Wednesday, January 10, 2007

Osteoporosis Isn’t Only a Concern for Women

All my family have very dense bones. I’ve a compression fracture of my L5 vertebrae when a rugby scrum collapsed on me, and Canadian Sis had the very same injury plus her patella punctured by a hand brake in a car accident which literally shredded her car into scrap metal; but otherwise our family does not experience broken bones. Not even when a van mowed my mother down as she was crossing the street at sixty five years of age because the driver was watching a gaggle of geese take off from nearby field. Nor a single broken bone in evidence when my youngest sister American Sis’ car was totaled on the 405 from behind and she walked away from the accident after being freed. Our family’s ability to survive trauma leaves most doctors shaking their heads. We credit this good fortune in large part to our strong bones and always being in good physical shape and it’s a great source of comfort. There are a lot of people out there, however, who live in mortal fear of an accident. The National Women’s Health Information Center says there are twenty eight million Americans who suffer either from osteoporosis or low bone mass and out of the ten million with osteoporosis two million are men. The fact so many men have osteoporosis surprises me too. A related story: American Sis was teaching a class one day when her client’s horse started to get edgy. “Time to put Henry to bed”, she said but the lesson was going well and Susan wanted to do one more circuit. American Sis relented. “It was really my fault, I should have said no. From now on when I say a horse needs to be put to bed there’ll be no discussion, that’ll be it”, she related to me sorrowfully afterwards. On the very next jump Henry acted up and Susan lost her seat and fell, first striking the soft surface of the arena with her right knee. “It was like watching a horse break its leg”, whispered American Sis, as she described seeing her client’s femur and pelvis start to shatter at the knee and then continue breaking all the way up through her hip. Susan had osteoporosis. It took multiple operations, a lot of metal, and a couple of years for her to recover. Amazingly she still rides today – Susan is not a quitter (personally I would tend towards the term foolhardy but full credit to her determination to live her life as fully as possible). But everybody who knows Susan would prefer not having to go through that horrible experience at all.

You’ll be glad to know osteoporosis is preventable and, no, taking calcium supplements won’t be enough. To even just absorb calcium properly the body needs other supplements and vitamins to be available as well. After analyzing the results of a study using healthy children the Menzies Research Institute in Hobart, Australia has suggested increasing vitamin D intake and eating more fruits and vegetables may be a better strategy for building healthy bones than supplementing diets with calcium. Besides which, just like sarcopenia (the loss of muscle) osteoporosis of the bone has a strong link to the level of physical inactivity. Plainly put a lack of exercise will have the body concluding it doesn’t need strong bones. "Without consideration of these effects," says the nutritional biochemist Dr. Neil S. Orenstein of Lenox, Massachusetts, "no amount of calcium supplementation will prevent osteoporosis."

I, of course, am going to concentrate on the need for exercise. The best bone builders are exercises that place stress on the bone, such as weight-bearing activities like running or dancing, and resistance exercises like weights. In general, the greater the impact and load involved, the more it strengthens. As every engineer will tell you the more the stress a structure has to sustain the stronger it has to be. However, certain aerobic exercises such as swimming, rowing, and biking do not strengthen bones precisely because they are non-impact and non-load bearing. This shouldn’t come as a shock as this is the very reason these activities are popular for rehabilitation purposes. In Prescription Alternatives, Professor Earl Mindell and Virginia Hopkins describe the amount and type of exercise needed to be productive: "In a recent study on bone density and exercise, older women who did high-intensity weight training two days per week for a year were able to increase their bone density by one percent, while a control group of women who did not exercise had a bone density decrease of 1.8 to 2.5 percent. The women who exercised also had improved muscle strength and better balance, while both decreased in the non-exercising group." High intensity weight training for osteoporosis seems to be working out for at least half an hour using moderate weights. The sooner the better, especially for women, for whom having a lot of estrogen around helps when trying to build bone. But everyone can benefit from strength training at any age. In the above landmark study referred to by Mindell and Hopkins the ladies were all post menopausal with some as old as seventy. And certainly if you like your bones at all don’t smoke. Smoking a pack a day over a lifetime will cause the loss of between five to ten percent of bone mass plus decrease estrogen levels, a double whammy on any woman on estrogen replacement therapy to treat her osteoporosis. But I don’t need to tell readers smoking is bad for them do I?

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