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KEEPING BONES HEALTHY

By Dr. Paul Barney

There are 25 million Americans who suffer from significant bone loss or osteoporosis today and as the population ages, the numbers are likely to increase. Eighty percent of these are women; and half of this number are women over the age of 50.

One million fractures directly related to bone loss will occur this year. The cost of hospitalization and rehabilitation is expected to be over 14 billion dollars. Osteoporosis is rapidly becoming one of the most important health issues facing women today.

There are no early symptoms of osteoporosis. It is a progressive problem usually starting in the fourth decade of a woman's life, and generally coinciding with the onset of menopause. In the fifth decade, the rate of bone loss increases significantly and then stabilizes again. Since our bones are not visible, we are not as aware of their slow deterioration until a fracture occurs.

Certain people are at greater risk than others. If you are a woman, you start out with a smaller frame with less bone density than a man and could lose up to a third of your skeletal density by the age of 70. If you are postmenopausal and your mother and grandmother had the condition, chances are good you will too. If you smoked, drank too much coffee or alcohol, than your bones have suffered. If your diet consisted of refined foods, and was high in meat protein and low in vegetables; if it contained inadequate sources of both calcium and other bone-building nutrients, then your bones did not get the nutrition they needed to maintain their health and density. If you are an insulin dependent diabetic, or have had prolonged use of steroids such as Prednisone, your bones will have suffered.

Lack of physical activity also plays an important role in predisposing you to a higher risk of developing osteoporosis. Bones need to be exercised as rigorously as muscles. Prevention plays a key role in minimizing bone loss. It is more important than treatment and more effective. Obtaining maximum bone density is usually done by the age of 35. After that, the bone stabilizes and starts to break down or decreases faster than it grows. To maximize bone density, it is important to have good nutrition including calcium supplementation that should start at an early age.

Girls as young as 12 should start taking calcium supplementation. According to studies on 12-year old girls who met the RDAs of calcium and were supplemented with 500mg of calcium per day, they showed a marked increase in their bone mineralization density (BMD). When it comes to calcium, RDAs should be the minimum and not the goal. I must emphasize the importance of exercise in the treatment of osteoporosis, even after it has started. Exercise that stresses bone such as weight-lifting has been shown to be of most benefit. Both aerobic and weight resistant exercise should be combined. Walking is a good activity but is not adequate to exercise bone. Running is good for the leg bones but may not give the upper body bone structure the stress-bearing exercise it needs.

Bone is a living organism that requires life-long care. We tend to forget it because it is not visible, but it is what holds us up and it will make itself felt if it is ignored.

Let's look at our bone structure for a moment. Our bone is constantly changing, building and breaking down. In medicine we call it bone remodeling. The remodeling consists of two phases called formation (building up) and resorption (breaking down). The bone formation is done by a group of cells called osteoblasts. The bone resorption is performed by another group of cells called osteoclasts. In essence, we have these two groups of cells that work in concert in the body. One builds and one breaks it down in a balanced fashion for the first 40 years of life. For the next 40 or some years, the resorption of bone occurs at a higher rate than the bone formation leading to lost bone density and osteoporosis. Can we do anything to stop this from happening, or arresting and possibly reversing this condition? Studies have shown

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