Sandra T. Labak, D.O.

Family Practice at Dreyer Medical Clinic - Hinckley

Osteoporosis, or “porous bones,” is a condition that causes bones to become weak and brittle. Although it is usually associated with women aged 50 and over, it is never too early or too late to take action against osteoporosis, and it can affect men as well as women.

Bones are constantly remodeling. The body breaks down and absorbs old bone to make way for new and stronger bone. Throughout life, bone mass undergoes many changes. Bone mass refers to the density, or strength, of our bones. During childhood and the teen years, bones add new tissue faster than old bone material is absorbed, so our bone mass increases significantly during this stage of life.

Because of this process, bones continue to grow thicker, heavier, and stronger until a person reaches the ages of 30 to 35. After age 35, however, the process begins to slow naturally and can even reverse, causing the breakdown of old bone to exceed the build-up of new bone. This can cause osteopenia, or low bone mass. Osteopenia, without treatment or modification to lifestyle, leads to osteoporosis.

There are no guaranteed methods to fully protect a person from osteoporosis, because one of the dominant risk factors, family history, cannot be changed. A person can, however, modify his or her lifestyle and put themselves at lower risk for osteoporosis by stopping smoking, increasing weight-bearing exercise, decreasing alcohol and caffeine intake, and altering diet choices. People at increased risk for osteoporosis have the following characteristics:

• Female, especially post-menopausal
• Caucasian or Asian heritage
• Slender, or have a small body frame
• Smoke
• Take corticosteroid medications, thyroid hormones, or diuretics
• Are depressed

If you feel you are at an increased risk for developing osteoporosis, discuss your concerns with your doctor, and try to avoid as many risk factors as possible. Depending on your risk factors, your doctor may suggest you have a bone scan or a bone mass density measurement. There is no set age for having such tests performed. A patient's clinical presentation and history dictate the overall risk for having osteoporosis and the need for a bone scan.

Diet and exercise are two of the most important factors in preventing, fighting, and slowing osteoporosis. Remember to get enough calcium, along with vitamins C and D. (Vitamin D helps the body absorb calcium.) Since the body stores calcium during the day and releases it at night, it is best to take calcium supplements with the evening meal. Although this may sound backwards, concentration gradients and other factors act to prevent excess release of calcium from the bones during the night, while the body works to build bone during the day.

Optimal daily calcium requirements from all dietary sources (food and supplements) as recommended by the National Institutes of Health are:

• Women, ages 25 - 50 = 1,000 mg
• Pregnant or nursing women = 1,200 - 1,500 mg
• Postmenopausal women, 50 -65 = 1,500 mg (1,000 if receiving estrogen)
• Women over 65 = 1,500 mg
• Men over 50 = 1,200 mg

There is no secret to calcium supplementation, and many types are available. The most elemental calcium (calcium carbonate) usually allows the highest bioavailability, or speed of absorption, per gram at the lowest cost. Calcium carbonate supplements like Oscal, Caltrate, Tums, etc. do require stomach acid for digestion and are generally better absorbed by older people when taken with meals. Calcium citrate (Citracal) does not require stomach acid. About the maximum amount of calcium a body can absorb at one time is 500 mg.

Foods high in calcium include yogurt, skim milk, cheeses, salmon, rhubarb, oatmeal, tofu, spinach, and many others, including (luckily) ice cream and chocolate pudding.

Osteoporosis can be a very preventable and treatable condition. Paying attention to the health of your bones while young can help keep them strong and healthy well into the golden years.