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Boning Up on Bone Health

by Belinda O’Connell, MS, RD, CDE

What are your plans for retirement? Are you saving for your financial future with an IRA or a work retirement account? Are you watching your fat and cholesterol intake to keep your heart healthy? Are you taking steps to prevent osteoporosis and ensure the health of your bones?

Most of us do not think about the health of our bones very often. We tend to take their supporting presence for granted. But perhaps we shouldn’t. Without strong bones, many daily activities such as grocery shopping, house cleaning, and walking can become increasingly difficult to do.

Osteoporosis, a disease that causes bones to weaken and fracture, can have surprisingly broad effects on the quality and length of your life. Your risk of developing osteoporosis is influenced by your genetic background, your lifestyle, and even your diabetes. Because most people are not aware that they have osteoporosis until bone loss is serious, it is important to take steps to prevent or slow bone loss early, before significant problems occur.

Bone growth and loss
Most people think of their bones as hard, unchanging structures, but this could not be further from the truth. Bone is a living, growing tissue that is continually being broken down and rebuilt. In childhood and adolescence, bone tissue is built more quickly than it is broken down, and there is a net increase in bone mass. Your body builds bone tissue efficiently until about the age of 30, when peak bone mass is reached. Peak bone mass refers to the point when bone mass is at its greatest and bones are at their strongest. After age 30, your body’s ability to build new bone decreases, and your bones begin to break down faster than new bone can be made. This results in a gradual, age-related loss in total bone mass. In women, loss of bone mass is accelerated by menopause, when the ovaries stop producing estrogen, a hormone that prevents bone loss. But men develop osteoporosis, too.

Although some loss of bone mass is a natural part of aging, when bone tissue is lost too quickly, or rebuilding of bone is too slow, osteoporosis can develop. Osteoporosis is more likely to occur in people who do not reach their maximum potential bone mass when they are young. Reasons for not reaching maximum potential bone mass include poor nutrition (particularly inadequate calcium and vitamin D intake), chronic or prolonged illness, and drug side effects.

Osteoporosis can affect any bone, but fractures of the wrist, hip, and spine are most common. One in two women and one in four men over age 50 will have an osteoporosis-related fracture in their lifetime. Hip fractures usually require surgery and hospitalization to repair, and they can permanently reduce mobility. In fact, 85% of people who have had a hip fracture cannot walk unaided across a room six months later. Degradation or collapse of spinal bone tissue can also decrease mobility and is often very painful. Since many fractures occur when a person falls, taking steps to prevent falls can reduce the risk of bone fractures.

Risk factors for osteoporosis
Approximately 10 million Americans currently have osteoporosis and another 34 million are at high risk for developing the disease because they have decreased bone mass. Factors that affect risk of osteoporosis include the following:

Genetics. Your genes influence your peak bone mass and your rate of bone loss as you age. Genetics may also influence how likely you are to experience a bone fracture. If your parents or grandparents had osteoporosis, you are at high risk of developing it too. You can’t change your genes, but you can control other risk factors for osteoporosis.

Sex. Women are four times more likely than men to develop osteoporosis. This is because women tend to have smaller bones than men and because hormonal changes in menopause dramatically increase the rate of bone loss. Women can lose up to 20% of their bone mass in the five to seven years following menopause.

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