn’t build bones, it can help increase stability and help prevent falls.

“Weight-bearing exercise is the best, but any exercise is of some value,” Einhorn says. “Find an activity that you will do regularly. Something with intensity that also comes with pleasure.”

According to the U.S. surgeon general, you need at least 30 minutes of weight-bearing or resistance exercise most days of the week for bone health.

We usually count on medicine to help alleviate a health problem. However, for many of the 44 million Americans who have osteoporosis or are at risk for it, the latest drugs may hurt more than they help.

Bone-building drugs called bisphosphonates (Fosamax, Actonel and Boniva) can cause nausea, gastrointestinal problems and severe muscle pain in some patients. In more rare cases, extended use of the drugs can lead to deterioration of the jawbone and fractures of the thighbone.

“Because there are many side effects, these are not drugs that are easily taken,” says Mary Ellington, director of orthopedics at Sharp HealthCare.

For those osteoporosis patients who can tolerate and choose to take the drugs, the benefit seems to plateau after a while. In the future, doctors may recommend that patients “take a holiday” from these drugs after four or five years, according to Ellington.

For these reasons, some doctors are advising patients to get back to basic bone health practices instead of relying only on drugs to treat the disease.

“Drug therapy for osteoporosis can be a problem, so try to avoid it if at all possible,” says Dr. Daniel Einhorn, clinical endocrinologist at Scripps Memorial Hospital in La Jolla. “It’s much better to use nutrition and exercise (to help prevent or treat) osteoporosis.”

Because May is Osteoporosis Awareness and Prevention Month, it’s a good time to bone up on bone health and test your knowledge with our osteoporosis quiz.

source: signonsandiego