Osteoporosis Overview

Facts and Figures Osteoporosis is a major public health threat for 28 million Americans, 80% of whom are women.

In the U.S. today, 10 million individuals already have osteoporosis and 18 million more have low bone mass, placing them at increased risk for this disease.

One out of every two women and one in eight men over 50 will have an osteoporosis-related fracture in their lifetime.

More than 2 million American men suffer from osteoporosis, and millions more are at risk. Each year, 80,000 men suffer a hip fracture and one-third of these men die within a year.

Osteoporosis can strike at any age.

Osteoporosis is responsible for more than 1.5 million fractures annually, including 300,000 hip fractures, and approximately 700,000 vertebral fractures, 250,000 wrist fractures, and more than 300,000 fractures at other sites.

Estimated national direct expenditures (hospitals and nursing homes) for osteoporosis and related fractures is $14 billion each year.

What is Bone?

Bone is living, growing tissue. It is made mostly of collagen, a protein that provides a soft framework, and calcium phosphate, a mineral that adds strength and hardens the framework.This combination of collagen and calcium makes bone strong yet flexible to withstand stress. More than 99% of the body's calcium is contained in the bones and teeth. The remaining 1% is found in the blood.

Throughout your lifetime, old bone is removed (resorption) and new bone is added to the skeleton (formation). During childhood and teenage years, new bone is added faster than old bone is removed. As a result, bones become larger, heavier, and denser. Bone formationcontinues at a pace faster than resorption until peak bone mass (maximum bone density and strength) is reached around age 30. After age 30, bone resorption slowly begins to exceed bone formation. Bone loss is most rapid in the first few years after menopause but persists into the postmenopausal years. Osteoporosis develops when bone resorption occurs too quickly or if replacement occurs too slowly. Osteoporosis is more likely to develop if you did not reach optimal bone mass during your bone building years.

Risk Factors. Certain factors are linked to the development of osteoporosis or contribute to an individual's likelihood of developing the disease. These are called "risk factors." Many people with osteoporosis have several of these risk factors, but others who develop osteoporosis have no identified risk factors. There are some risk factors that you cannot change, and others that you can:

Risk factors you cannot change:

Gender - Your chances of developing osteoporosis are greater if you are a woman. Women have less bone tissue and lose bone more rapidly than men because of the changes involved in menopause.

Age - the older you are, the greater your risk of osteoporosis. Your bones become less dense and weaker as you age.

Body size - Small, thin-boned women are at greater risk.

Ethnicity - Caucasian and Asian women are at highest risk. African-American and Latino women have a lower but significant risk.

Family history - Susceptibility to fracture may be, in part, hereditary. People whose parents have a history of fractures also seem to have reduced bone mass and may be at risk for fractures.

Risk factors you can change: Sex hormones: abnormal absence of menstrual periods (amenorrhea), low estrogen level (menopause), and low testosterone level in men.

Anorexia.

A lifetime diet low in calcium and vitamin D.

Use of certain medications, such as glucocorticoids or some anticonvulsants.

An inactive lifestyle or extended bed rest.

Cigarette smoking.

Excessive use of alcohol.

Prevention

To reach optimal peak bone mass and continue building new bone tissue as you get older, there are several factors you should consider:

Calcium. An inadequate supply of calcium over the lifetime is thought to play a significant role in contributing to the development of osteoporosis. Many published studies show that low calcium intakes appear to be associated with low bone mass, rapid bone loss, and high fracture rates. National nutrition surveys have shown that many people consume less than half the amount of calcium recommended to build and maintain healthy bones. Good sources of calcium include low fat dairy products, such as milk, yogurt, cheese and ice cream; dark green, leafy vegetables, such as broccoli, collard greens, bok choy and spinach; sardines and salmon with bones; tofu; almonds; and foods fortified with calcium, such as orange juice, cereals and breads. Depending upon how much calcium you get each day from food, you may need to take a calcium supplement.

Calcium needs change during one's lifetime. The body's demand for calcium is greater during childhood and adolescence, when the skeleton is growing rapidly, and during pregnancy and breastfeeding. Postmenopausal women and older men also need to consume more calcium. This may be caused by inadequate amounts of vitamin D, which is necessary for intestinal absorption of calcium. Also, as you age, your body becomes less efficient at absorbing calcium and other nutrients. Older adults also are more likely to have chronic medical problems and to use medications that may impair calcium absorption.