Own Your Bone Health
By Susan Bean, M.D., Vice President and Medical Director, Healthfirst
Osteoporosis has been called the silent disease since people tend to discover they have low bone density only after a fracture occurs. I’d like to lay out a few key facts about bone health to help shine some light on this topic.
Today, more than 50 million people have either low bone mass or osteoporosis. Every day 5,500 fractures occur, which adds up to about two million broken bones every year due to osteoporosis. Another startling statistic is that 25 percent of all people who have a hip fracture pass away within a year of the fracture. In short, osteoporosis is a very devastating disease.
To find out more about bone health, I spoke with David Lee, director of the National Bone Health Alliance. The National Bone Health Alliance is a public-private partnership launched in 2010 that brings together expertise and resources to collectively promote bone health and prevent disease; improve diagnosis and treatment of bone disease; and enhance bone research, surveillance and evaluation. For more information on bone health, check out 2million2many.org.
Dr. Susan Beane: When should adults start tuning into their bone health?
David Lee: It’s a lifespan issue. You’re building your bone bank as a child and through adolescence, and then your bone mass peaks by your early 20s. For women, menopause has a pretty major impact on your bone mass. For most folks, they should be doing the healthy things to keep their bone density up like making sure they have an adequate supply of calcium and Vitamin D and making sure they are doing weight-bearing exercises. But it’s really folks around age 50 who see the impact of their genetics or their lifestyle choices, alcohol use and smoking, on their bone health.
We have a campaign called 2Million2Many and the central message is if you or your loved one is age 50 and above and suffer a fracture, ask your doctor for a bone density test. If you have low bone mass or are diagnosed with osteoporosis, you probably need to have a conversation with your doctor about starting an osteoporosis medication.
Dr. Beane: How often should adults get a bone density screening?
David Lee: If there is a fracture, then certainly 50 and above, though people in their 30s and 40s can also suffer from osteoporosis. The guidance for most folks, and it depends on individual risk factors, is generally about age 65 for women in terms of getting a baseline bone density scan; and for men, it’s 70. Three quarters of the folks who have osteoporosis are women, so it definitely impacts women more than men. It definitely affects older folks, generally in their 70s or 80s.
For fractures, you can’t just slap a cast on it and not think about it. If you do have low bone mass or osteoporosis, you are more likely to get another fracture in a few years because you have underlying low bone mass. [With osteoporosis] your bones are fragile, and there’s a possibility it’s going to continue to occur. You’ll need to do something beyond preventive measures to take care of that.
Dr. Beane: So what are your recommendations for folks who have osteoporosis or low bone density?
David Lee: It’s an individual patient-physician conversation. You have to look at the whole bevy of risk factors, including smoking status and what your levels of Vitamin D and calcium are, which a physician can do a blood test to check. A physician then takes all the information—all the risk factors plus the patient’s bone density—and comes up with the best options for what specific medications a person should be on. There are a number of anti-osteoporosis medications available. Some are oral that you take every day, and some are monthly or bi-yearly injections. The good news is the evidence shows that usage of this group of medications can actually reduce the instance of recurrent fractures by up to 50 percent. So, they’re very effective.
Dr. Beane: How important is calcium in bone health?
David Lee: To me, that really is the front line of prevention—not only calcium, but Vitamin D. What we recommend is a food first approach. It’s good to get calcium through natural sources like different dairy products. It’s really hard to get a lot of Vitamin D in your diet because there aren’t a lot of foods rich in Vitamin D, unless you’re eating a lot of fatty fish or mushrooms. Doctors many times sit down with the patient and go over with them how many servings they are getting a day and figure out how much they need to supplement. Weight bearing exercises also really help keep your bone density up, too.
For more information on bone health, tune into this Healthfirst Radio podcast.