Mind, Body, & Spirit
Maintaining a Balance of Health & Wellness
Osteoporosis is a disease of the bone characterized by low bone mass and microarchitectural deterioration of the bone tissue, leading to bone fragility and an increase in the risk of fracture. Calcium and Vitamin D are needed for bone maintenance. "Calcium is found in dairy products like milk, cheese, and yogurt. Vitamin D helps us to absorb the calcium," explains Mary Ann Clement, MSN, CRNP, of Pinnacle Health at Seidle Hospital, Osteoporosis Center.
"Women need from approximately 1,200 to 1,500 mg. daily of calcium," says Clement. The amount of calcium in the bones, where the body stores 99% of its calcium, decreases with osteoporosis causing bones to lose density. Women especially need proper levels of calcium and Vitamin D — they account for 80% of the nearly 24 million Americans who suffer from the disease.
Osteoporosis leads to 1.5 million fractures, or breaks, per year, mostly in the hip, spine and wrist, and costs $10 billion annually, according to the National Osteoporosis Foundation. Osteoporosis affects almost half of all women over 50 and almost 90% of those over 75.
Surprisingly, younger women may already have risk factors that will not show up until later in life. "I advise women 35 and older to begin early screening," Clement says. She recommends a screening device called Accudexa to measure a woman’s bone mineral density. "It’s simple. We insert the non-dominant hand into a small device. With low dose x-ray we measure the bone mineral density of primarily the middle finger," Clement says. Before the test, women fill out a short questionnaire in order to identify any existing risk factors. This screening is available through Pinnacle Health Womancare Resource Centers.
"This is really a disease that affects all people," said Anne Klibanski, MD, Harvard Medical School. Osteoporosis, she points out, is a disorder that can occur throughout life, in childhood, adolescence, young adult life, and well into old age. "You have to start considering these issues in childhood," Klibanski says. "In terms of preventing osteoporosis, you can’t start doing that if you have a patient who is 55. You have to think about adequate nutrition, adequate vitamin supplementation, adequate calcium, the importance of physical activity, and the importance of adequate weight."
There are many reasons for women to identify as early as possible if they have a calcium deficiency. By the time women reach the age of 60, between 25 to 60% will develop spinal compression fractures. By age 90, one third of all women will experience a hip fracture. Annually, there are about 500,000 spinal fractures, 300,000 hip fractures, 200,000 broken wrists, and 300,000 other fractures. Most of these fractures, about 80%, occur from relatively minor falls or accidents.
"Steroid therapy is a factor in lowering bone mineral density," explains Clement. Women may be on steroid therapy for colitis, an autoimmune disorder, or for arthritis. "Smoking or excessive alcohol intake doesn’t help either," Clement mentions.
Early menopause or surgical menopause caused by removal of ovaries puts women at an even greater risk. Bone tissue loss also affects some young women who do not experience their periods for three months or longer. Women with eating disorders like anorexia may also be at risk because their nutritional balance has been disturbed for a long period of time or if their lack of body fat alters menstruation. The overall poor nutritional status does not promote healthy bones.
Drinking three or more caffeinated beverages daily can affect your bones. High sodium intake interferes with calcium retention; the higher the level of sodium the more calcium the body needs to meet its daily requirements. Young athletic women who keep strenuous exercise schedules may have lower estrogen levels, a factor that can lead to early bone loss.
"Early screening and detection of risk factors are important in order to prevent osteoporosis," says Clement. Apparently, it is. Only 50% of the women who suffer fractures ever return to the previous level of functioning after a hip fracture.