Saturday, July 12, 2008

What & How Prevention of Osteoporosis

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What Is Osteoporosis?

Osteoporosis is a bone-thinning disease that could lead to bone fractures. Although older women are more likely to get osteoporosis, older men can get it too, and so can younger people, particularly women. While your bones weaken and thin out as you age, osteoporosis is not a natural part of aging.

Women who have gone through menopause are at greatest risk for osteoporosis because their bodies stop producing estrogen, which protects their bones.

There are other factors besides menopause that could increase your risk for osteoporosis:

* Race – being a white or Asian woman
* Bone structure and body weight – being very thin and/or having a small frame
* Cigarette smoking
* Excessive use of alcohol
* Low lifetime calcium intake
* Vitamin D deficiency
* Abnormal absence of menstrual periods (amenorrhea)
* Medications/chronic diseases – use of certain medications to treat long-term health conditions, such as rheumatoid arthritis, thyroid problems, and seizures
* Family history of osteoporosis – Osteoporosis is a health threat for an estimated 44 million Americans, that is 55 percent of people 50 years and older

About 1.5 million people suffer a bone fracture related to osteoporosis each year.

The most serious kind of fracture for older people is a hip fracture. Every year, hip fractures send 300,000 people to the hospital. One in five people with a hip fracture ends up in a nursing home within a year.

Does Osteoporosis Have Symptoms?

Sometimes people with osteoporosis have symptoms, such as back pain or a bone fracture, but usually there are no symptoms. Some people don’t learn they have osteoporosis until their bones get so weak that a sudden strain, bump, or fall causes a fracture or a vertebra (bones or cartilage in the spine) to collapse. These collapsed vertebrae then produce symptoms such as severe back pain, loss of height, stooped posture, or other spinal defects.

Preventing Osteoporosis

The U.S. Surgeon General recommends a three-pronged approach to protect your bones and lower your risk of getting osteoporosis:

* regular physical activity
* a healthy diet
* regular checkups and screenings

Of course, these three things will also protect your overall health and help you ward off other diseases, such as diabetes, heart disease, and cancer.

Regular Physical Activity. Adults should aim for at least 30 minutes of physical activity a day. Weight-bearing activities (those that put weight on your skeleton) can help prevent osteoporosis, improve strength and balance, and decrease the risk of falling. Walking, jogging, dancing, yoga, and strength training are examples of weight-bearing activities.

A Healthy Diet. Calcium and vitamin D are essential for strong bones. Some good sources of calcium are:

* milk
* cheese
* leafy green vegetables
* soybeans
* yogurt (regular and frozen)
* sardines and salmon

Fortified milk also is a good source of vitamin D. Your body produces vitamin D naturally when your skin is exposed to the sun for a few minutes each day.

Adults under age 50 need about 1,000 milligrams (mg) of calcium daily and 200 International Units (IU) of vitamin D. Adults older than 50 need 1,200 mg of calcium daily and 400 IU of vitamin D (600 IU after age 70).

While food is the best source of calcium, vitamin D, and other minerals and vitamins, supplements can help people who don’t get enough in their diet meet daily requirements. You also can find juice and various foods, such as oatmeal and cereals, fortified with calcium.
Are You at Risk for Osteoporosis?
Take this easy interactive quiz to find out.

Regular checkups and screenings. It’s a good idea to get screened at menopause since that’s when bone loss can start to occur, advises Felicia Cosman, M.D., clinical director for the National Osteoporosis Foundation.

Men and women who have broken a bone after age 50 or have other risk factors also should talk to their doctor about screening, Cosman says. And all women over age 65 should be screened.

A screening, or bone density test, takes about five minutes and doesn’t hurt at all. “You don’t even have to get undressed for it,” says Cosman.

You also should get regular checkups. Ask your doctor to check your medications, as well as your vision. Poor vision and certain medicines that can make you dizzy or drowsy could lead to falls that cause fractures. You also should ask your doctor which medicines are safe for your bones and how you can protect your bones while you’re getting treated for other health problems.

Some people are ‘fast losers’. Their bones weaken rapidly within a short period after loss or withdrawal of estrogen. While this is unpredictable, it may be attributed to the risk factors.

Hormone replacement therapy (HRT) does not free women from the risk of osteoporosis. When women go off HRT, they experience as much bone loss as they would have lost at menopause. Medical experts recommend a bone density test right at menopause or at cessation of HRT if you have risk factors as mentioned above. Otherwise, a bone density test at five years after your last period is sufficient.

Preventing Falls

Since most falls occur at home, it’s also important to make your house as “fall-proof” as possible. Having good lighting inside and outside your home, securing loose carpeting or tiles, installing grab bars in the bathroom and handrails on stairs, and removing electrical cords or other things than can cause you to trip, can reduce your chances of falling.

Frail older people can wear hip pads, which protect the hips from breaking if they should fall.

Other Preventive Measures

If you smoke, quit, and if you drink, do so only moderately (no more than one drink in a day for women and two for men).

Maintain a healthy body weight. It’s important not only for bone health, but for your health overall. Weight loss and being underweight can contribute to bone loss.

How is Osteoporosis Treated?

If diagnosed in time, doctors can treat you for osteoporosis with drugs that help prevent bone loss and rebuild bone, before life-threatening fractures occur.

Getting enough calcium and physical activity are also part of osteoporosis treatment. “These preventive measures are used at all stages of the disease and have been shown to help at all stages,” says Cosman. “It’s never too early or too late to initiate these measures. But the sooner you can take preventive measures, the more likely they are to work.”

Because of health risks associated with hormone replacement therapy, doctors are no longer prescribing hormone replacement or estrogen replacement as a primary treatment for osteoporosis, according to Cosman. “There are lower-dose estrogen regimens being developed that might be quite a bit safer, but there are still a lot of studies that need to be done.”

If you’ve used HRT but have some risk factors for osteoporosis, you should have a bone density test shortly after stopping HRT.

A drug called Raloxifene, or Evista, provides the benefits of estrogen in treating osteoporosis without the harmful side effects. But while it increases bone mass and decreases the risk of spinal fractures, there isn’t enough evidence to show that it also cuts risk of other fractures, such as those in the hip and arm, says Cosman.

Other pills, such as Actonel, work by slowing bone loss to bring it back in synch with bone-building cells that continue to work, though more slowly. There are a variety of drugs to help treat osteoporosis – the main difference is in the frequency of the dose. For example, there is a daily injection, Fortea, which builds back bone in people whose osteoporosis was not diagnosed "in time," and Boniva, a once-a-month pill that slows bone loss and improves bone mass.

The U.S. Food and Drug Administration has approved a drug called Alendronate, or Fosamax, to treat osteoporosis in men, as well as women.

Developing and maintaining healthy bones is a lifelong undertaking that begins in childhood and continues throughout adulthood. But it’s never too late to improve your health. Living a healthy lifestyle and getting regular checkups can help you prevent osteoporosis and a host of other diseases as you age.

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