Aging Begins at 30

Shake Them Bones

Every year over a million elderly people suffer the pain and inconvenience of broken bones. But you don't have to be one of them. Osteoporosis means bones with microscopic holes in them. The total weight of the skeleton is therefore reduced. The bone that is left is normal, but there is much less of it. Bone lives and remodels or sculpts itself throughout life. Calcium and phosphorous turn over daily in our boney calcium bank. Bone is piezo electric, which in Greek, means pressure produces an electric current. The current, in turn, stimulates the formation of bone.

I remember an elderly lady, Mary, in her 85th year who was walking or even shuffling when she fell on her rump and fractured her hip. About ten years earlier she had developed a minor stoop and noted that she had lost an inch in height. She was petite and had a dowager's hump or minor hunchback. She had never drunk milk, she told me, as it made her gain weight. Her daughter, Agnes, accompanied her and her right wrist was in a plaster cast. I was able to warn Agnes that this could be the first sign of osteoporosis. She too needed a comprehensive workup.

In high school or shortly thereafter, women's bones are at their strongest. There is a steady loss of bone from age thirty onwards, but the loss accelerates after the menopause. Afro-American women have heavier skeletons in their teen-age years, and although they lose bone at the same rates as Caucasians, they develop osteoporosis much less often. Men can develop the disease, but do so ten to fifteen years later than women.

Bone comes in two types, spongy and cortical or tube-like. The spongy bone of the spine suffers weight loss first. Thus, there is a loss in height. More disabling damage results from the results from tube-like or cortical (tree bark-like) bone of the hip. This bone disease can be dangrous. Hip fractures lead to death in 15% within six months after the break.

Bad things can happen to hasten the disease. Inactivity will leech out the strength of the skeleton. Put a medical student to bed for three weeks and she will approach the leeched out bones and inactivity of an aging 80-year-old. Smokers' bones age faster. Hip fractures occur in 52% of osteoporotic smoking women and 20% of osteoporotic non-smokers and only in 8% of the general population of older women. Some, but not all investigators, believe that too much phosphorous, as supplied in soft drinks, will counteract the good effects of calcium. Alcohol, especially in men, will increase the risk of osteoporosis two-fold.

Now for the good news. A judicious mixture of estrogen, calcium, and exercise can slow the bone loss and prevent fractures. It is best if you start at 30 (when aging starts) with adequate exercise and calcium. Appropriate doses of estrogen, usually with progesterone, will slow the loss of calcium that occurs after menopause. Your doctor can prescribe how much and how often.

Postmenopausal women tend to excrete more calcium than they ingest. Calcium intake should be 1000 mgm a day in younger women and 1500 mg after the menopause. Twenty percent of older women take in less than 30 mg of calcium daily. A cup of 1% or skim milk provides 300 mg and a cup of creamed cottage cheese contains 200 mg of calcium. A cup of low-fat fruit-flavored yogurt will give you 350 mg of calcium, but is high in sugar and calories. Alternatively, calcium carbonate or TUMS, two to four tablets, will provide 400 to 600 mg of calcium at a cost of $2 to $4 monthly. Some physicians like to add a modest amount of vitamin D to enhance absorption of the calcium, but its easy to overdo the vitamin D.

Physical activity is essential to bone formation and to keep it there. Do what ever exercise you like. Any kind of exercise works. Weight bearing exercise is best.

Osteoporosis can be halted or even prevented. The earlier you make regular exercise and a good diet rich in calcium part of your lifestyle, the more certain you are that you will avoid a potentially painful and crippling bout with osteoporosis. Whenever you take your bones for a walk or move them briskly up and down the stairs remember that the shaking does them good.

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See related Patient Topics Bones, Joints and Muscles, Fractures, Injuries and Wounds, Osteoporosis, Seniors' Health or Women's Health.

See related Provider Topics Bones, Joints and Muscles, Fractures, Injuries and Wounds, Osteoporosis, Seniors' Health or Women's Health.

All contents copyright © 1992-2004 the Author(s) and The University of Iowa. All rights reserved.

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