Osteoporosis is a metabolic bone disease characterized by low bone mass, which makes bones fragile and susceptible to fracture. Osteoporosis is known as a silent disease because symptoms and pain do not appear until a fracture occurs. Without prevention or treatment, osteoporosis can progress painlessly until a bone breaks, typically in the hip, spine, or wrist. A hip fracture can limit mobility and lead to a loss of independence, and vertebral fractures can result in a loss of height, stooped posture, and chronic pain. The disease predominately affects women, due to their having a lower bone density than men.
Although African American women tend to have higher bone mineral density (BMD) than white women throughout life, they are still at significant risk of developing osteoporosis. The misperception that osteoporosis is only a concern for white women can delay prevention and treatment in African American women who do not believe they are at risk for the disease.
• Osteoporosis is underrecognized and undertreated in African American women.
• As African American women age, their risk for hip fracture doubles approximately every 7 years.
• African American women are more likely than white women to die following a hip fracture.
• Diseases more prevalent in the African American population, such as sickle cell anemia and lupus, can increase the risk of developing osteoporosis.
• African American women consume 50 percent less calcium than the Recommended Dietary Allowance. Adequate intake of calcium plays a crucial role in building bone mass and preventing bone loss.
• As many as 75 percent of all African Americans are lactose intolerant. Lactose intolerance can hinder optimal calcium intake. People with lactose intolerance often may avoid milk and other dairy products that are excellent sources of calcium because they have trouble digesting lactose, the primary sugar in milk.
Many risk factors can lead to bone loss and osteoporosis. Some of these things you cannot change and others you can.
Risk factors you cannot change include:
• Gender. Women get osteoporosis more often than men.
• Age. The older you are, the greater your risk of osteoporosis.
• Body size. Small, thin women are at greater risk.
• Ethnicity. White and Asian women are at highest risk. Black and Hispanic women have a lower risk.
• Family history. Osteoporosis tends to run in families. If a family member has osteoporosis or breaks a bone, there is a greater chance that you will too.
Other risk factors are:
• Sex hormones. Low estrogen levels due to missing menstrual periods or to menopause can cause osteoporosis in women. Low testosterone levels can bring on osteoporosis in men.
• Anorexia nervosa. This eating disorder can lead to osteoporosis.
• Calcium and vitamin D intake. A diet low in calcium and vitamin D makes you more prone to bone loss.
• Medication use. Some medicines increase the risk of osteoporosis.
• Activity level. Lack of exercise or long-term bed rest can cause weak bones.
• Smoking. Cigarettes are bad for bones, and the heart, and lungs, too.
• Drinking alcohol. Too much alcohol can cause bone loss and broken bones.
Osteoporosis is called the “silent disease” because bone is lost with no signs. You may not know that you have osteoporosis until a strain, bump, or fall causes a bone to break.
Exams and Tests
An examination to diagnose osteoporosis can involve several steps that predict your chances of future fracture, diagnose osteoporosis, or both. It might include:
• an initial physical exam
• various x rays that detect skeletal problems
• laboratory tests that reveal important information about the metabolic process of bone breakdown and formation
• a bone density test to detect low bone density.
Before performing any tests, your doctor will record information about your medical history and lifestyle and will ask questions related to:
• your risk factors, including information about any fractures you have had
• your family history of disease, including osteoporosis
• your medication history
• your general intake of calcium and vitamin D
• your exercise pattern
• for women, your menstrual history.
In addition, the doctor will note medical problems and medications you may be taking that can contribute to bone loss, including glucocorticoids, such as cortisone. He or she also will check your height for changes and your posture to note any curvature of the spine from vertebral fractures, which is known as kyphosis.
Treatment for osteoporosis includes:
• A balanced diet rich in calcium and vitamin D
• An exercise plan
• A healthy lifestyle
• Medications, if needed.
Possible complications include:
• Compression fractures of the spine
• Disability caused by severely weakened bones
• Hip and wrist fractures
• Loss of ability to walk due to hip fractures
When to Contact a Medical Professional
Osteoporosis prevention begins in childhood. The recommendations listed below should be followed throughout life to lower your risk of osteoporosis.
• Eat a well-balanced diet adequate in calcium and vitamin D.
• Exercise regularly, with an emphasis on weight-bearing activities such as walking, jogging, dancing, and weight training.
• Live a healthy lifestyle. Avoid smoking and, if you drink alcohol, do so in moderation.
Talk to your doctor if you have a family history of osteoporosis or other risk factors that may put you at increased risk for the disease. Your doctor may suggest that you have your bone density measured to determine your risk for fractures (broken bones), and measure your response to osteoporosis treatment. The most widely recognized bone mineral density test is called a dual-energy x-ray absorptiometry, or DXA test. It is safe and painless, a bit like having an x ray, but with much less exposure to radiation. This test can measure bone density at your hip and spine.
Stand tall against osteoporosis. No matter what your age, it’s never too late to stop bone loss now for better posture and fewer fractures down the road. According to research or other evidence, the following self-care steps may be helpful:
What You Need To Know:
• Pump it up
Make weight-bearing exercise a regular habit to increase bone density and prevent osteoporosis
• Cut the caffeine
Avoid excessive calcium loss in the urine from by switching to healthier beverages
• Aim for lifelong calcium and vitamin D nutrition
An extra 800 mg of calcium and 400 to 800 IU of vitamin D a day can help protect the bones of people at any age
• Get your soy
Make tofu, soy milk, soy protein, and other sources of beneficial isoflavones a regular part of your diet
• Fine-tune your protein
Too much or too little protein in your diet may increase osteoporosis risk
• Watch the salt
Avoid excessive salt intake and high-salt processed and restaurant foods that may contribute to calcium and bone loss
These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading the full osteoporosis article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.