KSC Fitness Centers - Osteoporosis

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Osteoporosis

Osteoporosis is known as the "silent disease" that is afflicting millions of Americans. It is considered to be the "silent disease" because it progresses over a lifetime. Many people do not realize they have osteoporosis until they have broken a bone and have to go through a long and slow recovery. According to the Center of Disease Control and Prevention, the definition of osteoporosis is: low bone mass and the structural deterioration of bone tissue leading to bone fragility and increased risk to fractures (CDC, 2005). Although the population greatest affected by this disease is women, the number of men suffering from osteoporosis is steadily increasing. The reason for this increasing number of affected individuals can be attributed to a quantity of factors such as diet, level of physical activity, gender, and genetics. Some ways to fight against this "silent disease" are through early detection, diet, exercise, and medications. However, the main key to fighting osteoporosis and other similar diseases is by prevention.

Why be concerned?
As of 2004, 44 million Americans are suffering from osteoporosis. Women make up 80% of this population. Though women account for the large majority of those affected, the number of men diagnosed with osteoporosis has doubled since the year 2000. In the year 2000, 1 in 8 men over the age of 50 were diagnosed or suspected to have this disease. However, in the year 2004, this ratio significantly increased to 1 in 4 men! (NOF, 2004). The severity of developing this disease must not be overlooked. "It is responsible for more than 1.5 million bone fractures each year in people over the age 50 with hip fractures being the most incapacitating" (NOF, 2004). The recovery time for these types of fractures often take 6 months or more and the level of activity is usually confined to the ability to walk across a small room unassisted. In addition, almost 24 percent of osteoporosis-related fractures result in death within a year of the fracture. Not only is this physically crippling but it is financially crippling as well. The National Osteoporosis Foundation (NOF) reported "the national direct expenditure for hospital and nursing home cost for fractures associated with this disease was approximately $17 billion in 2001, which equates to $47 million each day."

Causes/Risk Factors
Now that a cause for concern has been established, what are the next steps? Well, the first should be identifying the cause and/or risk factors of this disease. The biggest culprit in the development of osteoporosis is the lack of sufficient calcium and vitamin D intakes throughout a person's lifetime. These two components tend to come from an individual's diet, and are important in maintaining bone health. Calcium is the direct component that helps maintain bone tissues. All throughout life the old parts of bone are removed and new parts are formed. However, when an individual does not intake enough calcium to help develop new bone tissue, the density of bone decreases, causing porous bones or osteoporosis (NIH, 2000). When the old bone tissue is disposed of through the kidneys, vitamin D helps to reabsorb it. Therefore, if one lacks this particular component, calcium that could have been recycled is lost. The second culprit would be genetics. However, this cause can be reduced through the proper preventative measures discussed below. The risk factors to being deficient in either two of these components (calcium and vitamin D) are many, and are listed below:

Personal history of fracture after age 50
Current low bone mass
History of fracture in a first-degree relative
Being female
Being thin and/or having a small frame
Advanced age
A family history of osteoporosis
Estrogen deficiency as a result of menopause, especially early or surgically induced
Abnormal absence of menstrual periods (amenorrhea)
Anorexia nervosa
Low lifetime calcium intake
Vitamin D deficiency
Use of certain medications, such as corticosteroids and anticonvulsants
Presence of certain chronic medical conditions
Low testosterone levels in men
An inactive lifestyle
Current cigarette smoking
Excessive use of alcohol
Being Caucasian or Asian, although African Americans and Hispanic Americans are at significant risk as well

* Risk factors developed by the National Osteoporosis Foundation

How to Fight Back
The next steps to fighting this disease are detection and treatment. Unfortunately, there is no .at home. test that an individual can perform. The best way to detect whether or not an individual is at risk or may have osteoporosis is to have a bone mass measurement with a bone mineral density (BMD) test. Either the doctor will recommend this test to patients that may be at risk, or an individual may request it to be performed if he/she has many of the aforementioned risk factors. The procedure for this test is noninvasive, painless, and safe (NIH, 2000). It is very important to know the risk of developing osteoporosis, especially for men whom are often mis-diagnosed.

Once a person has gone through the first couple of steps, there are a number of ways to treat osteoporosis. One course of action to take is through diet management. A person must be sure to intake the proper amount of nutrients. The table below outlines the recommended amount of intakes for particular foods.

Food Pyramid diagram.

Image above: The food guide pyramid.

The foods that tend to be rich in calcium are dairy products, green leafy vegetables, and nuts. In addition, calcium and vitamin D supplements are often recommended if adequate intakes of calcium cannot be established. A person's calcium intake should be as follows:

Ages	Amount mg/day
Birth - 6 months	210
6 months - 1 year	270
1 - 3	500
4 - 8	800
9 - 13	1300
14 - 18	1300
19 - 30	1000
31 - 50	1000
51 - 70	1200
70 or older	1200
Pregnant & Lactating	1000
14 - 18	1300
19 - 50	1000

Table above: Dietary Reference Intakes for Calcium,
National Academy of Sciences, 1997.

A second course of action that one could take to fight osteoporosis is to establish an exercise regimen. Studies have shown that weight-bearing activities, such as resistance training, walking, jogging, hiking, and stair climbing, cause the body to use calcium more efficiently, resulting in healthier bones. The recommended time spent doing these activities should be 30 minutes on most days of the week. Lastly, depending on the severity of an individual's condition, medication is often recommended. The best result for treating osteoporosis is the combination of two or more of these methods.

Prevention is the Key
Although osteoporosis is largely in diagnosed in the elderly, it is a disease that progresses over a lifetime, and prevention must start early in life. A couple of ways to do so are:

Follow the guide for calcium intake throughout a person's lifetime and one will not have to play the game of catch later in life.
Enhance the potential to reach peak bone mass through the proper amount of physical activity.
Take in enough calcium.

No person is ever too young or too old to start developing good habits.

Timika Screven
Fitness Center Intern
Ohio State University

References:
National Institute of Health. (2000, October) Osteoporosis overview. Retrieved April 23, 2005 from Osteoporosis and Related Bone Diseases National Resource Center
http://www.osteo.org/osteo.html.

National Osteoporosis Foundation. (2004) Osteoporosis fast facts. Retrieved April 23, 2005 from
http://nof.org/osteoporosis/

Center for Disease Control and Prevention. (2005, February) Bone health: home. Retrieved April 24, 2005 from
http://www.cdc.gov/nccdphp/dnpa/bonehealth/

Changing Shape. (2000) Food Pyramid. Retrieved April 25, 2005 from
http://www.changingshape.com/resources/references/standardpyramid.asp

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