Osteoporosis isn't always just part of getting older

August 03, 1993|By Carey Quan Gelernter | Carey Quan Gelernter,Seattle Times

No, it's not just a "normal part of aging" to lose height, become stooped or get hip fractures.

And yes, there are ways, if you're still younger, to prevent osteoporosis -- the thinning of bone that causes these problems. And, if you're older, there are ways to slow the loss.

A recent poll found that three out of four women at high risk for osteoporosis say their doctors have never discussed it with them.

Dr. Charles Chestnut III, director of the Osteoporosis Research Center, University of Washington School of Medicine, says too many physicians still believe that it's an inevitable part of aging, which is untrue.

Yet this is a serious problem, with one out of two women -- and one in five men -- at risk of developing the devastating fractures associated with osteoporosis. A woman's risk of suffering a hip fracture is equal to her combined risk of developing breast, uterine and ovarian cancer.

Those most seriously at risk are women whose family members had it. (Not sure? Did your grandmother, aunt or mother lose several inches of height? Were they stooped, or have a hip fracture? If so, they probably did have the disease.) Here's some advice from Dr. Chestnut and others on how to prevent or lessen the impact of osteoporosis:

For younger women:

A woman forms her most mature and dense bone before age 35. So that's when you want to make as much bone as possible to ensure you go into older years with an adequate skeleton.

As early as the teen years, start ensuring adequate calcium intake -- 1,200 to 1,500 milligrams a day. After adolescence, take at least 1,000 milligrams a day of calcium.

The calcium can come either from foods such as dairy products (e.g., there are 300 milligrams in a glass of nonfat milk) or from supplements.

Through the 30s, it will help your bones to avoid behavior that leads to lowered bone mass: smoking, drinking too much.

Through the 40s, it will help to avoid behavior that leads to loss of menstruation, including excessive exercise and the eating disorders of bulimia and anorexia. In contrast, moderate exercise, which doesn't affect menstrual periods, is protective of bone.

For older women:

Rapid bone loss occurs within five years of menopause because of a decrease in estrogen production; this tends to taper off in the 60s and 70s. Keep up the calcium: Studies show women will lose 2 percent to 3 percent bone mass per year if they don't take calcium; if they take calcium, they don't gain but they also don't lose.

Post-menopausal women should decide whether to take estrogen, which is protective of bones and the heart but also is associated with a smaller but significant increase in chances of breast cancer.

If bone density is high, exercise, calcium and "clean living" may be enough without estrogen to prevent fractures.

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