Think about how much time and energy you spend trying to look good every day. Now estimate how much you focus on your bone health. Optimizing your bone health may not be a priority now, but regardless of your age, it needs to be a conscious part of your everyday routine. From day one, everything in your life impacts your skeleton.
Osteoporosis is the most common disease in women. You want to prevent the end result: fractures. One in two women over the age of fifty will break a bone. More women die due to broken hips and backs each year than from breast cancer.
Why don't you hear more about osteoporosis? No one says, “My osteoporosis is bothering me.” It is considered an old woman's disease, but that is a total misnomer. Osteoporosis begins much earlier but it is silent and without symptoms. Men break bones, too. One in four men over the age of fifty will sustain a fracture and men are even more likely than women to die after having a hip fracture.
Fractures are not inevitable. You can make a difference. The goal of this book is to teach you how. You must start now, no matter what your age. It is never too late, even if you have already had one broken bone. On the other hand, it is never too early. Bone health is important for all ages from conception on. Prevention of fractures in later life is the goal. You can take charge and do something to change your course with simple measures.
I always thought osteoporosis was just “an old woman's disease.” By taking a seminar, I learned [that] for my age group it is real important to build bone mass. I need to build up my bone mass now so I can protect myself from fracture in the future.
—Jennifer, age 21
Jennifer was an undergraduate student at the University of California, San Diego. She and her fellow classmates did a research project measuring bone density in collegiate women. They were astounded to find that many of the women had lower than normal bone density for their age, including Jennifer herself. She learned she had a chance to improve her bone mass, which peaks in one's late twenties or early thirties. Jennifer examined her lifestyle and made changes. By adding calcium, vitamin D, and regular exercise of running and weight training, she may ultimately reduce her risk for osteoporosis.
Your genes determine 60 to 80 percent of your bone health. You cannot pick your parents but you can adopt a bone-healthy lifestyle and make a difference in your life. You can lower your risk from genes and from the effects of aging and you can reduce your lifetime risk of fractures.
Unlike many women's health issues that have defined time frames, such as pregnancy or menopause, bone health is a lifelong endeavor for you and your family. Staying bone healthy is something you need to consider your whole life. Getting a healthy start is key to growing strong bones and establishing excellent lifelong habits.
Osteoporosis is a silent disease. For the majority of people there are no outward clues that it exists. The best analogy is the termite. Termites work slowly, breaking down the wood structure of your home. Little by little, small holes become larger and larger, creating weaker support structures. Usually, you cannot see their damage because it is hidden behind the walls. Everything looks normal—even the termite inspector does not see anything, until one day you strip off the dry wall during a remodel and you see the chewed-away wood. Worse, you have a structural failure and collapse: the bones of your house are breaking.
Osteoporosis is just like that. You cannot see it. You cannot feel it. Your doctors cannot tell it is there just by looking at you or asking you questions.
Osteoporosis affects your bones not your joints. An eighty-four-year-old friend recently told me, “I have osteoporosis—my hips just wore out.” No, what she has is degenerative arthritis, osteoarthritis, and the cartilage lining of her hip joint wore away. Her arthritis is a process totally unrelated to osteoporosis that required a total hip replacement to treat it.
How do you know if you have osteoporosis? It is a diagnosis usually reserved for women who are at least perimenopausal, which is late forties on average, and for men over the age of fifty. As a silent disease, a test must be done to detect osteoporosis before a fracture happens. Measurement of bone mass by dual energy x-ray absorptiometry (DXA) is the current standard test to determine if you have osteoporosis. If you have already had a fracture, even as a result of trauma, you most likely have osteoporosis.
Another common diagnosis is osteopenia. Osteopenia is not a disease; rather, it represents low bone mass. Thin bones do not necessarily mean weak bones. An assessment of risk factors for fracture along with bone-density testing will provide a more accurate picture of your fracture risk than bone-density testing alone. Management decisions should be based on a complete assessment of your fracture risk.
People always ask if I have osteoporosis because I am tall and thin, which are risk factors for the disease. No, I do not. My professional career has focused on bone health and osteoporosis. In the university setting, my research examined lifestyle and risk factors for bone loss and osteoporosis in both women and men. As an investigator, I participated in multicenter trials for new therapies for prevention and treatment of osteoporosis.
In addition, I have had health challenges that have required multiple back surgeries. Those experiences have helped me see life from the patient's perspective. They have taught me about how to seek out solutions when faced with a confusing and fragmented array of information and healthcare options, and then to take charge of my own health for the best quality of life.
This book puts everything about bone health into one resource. Utilizing the latest research, you will find solutions and practical help to aid in sorting out confusing and conflicting information. My goal is for you to feel as if you have a doctor in your house with up-to-date information based on scientific evidence to provide you with the answers you need for a bone-healthy life. As you read these chapters, pretend you are sitting down with me and having a friendly chat.
A few words on how to use the book: It is designed as a complete resource. Short individual sections condense vast amounts of information. Tens of thousands of research papers have been published on many of these topics; some scientists have spent their entire careers investigating one aspect of a single topic. The challenge is to summarize the latest research without oversimplification. Sometimes you may not find enough of what you are looking for, and in other places too much. Text boxes contain more technical information, and other boxed-text sections called “My Stories” are about my patients or individuals who have consulted with me about their challenges with bone health. Their experiences may be similar to yours.
While the book can be read from cover to cover, I have organized the information so that any section, or portion of the book, can be read separately to help you find the pertinent information and guidance you are seeking. Each section ends with a bottom-line summary of four to five points called “The Bare Bones.” This final summary will aid you in scanning for a review of the section's content or for easy reference later. An appendix titled “Big Words: Medical Terms Broken Down” serves as a glossary of selected medical terms.
Medical terms can be confusing and may seem like a foreign language. Each time a medical term is introduced, I will define it in common words. You will become familiar with some bone-related words that will be helpful in understanding your bone health.
Throughout the book I use the term “doctor” as a representative term for all healthcare practitioners. Instead of using the awkward she/he in referring to a doctor, I use “he” only because male physicians still outnumber female physicians. However, the pronoun use is meant to be gender neutral.
No book is truly “complete.” Medical knowledge is constantly changing with new research findings and knowledge. You can visit the website 4BoneHealth.org to stay abreast of the latest studies, tips, and news. You will find regular updates containing the latest bone-related headlines with expert commentary. The interactive tools are intended to help enhance a bone-healthy lifestyle. You can easily share the content with your family and friends. Check it out!
Finally, a reminder that this book is for informational purposes only. It is not intended to substitute for the professional medical advice or treatment recommendations provided by your doctor. You can use this book to help frame questions for your doctor, to ask your doctor's opinion about research findings or medications, and to help you understand your doctor's advice.
Sophocles, an ancient Greek playwright, said, “Look and you will find it—what is unsought will go undetected.” Don't let that happen to you! Increase your awareness and make changes for a long life with good, healthy bones.
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The Bare Bones
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