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Got Milk, Supplements, Weight-Bearing Workouts?

Posted on: Monday, 23 May 2005, 15:00 CDT

VITAL STATS

* Women and men of all ages susceptible to brittle bone disease

Osteoporosis myth No. 1: The bone disease occurs only in people old enough to be your parents or grandparents.

Osteoporosis myth No. 2: Men aren't affected by it.

Osteoporosis myth No. 3: You can't do anything about it once you have it.

The facts are that people of all ages can be diagnosed with osteoporosis, though it is more likely to occur in women after menopause when estrogen levels drop; that about 20 percent of those with the disease are men, according to the National Osteoporosis Foundation; and that bone can be built up.

That's why early detection of thinning bones -- before full- blown osteoporosis sets in -- is better than waiting for disability to occur from the breakage of brittle bones.

Early detection can lead to improved bone density with prescribed medication, says Dr. Elliot Pierce, medical director of the Osteoporosis Diagnostic Center in Albuquerque.

"We can build the bone back up," he says. "We have drugs that will increase bone mass."

The first step to early detection is a baseline bone mineral density scan, he says. A scan is important because outward symptoms of thinning bones are scarce.

The scan at Pierce's office uses a radiological imaging exam, or a dual-energy X-ray absorptiometry, with an instant vertebral assessment, which provides two more images of the spine to check for unrecognized fractures. The process uses less radiation than walking through an airport's metal detectors, says center spokeswoman Cheryl Everett.

Depending on the results and where a person falls on the scale that predicts the severity of bone loss, a T-scale, doctors may recommend treatment or subsequent exams to understand the rate of bone loss. The T-scale uses the average bone density of a 30-year- old and measures an individual's density by comparison, so a score of less than a negative one is within a normal range. A minus 1.1 to minus 2.5 indicates osteopenia, or the beginning of thinning bones, and minus 2.6 and more indicates a diagnosis of osteoporosis.

Low numbers may mean bone loss or low bone density to begin with, Pierce explains.

A close watch

Donna Ridenour recently underwent a second bone scan because she doesn't like the way her neck is beginning to curve.

"Even my hairdresser noticed it," says the 54-year-old McIntosh woman. Her mother had osteoporosis and a telltale hump in her spine. "So I have a family history."

But she has few other risk factors. She doesn't smoke or drink to excess and had a diet rich in dairy products while growing up, she says. "The only thing I'm probably not as good as I should be is with the exercise. I don't get as much of that as I need."

A baseline bone scan five years ago showed marginal loss.

"People should get screened for osteoporosis, just like they get a mammogram or a pap test," Ridenour says.

Pierce agrees. "The big message we're trying to get through here is that everyone older than 50 should have a bone scan."

Most insurance covers a bone density scan. Pierce's office works with primary care physicians to secure referrals for patients who want scans. And his office offers a discounted scan rate of about $170 for people without insurance.

Among the risk factors for thinning bones are declining hormones. In men, that means loss of testosterone; in women, estrogen. A slight frame, being of Asian or Caucasian heritage, a broken bone after age 40, calcium or vitamin D deficiency, cortisone use for more than three months and lack of exercise are also risk factors.

Gary Montague, who was recently diagnosed with osteopenia, says he thinks his bone loss could have started as many as 15 years ago when one of his hips started bothering him. He had a diagnostic bone scan recently because he is two inches shorter than he used to be.

Finding treatment

Two of the most commonly used medications to treat osteoporosis are in the class of drugs called bisphosphonates.

One, approved by the Food and Drug Administration, is marketed as Fosamax. In clinical trials, Fosamax increased bone density by as much as 8 percent, according to the FDA. The other is Actonel.

Beyond drugs, nutrition and exercise play critical roles in keeping bones healthy, says Pierce.

"Boomers' kids need a diet that's high in calcium," he says. "I'm recommending ice cream." And he says it's important that teens don't switch from milk to sodas as they grow older.

As for boomers, they should take 500 milligrams of calcium three times a day, he says. "Everyone should take that much." He explains that the body can't absorb more than 500 milligrams at a time and that to increase absorption the supplement should be taken with food.

Additionally, adults should take 800 international units of vitamin D daily. Healthy bones also require about 800 micrograms of folic acid.

The minimum amount of exercise necessary to maintain bone health is 30 minutes of weight-bearing exercise three times a week. But Pierce says that doesn't necessarily mean lifting weights. Swimming isn't a weight-bearing exercise and bicycling is a limited weight- bearing exercise.

"Walking is a great weight-bearing exercise," he says. "Walking and swinging some hand weights is great."

Source: Albuquerque Journal

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