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Growing risk of osteoporosis detailed
By The Associated Press;LAURAN NEERGAARD
Friday, October 15, 2004
NWASHINGTON - Half of Americans older than 50 will be at risk of fractures from too-thin bones by 2020, the surgeon general warned yesterday, urging people to get more calcium, vitamin D and exercise to avoid crippling osteoporosis.
The bone-thinning disease is on the rise as the population grays, but weak bones aren't a natural consequence of aging, Surgeon General Richard Carmona stressed.
Strong bones begin in childhood, and years of eating right and physical activity can leave even 80-somethings with sturdy bones. Unfortunately, Carmona said, too few Americans follow that prescription, setting the stage for worrisome increases in broken hips and other fractures as more people pass 50.
"Osteoporosis isn't just your grandmother's disease," Carmona said in releasing the first surgeon general's report on bone health. "We all need to take better care of our bones."
Osteoporosis affects an estimated 10 million Americans, and each year, about 1.5 million suffer a fracture as a result. An additional 34 million Americans have less severe bone-thinning but enough to risk a fracture.
By 2020, about 14 million people older than 50 are expected to have osteoporosis and 47 million more will have low bone mass, the report predicts.
Women are at highest risk, especially white women, and particularly after menopause when estrogen - which helps keep bones strong - plummets. But osteoporosis affects men, too, and people of all races.
It's underdiagnosed because many people don't know their bones are thinning until one breaks. But often doctors are just as guilty in overlooking the risk, even forgetting to check bone density when middle-age or older patients have fractures.
Consider hip fractures. About 20 percent of senior citizens who suffer one die within a year, partly because the break often triggers a downward spiral of inactivity, depression and other problems. Yet the report cited one study that found fewer than one-quarter of hip-fracture patients were given calcium and vitamin D supplements to help build up their bones or a bone-density test to check the severity of their bone-thinning.
Bone health is a balancing act: Cells called osteoclasts dissolve worn-out bone while other cells called osteoblasts form new bone. Peak bone formation occurs before age 30, and then the bone-building cells can gradually slow down over the ensuing decades.
While risk rises with age, other factors can thin bones sooner.
A number of drugs treat osteoporosis, by slowing bone's breakdown or pushing new bone formation. But Carmona said the focus must be on preventing thinning bones, not on medication.
Among his recommendations:
• Eat enough calcium and vitamin D starting in childhood. Recommended amounts vary by age, but the average adult younger than 50 needs about 1,000 milligrams of calcium and 200 international units (IU) of vitamin D each day. That rises to 1,200 mg of calcium and 400-600 IU of vitamin D after 50.
• Adults need at least 30 minutes of physical activity a day, and children 60 minutes, including weight-bearing activities that improve bone strength and balance.
• All women older than 65 - and any man or women who has even a minor fracture after 50 - needs a bone-density test.
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