Osteoporosis, a term that means porous bone, is a disease of the bones characterized by low bone mass and fragile bones. Osteoporosis increases the risk of fractures, especially in the bones of the hip, spine, and wrist. Contrary to popular belief, osteoporosis affects both men and women. Osteoporosis affects 44 million Americans, about 70% of them women—10 million already have the disease and 34 million have low bone mass putting them at risk for osteoporosis. Half of all women and one man in four over 50 will have an osteoporosis-related fracture in their lifetime.

Bone is living tissue that is both flexible and strong. Bone is made up mostly of collagen, a protein that provides a soft framework of connective tissue. Calcium phosphate is a mineral that hardens the framework and adds strength. New bone is continually being built and old bone is being removed. During childhood and young adulthood, new bone is added faster than old bone is removed; as a result, the skeleton becomes heavier, larger, and denser. Peak bone mass occurs at about age 30. After age 30, bone resorption (breakdown) slowly begins to exceed bone formation, causing bones to lose mass. Osteoporosis is more likely if optimal peak bone mass is not achieved during bone-building years. For women, bone loss is fastest in the first few years after menopause and continues into the postmenopausal years.

There are several risk factors beyond control. These include: gender, women are at greater risk because bone loss increases after menopause; age, bones become thinner and weaker with age; body type, thin, small women are at greatest risk; ethnicity, Caucasian and Asian women are at greatest risk; and family history. Other risk factors can be controlled including: hormone levels, low estrogen levels in women and low testosterone levels in men contribute to osteoporosis; anorexia nervosa, an eating disorder, is a risk factor; low calcium and vitamin D intake; long-term use of certain medications including glucocorticosteroids and anticonvulsants increase bone loss; lifestyle, inactivity and prolonged bed rest make bones weaker; cigarette smoking and alcohol abuse increase bone loss.

Osteoporosis prevention involves reaching optimal bone mass and continuing to build bone as you age. Several factors are involved in preventing osteoporosis. Low calcium intake contributes to osteoporosis. Surveys show that many people consume less than half the calcium they need to achieve maximum bone mass. Recommended amounts of calcium intake increase from 210 mg/day for newborns to 1300 mg/day at age 9. Good dietary sources of calcium include low-fat dairy products, dark green leafy vegetables, sardines, and fortified foods. Vitamin D is important for calcium absorption and bone health. Vitamin D is made by the skin when exposed to sunlight, but often supplementation is necessary to ensure daily intake of 400 to 800 IU to maintain healthy bones. Exercise is vital to building and maintaining strong bones. Avoiding tobacco and excessive alcohol consumption also is important for bone health.

Many medications are used to treat osteoporosis. Bisphosphonates (Fosamax®, Actonel®, and Boniva®) and Evista® (a selective estrogen receptor modulator) are among the most commonly used. Recently reports of jaw bone loss associated with use of bisphosphonates have raised concerns about their safety. Although rare with oral forms of the drugs, patients taking these medications should inform their dentist if they are taking bisphosphonates to prevent osteoporosis.

Reference: http://www.niams.nih.gov/bone/hi/overview.htm.

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