It’s been called the "silent disease" because it develops slowly over a period of years without symptoms. The first sign may be a fracture or the discovery that you’re two inches shorter than you were at age 21.
Osteoporosis is so silent that, while it’s the most commonly diagnosed bone disease in American women, it’s also the most under-diagnosed, according to a recent study published in the American Journal of Public Health. In a review of data from the National Ambulatory Medical Care Survey, researchers at the University of Massachusetts found that fewer than 2 percent of women aged 60 and older who were surveyed showed diagnoses of osteoporosis on their charts. In comparison, it’s estimated that 20 to 30 percent of American women over 60 actually have osteoporosis and that up to 50 percent eventually will suffer an osteoporosis-related fracture sometime in their lifetime.
At greatest risk for osteoporosis are older white and oriental women who are petite or thin and who experience early menopause. However, older men and women of all races and ethnic groups also are at significant risk of osteoporosis. Lifestyle factors that increase one’s risk of low bone density include cigarette smoking, excessive alcohol consumption, inadequate calcium intake and too little exercise.
While the most important years for laying down bone mass are in the first 20 to 35 years of life, there are several lifestyle and therapeutic measures middle-aged and older adults can follow to improve or at least slow down the deterioration of bone health. These include:
- Exercise regularly. Research has shown that a sedentary lifestyle is conducive to bone loss and that regular, weight-bearing exercise, such as walking or jogging for at least 30 minutes most days of the week, helps strengthen bone mass. Note that with any exercise program, it is important to start slowly, build gradually and stay within your limits.
- Eat right. Most adult women consume about 500 milligrams of calcium a day, less than half of the 1,000-1,200 mg experts say we need each day. You can increase your dietary intake of calcium by eating more dairy products, fish with tiny edible bones, legumes, and certain dark green vegetables. Among the dark green, leafy vegetables, broccoli, kale, and collard, mustard and turnip greens are the best sources of calcium. Tofu, when made with calcium sulfate, and calcium-fortified orange juice also are good sources of calcium. Supplements are a possibility, but can be a double-edged sword. Because of this, it’s best to consult with your doctor or dietitian about how much calcium you’re already getting and which types of supplements would be best for you.
- Avoid cigarettes and excess alcohol. Smoking and high intake of alcohol have been associated with an increased risk of osteoporotic fracture.
- Consider estrogen-replacement therapy. With menopause comes a sharp drop in estrogen levels and an increase in bone loss. Women lose 10 to 15 percent of their bone mass in the first 10 years following menopause. If you’ve gone through or are going through menopause, ask your doctor about estrogen and other new therapies. Estrogen treatments can reduce bone loss. However, those treatments also may have side effects.