Osteoporosis: How Much Do You Know?

Osteoporosis is a disease in which the bones become brittle. It is the most common bone disease and affects both men and women. It is a progressive disease that frequently goes undetected until a fracture occurs. It is characterized by low bone mass and thinning bone tissue, making the bones look more porous than normal, hence, quite brittle. The principal sites of osteoporotic fractures are the spine, hip and wrist. Do not ignore fractures that occur at other sites.

Both men and women need to educate themselves about the risks of this disease and take preventive measures to avoid osteoporosis. Swimmers, although we are very active and exercise almost daily, are not receiving the maximum benefits of exercise for our bones. Yes, the muscles are tugging on our bones to stress them, but not nearly as well as weight bearing exercise, for example: running, walking, hiking or dancing.

Medical technology makes accurate testing for osteoporosis available for early detection and ultimately prevention. The following are some of the risk factors for osteoporosis from the National Osteoporosis Foundation:

Non-modifiable:
o Personal history of fracture as an adult.
o History of fracture in first-degree relative.
o Caucasian race.
o Advanced age.
o Female sex.
o Dementia.
o Poor health/frailty.
Potentially modifiable:
o Current cigarette smoking.
o Low body weight (less than 127 pounds).
o Estrogen deficiency.
o Early menopause (age 45 or earlier) or bilateral ovariectomy.
o Prolonged pre-menopausal amenorrhea (more than 1 year).
o Low calcium intake (lifelong).
o Alcoholism.
o Impaired eyesight despite adequate correction.
o Recurrent falls.
o Inadequate physical activity.
o Poor health/frailness.

Below are 6 statistics that we should all be aware of:
1. The average adult takes in 450-650 mg of calcium per day but it is recommended to take 1000-1500 mg/day.
2. We tend to lose bone mass density at 0.5% to 1% per year after the age of 30.
3. A woman's risk of developing osteoporosis doubles every 5 years after menopause (age 50).
4. Approximately 1 in 2 women over age 50 will experience an osteoporotic hip fracture in her lifetime, with the risk dramatically increasing with age.
5. One in 8 men over age 50 will experience an osteoporotic fracture during his lifetime.
6. On the average a man loses 20-30% of his total bone mass in his lifetime; a woman loses 30-40%.

Preserving Bone Health:
- Eliminate or reduce risks: tobacco, alcohol, caffeine and steroid use.
- Alcohol damages osteoblasts, making it difficult for these cells to build new bone.
- It is known that excess caffeine promotes calcium loss into the urine via the kidneys (conflicting evidence about how much is detrimental).
- The average person loses 100-250 milligrams of calcium into the urine each day.
- The greatest calcium loss in urine after drinking caffeinated coffee occurs within the first 3 hours after drinking coffee; this loss can be minimized if calcium intake is at least 600 milligrams per day.
- Ingesting more than 1000 milligrams per day of caffeine markedly increases calcium loss in the urine.
- How much is too much caffeine? More than 400 milligrams per day (approx 3-4 cups of coffee) has been deemed the "critical point" by pharmacologists.
- Use extreme caution walking on slippery surfaces (pool decks & locker rooms); improper or poorly fitting footwear may increase your risk of falling.
- Foot problems can increase risk of falling.
- Due to age-related bone loss, most women & many men in their seventies are at risk for fractures from falls.

Vitamins & Minerals role in your body:
- Calcium's role in the body is to provide strength and hardness to the structural framework.
- Vitamin D's role in the body: help calcium to be absorbed in the intestines; help keep calcium levels in body balanced.
- Ninety-five percent of body's calcium is in your bones.
- Calcium is also necessary for muscle contraction, regular heart beat, proper brain and nerve functions, kidney function, teeth to be hard, and blood to clot.
- Bone acts as a reservoir for calcium.
- It is agreed by clinicians world wide that the single most important thing you can do to prevent and treat osteoporosis is to obtain adequate calcium & Vitamin D, especially early in adolescence and continuing throughout one’s life.
- Healthy bones require healthy eating habits.

Exercise information:
- Abdominal breathing increases capacity to take in oxygen & encourages relaxation.
- Exercise essentials: warm up, stretch, and cool down.
- Weight bearing exercise + strength training + balance + posture exercises = strong bones.
- Unfortunately aquatic exercise (vertical or horizontal) does not seem to give the same bone building benefits as weight bearing or working against gravity on dry land. Why is this important? The increased stress load on the hip with weight bearing exercises improves hip strength (walking, slow jogging, running, hiking, stair climbing, dancing).
- Note that there are special exercise considerations if you have osteoporosis; see your doctor, or health care practitioner.

Women and Estrogen:
- Risks of taking estrogen include: breast cancer, uterine bleeding, heart attack and stroke.
- Benefits include: stronger bones and relief of menopausal symptoms.
- Make an informed decision with your health care provider.

Internet sites for more information:
American Society for Bone & Mineral Research: www.asbmr.org.
Foundation of Osteoporosis Research & Education: www.fore.org.
International Society for Clinical Densitometry: www.iscd.org.
The North American Menopause Society: www.menopause.org.
Osteoporosis National Resource Center: www.osteo.org.
Osteoporosis Links: http://www.docguide.com/news/content.nsf/PatientResAllCateg/Osteoporosis?OpenDocument.
National Osteoporosis Foundation: www.nof.org.

Source: Cole, Raymond E: Osteoporosis: Unmasking A Silent Thief: 2000.

Sara Quan, Fitness Co-Chair of the Oregon LMSC

This month's article was written by Sara Quan, co-chair of Fitness for the Oregon LMSC.