Osteoporosis Risk Factors: Fact vs. Fiction


Think you know all about osteoporosis? Chances are, some of the things you think you know about osteoporosis risk factors may be wrong. Osteoporosis is a complicated disease, one that we are still learning about. With all the changing information out there, it's easy to get confused.

Here are a few common myths about osteoporosis risk factors.

Fiction: Only women need to worry about osteoporosis.

It's true osteoporosis affects women far more than it does men. About 80% of all osteoporosis patients are women. But that means that men account for 20% of cases -- and since the disease affects 10 million people (and growing), that means 2 million men in the U.S. have osteoporosis right now. Another 3 million have osteopenia, the decline in bone mass that can progress to osteoporosis if not properly treated. Men actually have a greater risk of developing a fracture related to osteoporosis than prostate cancer, and they're nearly twice as likely as women to die in the year following a fracture.

"In older men and women of the same age, women have about 90% of the spine fractures. But men have about one-third of the hip fractures, and that's an awful lot," says Robert Heaney, MD, FACP, a professor of medicine at Creighton University, in Omaha, Neb., and a nationally recognized expert on osteoporosis. He is also an advisory panel member for the National Dairy Council's 3-A-Day of Dairy program. "It's not an exclusively female disease by any means, and men need to take it seriously as well."

Fiction: If you are on an osteoporosis drug, you don't need to worry about getting enough calcium and vitamin D.

You may assume that the drug you're taking to treat your osteoporosis has calcium and vitamin D in it as well -- but that's not necessarily the case. "The drugs can help prevent bone loss, but they don't give you the raw materials -- calcium and phosphorus -- that make up bone minerals. If the body doesn't have that, the drugs can't help it." Heaney told WebMD. Be sure to eat a diet rich in calcium, even if you are taking medication, and ask your physician about osteoporosis drugs that include Vitamin D.

Fiction: It doesn't matter if you get calcium and vitamin D from your diet or from supplements.

It's true that you should get calcium and vitamin D any way you can, and if supplements are the only way you can get them, then it's better to take supplements than miss out on these essential nutrients entirely.

However, study after study has shown that people aren't very good at taking supplements regularly, says Heaney. "But eating is something you do every day, so it's easier to make a habit of dairy consumption. Whether it's milk, yogurt, or cheese doesn't really matter -- they're all good." You can also get vitamin D from the many new fortified foods, like cereals and orange juices, now available.

Second, foods give you more of the nutrients you need than supplements. There are many dietary sources, such as dairy products, that contain many nutrients necessary for bone health, Heaney says. Bone is made of protein as well as minerals, with calcium being a principal one. Many dietary sources contain protein, phosphorus, and many other nutrients necessary for total body health.

Fiction: If you have osteoporosis, it's too late to do anything about it.

"After being diagnosed with osteoporosis, some people think they should just go home and give up. That's a terrible mistake," says Heaney. "We can do a lot to slow the disease and lower the risk of fracture. Getting a diagnosis is a good thing compared with having the disorder and not knowing it, because now you can take steps."

There are a variety of osteoporosis drugs available. Most cannot build new bone -- instead, they slow the rate of bone loss. These drugs include bisphosphonates, hormone replacement therapy, selective estrogen receptor modulators (SERMs), and calcitonin. Your doctor can help you decide which drug is right for you, but it's important to know that these treatments can reduce your risk of spinal fractures by up to 65%, and your risk of fractures elsewhere in the body by up to 53%.

People with osteoporosis don't have to sit at home and stare out the window. Regular weight-bearing exercise has been shown to reduce the risk of fracture, both because it strengthens the bones and because it can help you stay strong and agile and avoid falls. Talk with your doctor about exercise that you can safely do when you have osteoporosis.

Fiction: If you only have osteopenia, not osteoporosis, you don't have to worry about fractures.

"Osteopenia is a complicated thing," says Ethel Siris, MD, director of the Toni Stabile Osteoporosis Center at Columbia University Medical Center and president of the National Osteoporosis Foundation. "In younger postmenopausal women, it does increase fracture risk down the road, but it's not as huge a risk. But in an older person, in their mid-60s or 70s, osteopenia may be a very significant risk factor for a fracture. I know women who say 'My girlfriend has osteoporosis and I only have osteopenia, so I'm better off.' That may or may not be true."

In fact, the majority of fractures occur in people with osteopenia -- although the risk of fracture with osteoporosis is higher, there are so many more people with osteopenia that they have more fractures overall. If your doctor tells you you have osteopenia, treat it as a warning sign -- a chance to practice good bone health by eating a calcium-rich diet (and taking supplements if you need to) and getting regular weight-bearing and resistance exercise.

Fiction: If you've been on an osteoporosis drug but your bone density hasn't gone up, it means the drug must not be working!

Most osteoporosis drugs don't "build bone" -- they slow the rate of bone loss. So if you go in for a bone scan after taking medication for osteoporosis for a couple of years, and your T-score (the measure of your bone density) hasn't changed, that doesn't mean the drug isn't working. "As long as your T-score is stable and hasn't dropped, that implies that the drug is working," says Siris. "What these drugs do is they make the bone stronger and do it fairly quickly, within a year. Even without a dramatic change in bone density, there's a decline in the risk of fractures."

In fact, even a decline in bone density in your first scan after taking medication doesn't necessarily mean you're getting no benefit from the drug you're taking. One study found that women who lost the most bone during the first year of treatment experienced the most improvements in the years afte

Fri, 26 Nov 2010 @14:01

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