Osteoporosis Alison Mesler

What is Osteoporosis??? A condition in which bone tissue decreases Our bodies are constantly building new bone and removing older bone From birth through young adulthood, more bone is built than removed After maturity is reached at age 30-40, the amount of bone removed gradually outnumbers the amount formed Osteoporotic bones have a “moth eaten” microscopic appearance -> “Porous bone” This condition usually first appears in the bones of the forearm and spine Healthy Osteoporosis

“Stats” As of 2000, 10 million Americans had osteoporosis Another 18 million at risk Although age and gender are a risk factor, this disorder is no longer considered age or gender-dependent

Characteristics: An Overview “Silent disease” Many times, bone loss occurs without symptoms Dowager’s Hump Restricted movement Increased fractures

Characteristics: “Dowager’s Hump” The humped back that results in decreased height due to vertebral collapses. “Crush fractures” or “spine compression fractures” occur when weakened bones of the spinal column, compressed by body weight and gravity, collapse. Bending forward to make a bed or to lift a casserole from the oven can be enough to weaken a vertebrae.

Characteristics: Fractures Osteoporosis rears its horns by increasing susceptibility to fractures of the hip, spine, & wrist. 1 in 2 women will have an osteoporosis-related fracture 1 in 8 men A women’s risk of hip fracture = breast + uterine + ovarian cancer risk

Risk Factors: Age Most cases are diagnosed between a person’s 50’s-60’s Older women who are approaching or have passed menopause Bone loss accelerates at this time because estrogen deficiency produces an increase in bone turnover where osteoclastic activity predominates If an individual doesn’t reach peak bone mass during growth, osteoporosis may occur without accelerated bone loss. After your mid-30s, you begin to loose bone mass. Women lose bone mass faster after menopause, but it happens to men too. -U.S. Office of the Surgeon General

Risk Factors: Men vs. Women 8 times more common in women than men- partially because women have less bone mass to start with Around ages 45-50, women suffer wrist fractures 10 times more often due to vulnerability from osteoporosis Women who recently had surgical removal of the ovaries are at great risk

Risk Factors: Family History Women who have a family history in their mother, aunts, or sisters are at great risk Those who are genetically predestined can be taught early intervention measures to help resist the consequences.

Risk Factors: Ethnicity (Many risks factors are discovered by studying the correlation between fractures and osteoporosis) By age 65, a quarter of all white women have had 1+ fractures related to osteoporosis African Americans are at much lower risk because they tend to have greater bone mass Hip fractures are three times more common among white women than African American women.

Risk Factors: Some female athletes In some cases, young women who are serious athletes can develop osteoporosis A low caloric intake and excessive exercise can increase risk factors The female athlete triad includes osteoporosis!

Detection: X-ray??? Osteoporosis cannot be detected by x-ray until 30-50% of bone mass has been lost At this point, calcium depletion cannot be reversed

Detection: Bone Mineral Density Test (BMD) Measures bone mass & can confirm a diagnosis of osteoporosis Painless, non-invasive High frequency sound waves or a minimal energy source is passed over the body The data is then evaluated by a computer program Allows physician to see how much bone mass the patient has Gives ~ measure of bone strength If the data suggests osteoporosis, treatment programs can be started.

Case Study- March 10, 03

Case Study For some, Fosamax may help repair bones FDA approved to preserve bone strength and reduce fracture risk 2-year study of 1,200 women “slowed bone loss and restored up to 3.5 percent of lost bone in postmenopausal women ages 45-59” Oral medication Expensive- $1.55 per day

Case Study- Dec. 29, 08

Case Study- Dec. 29, 10

Case Study- BMD

What about “Osteopenia”???

Calcium: Absorption The body’s calcium amount is dependent on the amount absorbed Normally absorb ~25% of the calcium in food Absorption plays a major role in bone structure and osteoporosis prevention Calcium absorption increases from: Increased estrogen The aid of the parathyroid hormone A slightly acidic environment Adequate vitamin D intake Times of need (growth periods- pregnancy, childhood)

Calcium: Reasons for a decrease in absorption Rapid intestinal motility (diarrhea) High fiber intake, phytic acid Excess phosphorus intake Vitamin D deficiency Presence of polyphenols (tannins) in tea Menopause Aging Achlorhydria (lack of stomach acid) A tannin is an astringent, a substance/chemical compound that tends to shrink or constrict body tissues.

Calcium: Regulation Calcitonin Parathyroid Hormone A hormone that may decrease the rate of bone removal Parathyroid Hormone

Prevention: An Overview Maintain healthy body weight Normal menses Moderate protein, phosphorus, sodium, and caffeine intake Adequate diet Weight-bearing physical activities Non-smoker

Prevention: Adequate Diet Meet calcium and vitamin D needs Be aware of the amount of calcium absorbed in foods Spinach is very high in calcium but contains oxalic acid, which binds to the calcium, making in poorly absorbed If you are trying to limit your daily caloric intake, choose low-fat skim milk products Vitamin D is needed to help the absorption Sun exposure allows the body to make it Food sources include vitamin D-fortified milk, some cereals, & salmon (Atlantic)

Prevention: Weight-bearing activities Walking, climbing stairs, jump roping These activities stimulate bone cells to be more active and to produce stronger bones Physically active persons have denser bones Exercises to build other mm. that give support to the body are important too

Prevention: Quit smoking Smoking cigarettes doubles the risk Substances in cigarettes cause chemical and hormonal changes Osteoporosis happens earlier and continues more rapidly in smokers Also, some smokers tend to be underweight. By quitting smoking and maintaining a healthy body weight, osteoporosis can be avoided

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