Prevention of Osteoporosis
Donald Aulds, M.D.
Osteoporosis is an under diagnosed and often untreated disorder of the skeletal system. It has been shown to affect over ten million people in the US and over 80% are women. This disorder along with osteoarthritis accounts for over 30% of office visits to physicians in women over age seventy-five. Approximately one third of all women who are postmenopausal have osteoporosis, which is as much as women with breast, uterine, and ovarian cancers combined. The disease accounts for over 1.5 million fractures yearly resulting in a direct cost of almost 20 billion dollars in nursing home and hospital costs. After a fracture from osteoporosis, the one-year mortality rate is 10-20%, which could be prevented with proper therapy.
What are the risk factors for osteoporosis?
Several risk factors have been associated with osteoporosis. Some factors can be modified while others cannot.
- Race - Caucasian and Asian American women are at highest risk, but all races have reports of the disease occurring. Studies have shown that one out of every two Caucasian women will develop some degree of osteoporosis in her lifetime. While African-American women are at lower risk, their risk increases steadily with advancing age. Hip fractures are associated with higher death rates in African-American women than in Caucasian women.
- Medications and medical conditions - Medications that have been associated with high risk include long-term use of steroids, anticonvulsant medications, anticancer drugs, long-term use of heparin, aluminum, lithium, and others. Medical conditions include amyloidosis, anorexia, Cushing's disorder, gastrectomy, HIV, irritable bowel syndrome, diabetes, lymphoma, rheumatoid arthritis, hyperthyroidism, and weight loss along with other conditions.
- Poor nutrition - This not only includes poor intake of calcium, but also poor intake of protein and other minerals needed for bone formation.
- Lifestyle choices - cigarette smoking, inactive lifestyle, excessive use of alcohol.
- Estrogen deficiency
- Low body weight
- History of fractures after age 50
What can be done to try to prevent osteoporosis?
The approach to prevention is best summed up as a lifestyle that is healthy. The following approach can help to limit that risk for most women.
- A diet rich in calcium and vitamin D - the current USDA recommendation for the daily allowance for calcium at any age is 1000 to 1200 mg of calcium daily and 400 to 800 IU of vitamin D. The vitamin D is essential for proper absorption of the calcium.
- Other minerals - studies have shown that magnesium in the range of 200-400 mg daily can be essential for proper bone health and boron and selenium have been shown to stimulate bone rebuilding.
- Weight-bearing/muscle-strengthening exercise - this plays a major role as studies have shown that inactivity rapidly brings about loss of bone.
- Smoking cessation - there are many programs available to assist in stopping smoking. Talk to your doctor.
- Avoiding excessive use of alcohol
- Testing regime - Studies have shown that bone density testing is a good screening for diagnosis of loss of bone that might eventually lead to osteoporosis. Bone density studies cannot predict whether a person will have a fracture but can tell who might be at risk.
If you have been diagnosed with loss of bone mass, talk to your doctor about the available options. Together, select the best course of action to help control the disorder and diminish your risk of fracture and future health problems.
More about Dr. Aulds
Donald G. Aulds, MD is an Obstetrician and Gynecologist and currently serves as the Medical Director for both the Women's Center and the Best Start Program of North Alabama. He is a Diplomat of the American Board of Obstetrics and Gynecology and Fellow of the American College of Obstetricians and Gynecologists.
Dr. Aulds completed his medical education at Louisiana State University School of Medicine, New Orleans, LA and his Internship and Residency in Obstetrics and Gynecology at Ochsner Medical Foundation, New Orleans, LA.
Dr. Aulds has been an active member of the Huntsville Hospital Medical Staff since 1980.
