What is osteoporosis?

Osteoporosis is a disease of progressive bone loss associated with an increased risk of fractures. It literally means “porous bone.” The disease often develops unnoticed over many years, with no symptoms or discomfort, until a fracture occurs. Osteoporosis often causes a loss of height and dowager’s hump (a severely rounded upper back).

Left to right: normal vertebrae, vertebrae with mild osteoporosis, and vertebrae with severe osteoporosis

Why should I be concerned about it?

Osteoporosis is a major health problem, affecting 28 million Americans and contributing to an estimated 1.5 million bone fractures per year.

One in two women and one in five men over age 65 will sustain bone fractures due to osteoporosis. Many of these are painful fractures of the hip, spine, wrist, arm and leg that often occur as a result of a fall. However, even simple household tasks can produce a fracture of the spine if the bones have been weakened by the disease.

The most serious and debilitating osteoporotic fracture is the hip fracture. All hip fracture patients will require walking aids for several months, and nearly half will permanently need canes or walkers to move around their house or outdoors. Hip fractures are expensive. Health care costs from hip fractures total more than $10 billion annually – $35,000 per patient.

Osteoporosis Prevention Starts Early

Most people think osteoporosis is a disease of the elderly. People lose bone mass as they age. Bone growth during childhood and adolescence is just as important in developing osteoporosis. That’s what experts said at the National Institutes of Health (NIH) conference on Osteoporosis Prevention, Diagnosis and Therapy in March 2000. (Primary sponsors were the National Institute of Arthritis and Musculoskeletal and Skin Diseases and the NIH Office of Medical Applications of Research.)

“ Only about 25 percent of boys and 10 percent of girls ages 9 to 17 have a diet that meets these recommendations. ”

Bones grow in size and strength during childhood. The bone mass you reach while young helps determine your skeletal health for the rest of your life. The more bone mass you have after adolescence, the more protection you have against losing bone density later.

Childhood is critical for developing lifestyle habits that support good bone health. Cigarette smoking could start in childhood. It has a harmful effect on reaching peak bone mass.

Good nutrition is vital for normal growth. Like all tissues, bone needs a balanced diet, enough calories, and appropriate nutrients. But not everyone follows a diet that is best for bone health. For example, the Institute of Medicine recommends calcium intake for children ages 9 to 17 of 1,300 mg/day (800 mg/day for children ages 3 to 8). Only about 25 percent of boys and 10 percent of girls ages 9 to 17 have a diet that meets these recommendations.

Calcium is the most important nutrient for reaching peak bone mass. It prevents and treats osteoporosis. The body requires vitamin D to absorb calcium effectively. Most infants and young children in the United States get enough vitamin D from fortified milk. But adolescents don’t consume as many dairy products. They may not get adequate levels of vitamin D. Dieting and fasting to be thin may harm nutrition and bone health. Teens who diet may need to take calcium and vitamin D supplements.

Risk Factors / Prevention

Several groups of children and adolescents may be at risk for poor bone health. They include:

  • Premature and low birth weight infants who have lower-than-expected bone mass in the first few months of life
  • Children who take medications such as systemic or inhaled steroids to treat chronic inflammatory or respiratory diseases such as asthma
  • Children who have cystic fibrosis, celiac disease, and inflammatory bowel disease because these conditions make it difficult for the body to absorb nutrients appropriately
  • Adolescent girls who have minimal, delayed or irregular menstrual cycles because of strenuous athletic training, emotional stress, or low body weight
  • Children with cerebral palsy and other conditions causing limited weight bearing, especially when children are taking chronic medications for seizure control

Many more studies are needed on ways to maximize peak bone mass in girls and boys. Parents and children alike can benefit from following these suggestions:

  • Make sure you get enough calcium and vitamin D throughout your life.
  • Exercise regularly, using resistance and high-impact activities.
  • Eat a healthy diet and follow a healthy lifestyle.