Bone Up On Bone Health

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Half of all elderly people will have bone-thinning osteoporosis or be at high risk of getting it by 2020 — unless they start strengthening their bones now with a boost of calcium, vitamin D and exercise, the U.S. surgeon general warned Thursday.

Weak bones, from osteoporosis and a variety of other bone diseases, aren't a natural part of aging, Surgeon General Richard Carmona stressed, though the risk of osteoporosis does increase over age 50. But often doctors are just as guilty as their patients in overlooking the risk — even forgetting to check bone density when middle-age or older patients suffer fractures.

"Osteoporosis isn't just your grandmother's disease," Carmona said in releasing the first surgeon general's report on bone health. "You are never too old or too young to improve your bone health."

Women are at particular risk, especially white women. But osteoporosis does affect men, too, and people of all races — a risk that increases over age 50 as it becomes harder for new bone to form.

Osteoporosis is an under-diagnosed disease, because many people don't know their bones are thinning until one breaks, the report notes.

For older people especially, fractures are much more than nuisance: Nearly one in five hip-fracture patients winds up in a nursing home, and their risk of death during the next few months is up to four times greater than that of similarly aged people with healthy bones.

Yet the report found that in one study, only one-eighth to a quarter of patients who had a hip fracture were given a bone-density test to check the severity of their bone-thinning. Also, fewer than a quarter were given calcium and vitamin D supplements to help build up their bones, and fewer than a tenth were prescribed effective osteoporosis drugs.

The new report makes a series of recommendations:

  • Strong bones begin in childhood with proper calcium and vitamin D. Recommended amounts vary by age, but about three 8-ounce glasses of low-fat milk a day — combined with calcium from the rest of a normal diet — is enough to meet most people's needs. Calcium is present in other foods, too, such as broccoli and fortified orange juice; vitamin D also is added to certain foods and can be absorbed from sunshine. But many people also require supplements to get enough.

  • Adults need at least 30 minutes of physical activity a day, and children 60 minutes, including weight-bearing activities that improve bone strength and balance.

  • Older people should minimize the risk of falls by moving flimsy rugs or other items they might trip over, improving lighting and getting vision checks.

  • All women over 65 and any man or women who suffers even a minor fracture after age 50 needs a bone-density test.

  • Doctors should look for warning signs of bone thinning, including people under 50 who have had multiple fractures. Also at risk are those who take medications, such as steroid-containing drugs, or who have hormonal, kidney or other diseases that over time can thin bones.
    • Jaime Holguin

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