No Bones About It: Prevention of Osteoporosis in Women
By Kelly P. Rainwater, MD
Florence OB/GYN Associates, PA
This article was first published in Health View, February 2001.
Mom always told you that an ounce of prevention was worth a pound of cure. Mom was right - especially when it comes to preventing osteoporosis.
"Osteoporosis, which literally means 'porous bones,' is a debilitating disease resulting from a gradual loss of mineral or calcium, from your bones," says Kelly P. Rainwater, MD, an obstetrician/gynecologist on staff at Carolinas Hospital System. "Calcium is a critical element in our blood, contributing to muscle contraction, beating of the heart and clotting of blood. When the blood calcium level drops, your body takes more calcium out of the bones to maintain the appropriate level." The result is osteoporosis, the breakdown of bones that occurs as the body attempts to supply its own calcium, a process that leaves bones soft and vulnerable to injury and fracture.
"As a person grows during youth, bones are metabolically active and calcium is deposited into bone faster than it is taken out. These bone deposits peak at about age 35, the time when bones are most dense and strong. During the late thirties, calcium begins to be lost from bones faster than it is replaced, and bones become less dense. This process occurs naturally and quite gradually. For women, this process is compounded by the fact that at about age 45, women begin to absorb less calcium from food (this doesn't occur in men until past age 60) making it harder to maintain the appropriate dietary intake of calcium," says Dr. Rainwater.
"Osteoporosis, which occurs in 15 to 20 million people in the United States, is considered to be a contributing factor to more than 1.3 million fractures each year in women 45 years or older (70 percent of all fractures in this age group). The most common sites for osteoporotic fractures are the wrist, spine and hip. Although it occurs in men, osteoporosis is much more common in women," says Dr. Rainwater.
Medical advances are providing new treatment options for those already suffering with osteoporosis, but it is universally agreed that the best solution is the prevention of the disease.
Scientists have identified several measures that may help reduce the physical toll of osteoporosis, including:
- Estrogen Replacement There is well-documented evidence of the effectiveness of estrogen replacement in the prevention of fractures and osteoporosis.
- Adequate Intake Of Dietary Calcium According to Dr. Rainwater, the recommended daily allowance for women is between 1000 mg and 1500 mg daily. "Unfortunately, studies indicate that the average intake for women in the United States is less than 500 mg. It's important to talk with your doctor to determine your personal calcium needs, which vary with age, lifestyle and general health," says Dr. Rainwater. "For example, post-menopausal women not taking estrogen will require higher amounts of dietary calcium than pre-menopausal women. Pregnant women will require much more calcium - around 2000 mgs daily." It is also recommended that women under 19 years of age have a daily intake of 2000 mgs, in order to maintain a peak calcium level. This will aid in the prevention of osteoporosis.
- Building A High Peak Bone Mass Through adequate dietary intake throughout life and an active lifestyle that includes regular weight-bearing exercise, women can increase their peak bone mass. This denser bone mass will lessen the impact of the gradual loss of calcium that occurs naturally, reducing the risk for osteoporosis later in life.
"Exercise is an important part of prevention and treatment of osteoporosis. It's clear that inactivity leads to bone loss," says Dr. Rainwater. "Research has shown us that patients who are restricted to bedrest lose bone mineral at an accelerated rate."
"Weight-bearing activity seems to be an important component," continues Dr. Rainwater. "Several studies have revealed that astronauts living in a weightless environment lose bone mass at an accelerated rate." As a result of this information, doctors encourage patients with osteoporosis to remain as physically active as possible, incorporating weight-bearing exercise such as walking, jogging, or tennis or weight training.
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