As people age, their bones grow more porous and brittle - indeed, the word “osteoporosis” means “porous bone.” Women are particularly vulnerable - when estrogen levels drop at menopause, the decrease in bone density is dramatic.

Bone density is formed during a person’s 20s and 30s, and depends partly on heredity and partly on how active a person is at that age.

Peak bone density occurs at age 16 in women, age 20 in men. So female teenaged couch potatoes, especially those who smoke and think exercise is for jocks, will be particularly at risk in their senior years.

According to Osteoporosis Canada (www.osteoporosis.ca), a charitable organization, almost 2 million Canadians now are living with OP. One in four women and at least one in eight men over 50 have the disease, which can result in fractures, usually of the wrist, spine and hip bones. Fractures of the hip, especially, typically lead to a seriously decreased quality of life and, in some cases, death.

In 1993, Canadians suffered some 25,000 hip fractures. Eighty percent of hip fractures are osteoporosis-related, and end in death in up to 20 percent of cases.

But it’s never too late to do something about OP, say the experts, including those at the Mayo Clinic (www.mayoclinic.com).

First step: ask a family doctor for a bone density test. Depending on the results, exercise and dietary changes may be recommended, as well as some drugs, to increase bone density. Be aware that only “weight-bearing” exercise, such as walking, jogging and resistance training, builds new bone; swimming and cycling do not.

Osteoporosis Canada recently lowered its recommended calcium requirements for people 50 and better to 1,200 mg a day, down from 1,500 mg, according to Tanya Long, National Education Manager for the Toronto-based organization. Recommended vitamin D intake is from 800 to 2000 IUs day. Long says it is preferable to get as much calcium as possible from food, rather than supplements.

“One of our key messages is understanding fracture risk,” she added. Bone density is only one of many risk factors for fractures. Others include being 65 or older; a history of spine compression fracture; a fracture with minimal trauma (such as a broken wrist) after age 40; a family history of fracture (especially if the person’s mother had a hip fracture); long-term (more than three months) use of drugs such as prednisone; medical conditions such as celiac disease and Crohn’s disease; and primary hyperparathyroidism.

There is also a family of pharmaceuticals designed to counter osteoporosis called “bisphosphonates.” They must be taken following very specific instructions. Following these allows the body to absorb the drug properly and may help minimize side-effects. Because calcium interferes with their absorption, calcium supplements must not be taken with bisphosphonates, but at another time of day. Talk to a doctor about side-effects.

Recent evidence from a Toronto research team suggests that, in addition to exercise, vitamin D and calcium, women at risk for OP should be consuming lycopene, an antioxidant found in tomatoes, papaya, watermelon and red carrots (sometimes found at farmers’ markets). Between 30 mg - the equivalent of two glasses of tomato juice - and 70 mg a day are recommended.

The recommended amount of calcium for those over 50 is 1,200 mg, accompanied by at least 800 IUs of vitamin D, or as much as 2000 IUs, to help its absorption.
A cup of milk contains 300 mg of calcium, while three-quarters of a cup of plain yogurt contains, on average, 290 mg.
An Extra Strength Tums tablet contains 300 mg of elemental (bioavailable) calcium, and five tablets taken throughout the day with meals (900 mg) is the recommended dose.
One cup of milk contains 100 IUs of vitamin D, so a supplement is usually required.

JANUARY 2011 SENIOR LIVING MAGAZINE VANCOUVER ISLAND
JANUARY 2011 SENIOR LIVING MAGAZINE VANCOUVER & LOWER MAINLAND