January 1998

Building Bone Will Pay Off
by Charlotte Armstrong

Breaking a bone may not seem like a life-threatening event. But for an 80-year-old, a hip fracture is just that. Returning to health--and to the life and mobility someone knew before the fracture--is an uphill battle.

Fractures of the hip and other bones due to osteoporosis are of particular concern to women. They are the ones most likely to develop this disease--the thinning of bone that, with age, greatly increases the risk of fractures. At a talk at the National Institutes of Health in Bethesda, Maryland, Dr. Ethel Siris, Director of the Toni Stabile Center for the Prevention and Treatment of Osteoporosis at the Columbia-Presbyterian Medical Center in New York City, outlined some of the measures women can take to prevent osteoporosis and reduce the risk of fractures.

No matter what a person's age is, everyone needs enough calcium and enough vitamin D. Between the ages of 25 and 50 men and women need about 1,000 milligrams (mg.) of calcium every day, about the amount in three eight-oz. glasses of milk. After menopause, a woman needs 1,000 mg. a day of calcium if she is taking hormone replacement therapy (HRT), but 1,500 mg. if she is not. Vitamin D is necessary to absorb calcium. For older adults who don't get enough vitamin D from their diet or from being outdoors in the sun, a multi-vitamin can help.

View larger image


appleTake as much calcium as you need--not more.

appleIt's best to get your calcium from food; if you can't, use calcium supplements.

appleDo not take more than 500 or 600 mg. of calcium at a time.

appleIt's best to take calcium carbonate supplements after a meal--stomach acid helps you absorb calcium. (Calcium citrate can be taken on an empty stomach.)

After menopause, a woman loses bone--even if she had plenty of calcium and vitamin D before. HRT can reduce her increased fracture risk by 50 to 70 percent. HRT consists of estrogen coupled with progestin, says Dr. Siris; however, if a woman has had her uterus removed, she can take estrogen alone. HRT also protects against heart attack, the most common cause of death in women. Research is under way that will eventually provide a more complete picture of both the benefits and the risks of HRT than we have today. In the meantime, each woman must decide for herself on whether or not to take HRT, after talking it over with her doctor.

Doctors can use a scanning method called dual energy x-ray absorptiometry (DEXA) to measure bone mass. This way they can identify if a woman is at increased risk for osteoporosis or already has it; in either case, she would have a higher than normal risk of fracture. Alendronate, a drug that belongs to a class of agents called bisphosphonates, can increase bone mass. The drug has been shown to reduce the risk of hip, spine, and forearm fracture and has been approved for use in treating and preventing osteoporosis. Other treatments for osteoporosis include the hormone calcitonin. Scientists continue to search for other therapies.

"Osteoporosis" said Dr. Siris, "is not an inevitable part of aging. There are ways to diagnose, treat, and prevent osteoporosis." --an NIH HEALTHWise report, January 1998

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) sponsors research on osteoporosis and other bone diseases and disseminates health and research information. For information on NIAMS, visit the web site at http://www.nih.gov/niams/. NIAMS also funds a national resource center on osteoporosis. To find out more about the materials available and to order printed publications contact:

Osteoporosis and Related Bone Diseases-National Resource Center
1150 17th St., N.W.--Suite 500
Washington, DC 20036-4603
Phone: 202-223-0344 or 1-800-624-BONE
TTY: 202-466-4315
Fax: 202-223-2237
Web address: http://www.osteo.org/.

Check out the Center's on-line publication on osteoporosis at http://www.osteo.org/osteo.html.

The National Institute on Aging (NIA) conducts research on the aging process and age-associated diseases, including osteoporosis. Information about publications on aging, health care, and diseases that are more common with age is available at NIA's health information web site at http://www.nih.gov/nia/health/health.htm. NIA has an on-line Age Page fact sheet on osteoporosis at http://www.nih.gov/nia/health/pubpub/osteo.htm. You can order print copies of the fact sheet by contacting:

NIA Information Center
P.O. Box 8057
Gaithersburg, MD 20898-8057
Phone: 1-800-222-2225
TTY: 1-800-222-4225

For more information, contact:

Charlotte Armstrong
Writer/editor, NIH
Phone: 301-496-8855
Fax: 301-496-0019
E-mail: Charlotte_Armstrong@nih.gov


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