I was asked to comment on a piece recently published in the L A Times which noted that cycling, and swimming to some degree, are sports which keep you in shape but are low impact, put little mechanical stress on the skeleton, possible contributing to decreased bone mass. Osteoporosis.
So what is osteoporosis? Essentially it means porous bone, a condition that diminishes bone mass and density. Your bones are not static. They are constantly remodelling related to the stress they undergo. Although we’re used to seeing the sequelae of osteoporosis in the elderly manifesting itself as hip, wrist and spine fractures…why grandma keeps getting shorter…but, in truth, as we age bone formation often doesn’t keep pace with bone loss. In women, this bone loss accelerates after menopause. It’s been noted that in the decade following menopause that women can lose one fifth of their bone density! Definition-wise, osteopenia is diminished bone density, osteoporosis the actual disease state. In osteoporosis, fragility fractures fractures can occur from the simplest of causes, a minor fall, even just sneezing. In fact, I’ve had patients over the years with broken hips certain that the hip “just broke” before they fell. I believe them!
The potential for osteoporosis affects 55% of Americans over the age of 50, 10-12,000,000 already being affected. 80 plus percent are women, although it’s more prevalent in Caucasian females than black and Hispanics. Of concern is the fact that estimates put the number of hip fractures alone at 297,000 in 2005. And, and average of 24% of hip fracture patients over the age of fifty die in the year following their fracture. Those in the risk group might include:
1) Being female
2) Older
3) Diminshed size (and weight)
4) Positive family history
5) History of previous fractures
6) Diet low in calcium and/or vitamin D
7) Inactive lifestyle
8) Smoking
If your doctor feels it appropriate, tests can be obtained which measure bone mineral density. Until then, what do you do? Get regularweight bearing exercise, avoid smoking and excess alcohol, consume the recommended allowances of calcium and vitamin D (We know that vitamin D comes from the sun and I’ve taken a vitamin D supplement for years, particularly in the winter.) Be aware that this may be an issue for you and discuss it with your health care provider.
Prevention, as usual, is the best medicine.