People usually think of osteoporosis as the little old lady’s affliction, but brittle bones and stooped shoulders are not exclusive to elderly females. And, despite being referred to as the dowager’s hump, neither is the hunched back that is often a hallmark of the disease. Osteoporosis develops in women and in men of all ages. In fact, men are at greater risk for osteoporosis than they are for prostate cancer.

Osteoporosis does appear more often in middle-aged and older women; one in two over age 50 will break a bone because of it. This does not make the consequences any less devastating for the one in four men who are also affected. Osteoporosis increases the likelihood of suffering a fall that results in a life-altering and, sometimes, deadly fracture. To reduce the risk of osteoporosis in their later years, women and men must take precautions now.

What is osteoporosis?

Healthy bones are a dense conglomeration of protein, collagen and calcium. The body continuously replenishes this material until around the age of 35, at which point bones start losing density. Loss of bone mass happens to everyone, but with osteoporosis, what is a natural occurrence of aging becomes extreme. Bones turn porous, thin and easily break. This can happen after a fall, but sometimes all it takes is a cough or a sneeze. The hip, spine and wrist are particularly susceptible to osteoporosis-related fractures, but any bone can be affected. People who have osteoporosis often lose several inches of height. They may also develop severe back pain.

Osteoporosis is silent in the early stages. Often, it is only after they suffer a fracture that people learn they have the disease. By then, the likelihood of making a full recovery is slim, particularly when the fracture is in a hip. According to the American Academy of Orthopaedic Surgeons and the American Association of Orthopaedic Surgeons (AAOS), hip fractures are responsible for 350,000 hospital admissions every year and 60,000 nursing home admissions. Twenty-four percent of hip fracture patients die within a year of the injury. Half lose the ability to walk and spend the remainder of their lives in wheelchairs and in pain. According to the AAOS, medical care related to osteoporosis currently costs the United States $17 billion a year. With people living longer, this figure will continue to increase.

Why does osteoporosis develop?

Osteoporosis is a consequence of estrogen loss. This can occur for a number of reasons. Sometimes there is a genetic component. People are more at risk if there is a maternal history of osteoporosis or if they are Caucasian or Asian. Certain medications and drug therapies can also increase risk. For example, chemotherapy can cause bones to thin. So can taking a glucocorticoid medication (sometimes called corticosteroids) for treatment of inflammatory arthritis. Because estrogen loss is part of the aging process, osteoporosis eventually becomes a risk for everyone. Estrogen loss is acute after menopause, leading to frequent occurrences of osteoporosis in older women. In men, the decrease in estrogen is gradual, which makes them more likely to be older when they are afflicted. Men are also twice as likely as women to die after a hip fracture.

In women and in men, risk factors and behaviors that increase the likelihood for osteoporosis include:

• A parent who suffered from osteoporosis
• Smoking, excessive alcohol use, low calcium intake, inadequate physical activity
• Prolonged use of steroids like prednisone or cortisone that are used for treating asthma or arthritis, as well as anticonvulsants, certain cancer treatments and aluminum-containing antacids
• Chronic diseases affecting the kidneys (including kidney stones), lungs, stomach and intestines
• Low levels of testosterone in men (men convert testosterone to estrogen to build bone mass)

Steps taken now can help prevent a future without osteoporosis later:

• Eat a diet rich in calcium and vitamin D (low-fat milk, yogurt, cheese and calcium-added orange juice, cereals and breads)
• Do weight-bearing exercises like walking, jogging, dancing, climbing stairs and lifting weights
• If you drink alcohol, drink in moderation
• Quit smoking

It is also important for everyone to undergo osteoporosis screening. Early detection can reduce your risk for suffering a debilitating fracture. Talk to your health care provider about the appropriate time to have a bone density test. The National Osteoporosis Foundation recommends bone density testing for:

• Women age 65 or older
• Men age 70 or older
• Anyone who breaks a bone after age 50
• Women of menopausal age with risk factors
• Women under age 65 with risk factors
• Men age 50-69 with risk factors

Osteoporosis cannot be cured, but with lifestyle changes and medication, you can reduce your risk or, if you have the condition, keep it from progressing.

The LHSFNA’s training manual, Nutrition & Fitness for Laborers, and the Nutrition & Fitness for Laborers and Build a Better Body brochures are designed to help Laborers improve their dietary and exercise habits and can reduce their risk for osteoporosis. Order these materials through the LHSFNA’s website by clicking on Publications.

[Janet Lubman Rathner]