1. Osteoporosis Alison Mesler

2. What is Osteoporosis??? A condition in which bone tissue decreases
Our bodies are constantly building new bone and removing older bone
From birth through young adulthood, more bone is built than removed
After maturity is reached at age 30-40, the amount of bone removed gradually outnumbers the amount formed
Osteoporotic bones have a “moth eaten” microscopic appearance -> “Porous bone”
This condition usually first appears in the bones of the forearm and spine
Healthy
Osteoporosis

3. “Stats” As of 2000, 10 million Americans had osteoporosis
Another 18 million at risk
Although age and gender are a risk factor, this disorder is no longer considered age or gender-dependent

4. Characteristics: An Overview
“Silent disease”
Many times, bone loss occurs without symptoms
Dowager’s Hump
Restricted movement
Increased fractures

5. Characteristics: “Dowager’s Hump”
The humped back that results in decreased height due to vertebral collapses.
“Crush fractures” or “spine compression fractures” occur when weakened bones of the spinal column, compressed by body weight and gravity, collapse.
Bending forward to make a bed or to lift a casserole from the oven can be enough to weaken a vertebrae.

6. Characteristics: Fractures
Osteoporosis rears its horns by increasing susceptibility to fractures of the hip, spine, & wrist.
1 in 2 women will have an osteoporosis-related fracture
1 in 8 men
A women’s risk of hip fracture = breast + uterine + ovarian cancer risk

7. Risk Factors: Age
Most cases are diagnosed between a person’s 50’s-60’s
Older women who are approaching or have passed menopause
Bone loss accelerates at this time because estrogen deficiency produces an increase in bone turnover where osteoclastic activity predominates
If an individual doesn’t reach peak bone mass during growth, osteoporosis may occur without accelerated bone loss.
After your mid-30s, you begin to loose bone mass. Women lose bone mass faster after menopause, but it happens to men too. -U.S. Office of the Surgeon General

8. Risk Factors: Men vs. Women
8 times more common in women than men- partially because women have less bone mass to start with
Around ages 45-50, women suffer wrist fractures 10 times more often due to vulnerability from osteoporosis
Women who recently had surgical removal of the ovaries are at great risk

9. Risk Factors: Family History
Women who have a family history in their mother, aunts, or sisters are at great risk
Those who are genetically predestined can be taught early intervention measures to help resist the consequences.

10. Risk Factors: Ethnicity
(Many risks factors are discovered by studying the correlation between fractures and osteoporosis)
By age 65, a quarter of all white women have had 1+ fractures related to osteoporosis
African Americans are at much lower risk because they tend to have greater bone mass
Hip fractures are three times more common among white women than African American women.

11. Risk Factors: Some female athletes
In some cases, young women who are serious athletes can develop osteoporosis
A low caloric intake and excessive exercise can increase risk factors
The female athlete triad includes osteoporosis!

12. Detection: X-ray???
Osteoporosis cannot be detected by x-ray until 30-50% of bone mass has been lost
At this point, calcium depletion cannot be reversed

13. Detection: Bone Mineral Density Test (BMD)
Measures bone mass & can confirm a diagnosis of osteoporosis
Painless, non-invasive
High frequency sound waves or a minimal energy source is passed over the body
The data is then evaluated by a computer program
Allows physician to see how much bone mass the patient has
Gives ~ measure of bone strength
If the data suggests osteoporosis, treatment programs can be started.

14. Case Study- March 10, 03

15. Case Study For some, Fosamax may help repair bones
FDA approved to preserve bone strength and reduce fracture risk
2-year study of 1,200 women
“slowed bone loss and restored up to 3.5 percent of lost bone in postmenopausal women ages 45-59”
Oral medication
Expensive- $1.55 per day

16. Case Study- Dec. 29, 08

17. Case Study- Dec. 29, 10

18. Case Study- BMD

19. What about “Osteopenia”???

20. Calcium: Absorption
The body’s calcium amount is dependent on the amount absorbed
Normally absorb ~25% of the calcium in food
Absorption plays a major role in bone structure and osteoporosis prevention
Calcium absorption increases from:
Increased estrogen
The aid of the parathyroid hormone
A slightly acidic environment
Adequate vitamin D intake
Times of need (growth periods- pregnancy, childhood)

21. Calcium: Reasons for a decrease in absorption
Rapid intestinal motility (diarrhea)
High fiber intake, phytic acid
Excess phosphorus intake
Vitamin D deficiency
Presence of polyphenols (tannins) in tea
Menopause
Aging
Achlorhydria (lack of stomach acid)
A tannin is an astringent, a substance/chemical compound that tends to shrink or constrict body tissues.

22. Calcium: Regulation Calcitonin Parathyroid Hormone
A hormone that may decrease the rate of bone removal
Parathyroid Hormone

23. Prevention: An Overview
Maintain healthy body weight
Normal menses
Moderate protein, phosphorus, sodium, and caffeine intake
Adequate diet
Weight-bearing physical activities
Non-smoker

24. Prevention: Adequate Diet
Meet calcium and vitamin D needs
Be aware of the amount of calcium absorbed in foods
Spinach is very high in calcium but contains oxalic acid, which binds to the calcium, making in poorly absorbed
If you are trying to limit your daily caloric intake, choose low-fat skim milk products
Vitamin D is needed to help the absorption
Sun exposure allows the body to make it
Food sources include vitamin D-fortified milk, some cereals, & salmon (Atlantic)

25. Prevention: Weight-bearing activities
Walking, climbing stairs, jump roping
These activities stimulate bone cells to be more active and to produce stronger bones
Physically active persons have denser bones
Exercises to build other mm. that give support to the body are important too

26. Prevention: Quit smoking
Smoking cigarettes doubles the risk
Substances in cigarettes cause chemical and hormonal changes
Osteoporosis happens earlier and continues more rapidly in smokers
Also, some smokers tend to be underweight. By quitting smoking and maintaining a healthy body weight, osteoporosis can be avoided

27. Remember…