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Osteoporosis is called a silent thief because it works steadily and in hiding for years, robbing bones of their strength.
“It’s a disease that comes in under the radar, starting when people, especially women, are in their 30s,” says Vincent Killeen, M.D. “If it goes untreated, it doesn’t stop until the bones are too brittle to support the weight of the body.”
Killeen is a gynecologist and obstetrician who leads Bayside Health, a practice in Lewes and Georgetown. He starts talking about bone health with patients in their 20s and 30s before the damage is done. “In almost all cases, osteoporosis is totally preventable,” he says.
The Rx is simple and inexpensive: “Take calcium. Take vitamin D. Do weight-bearing exercises.”
Still, more than 3 million women in the U.S. are diagnosed with the disease every year. More women are hospitalized with injuries related to brittle bones than for heart attacks and breast cancer combined, according to a study published in the Journal of Bone and Mineral Research. One of four women hospitalized for a hip fracture will die within a year.
Women over age 50 are at higher risk for osteoporosis and osteopenia, a thinning of the bones that leads to osteoporosis if it is not treated. But the decline in bone density starts much sooner, at about age 30.
For years, bone loss is imperceptible. As the condition progresses, it results in back pain, hip pain and the stooped posture known as dowager’s hump, the result of multiple tiny fractures in the spine.
“Your bone should look like a nice sponge,” Killeen says. “With osteoporosis, it looks like a cobweb.”
There are lots of medications that treat osteopenia and osteoporosis, so seeking treatment is essential. What goes in the shopping cart matters, too. The doctor suggests skim milk, collard greens, orange juice fortified with calcium and vitamin D, and other bone-friendly foods.
Vitamin D is mandatory because our bodies can’t process calcium without it. It’s called “the sunshine vitamin” because the sun is the major source of vitamin D.
“We have all been scared away from going out in the sun, but a few minutes a day can do us some good,” Killeen says. “In Delaware, we have access to healthy foods and sun all year around.”
For women who already have developed osteoporosis or osteopenia, the sun never sets on chances to prevent further bone loss and rebuild new bone.
Prolia is a treatment of osteoporosis in postmenopausal women who are at a high risk for fractures. It’s an antibody produced in the laboratory that deactivates the body’s bone-breakdown mechanism. It is given by injection twice a year. Other medications, taken by mouth or injection, also have
proven effective in treating the disease.
“We have seen lots of patients who have made dramatic improvements,” Killeen says. ‘This is one disease process where the patient can take the reins and play a role in whether she will be playing tennis when she is 70—or sedentary and riding around on a scooter.”
Anyone can develop osteoporosis. But the people most likely to lose bone density are fair-skinned white women over age 50.
A study at the University of Delaware says diabetes also impacts bone health. The good news is that regular exercise can help to mitigate the damages in milder cases of diabetes.
“Clinical trials have revealed a startling elevation in fracture risk in diabetic patients,” Liyun Wang, associate professor of mechanical engineering at UD, said in a statement. “Our work demonstrates that diabetic bone can respond to exercise when the hyperglycemia is not severe.”
Laura Kraman, founder of E-volve Fitness Studio in Wilmington, says she works with a number of women in their 40s who are focused on bone health.
“Sometimes they have mothers who have osteoporosis and are very frail,” she says. “They don’t want to get that way. They want to get strong.”
Kraman coaches women in weight bearing exercises such as dead lifting and resistance training.
“Exercise improves bone density,” she says. “It also builds the muscles, tendons and ligaments that support the bones. And you don’t have to train for hours and hours every day. Even a half hour of strength training three times a week is beneficial.”
She also recommends exercises that mimic real life.
“I teach people the proper way to lift something and put it down, without rounding your back. Or how to squat properly to get in and out of a car.”
Water aerobics acts as a form of resistance but isn’t hard on the joints. For women at risk of falling, Kraman trains them in exercises that improve balance.
“There are so many things we can do to improve our bone density,” she says. “We definitely have a say in our own health.”
RISK FACTORS FOR OSTEOPOROSIS
What you can’t control
Age: Being over 50. And the older you get, the more likely you are to develop osteoporosis.
Gender: Women are at far greater risk than men.
Ethnicity: Asian women and white women, especially those of Northern European ancestry, are at greater risk than women of African, Hispanic or Mediterranean descent.
Family history: Having a relative with osteoporosis.
Body build: People with small frames are at increased risk because they have less bone mass to draw on as they age.
Hormonal changes: Decreased estrogen and thyroid and adrenal gland problems are factors.
What you can control somewhat
Anorexia and gastrointestinal surgery: Both reduce the intake of calcium.
Medications: Steroids and some medicines used to treat seizures and cancer interfere with the body’s ability to absorb nutrients, including calcium.
What you can control
What you eat: A diet rich in calcium and Vitamin D decreases the risk of osteoporosis.
An active lifestyle: Weight-bearing exercise and activities that promote balance and good posture are good for your bones.
Curbing alcohol: Imbibing more than two drinks a day increases risk.
Don’t smoke: Tobacco use contributes to weak bones.