Osteoporosis illustration

Having osteoporosis -- a disease in which bones become fragile -- greatly increases your risk for fractures.

With each new year comes resolutions: Lose weight. Eat healthy. Exercise more.

All good intentions that can be sidelined by fragile or shrinking bones.

Most of us don’t really think about our bones until we break them, and by then, it may be too late.

Severe bone loss, or osteoporosis, is responsible for 2 million broken bones per year, but nearly 80 percent of older American who suffer bone breaks are not tested or treated for osteoporosis, according to the National Osteoporosis Foundation.

“One in two women and one in four men over age 50 will break a bone due to osteoporosis,” the foundation said. “People with osteoporosis can break a bone from a minor fall, or in serious cases, even from simple actions like sneezing or bumping into furniture.”

Bones weakened by osteoporosis or osteopenia -- early bone loss -- are more likely to break and lead to lifelong disabling consequences. But bodies with strong dense bones fortified by calcium, vitamin D and weight-bearing exercise can withstand and heal from the blows life throws their way.

To gather more information on bone loss, the University of Nebraska Medical Center College of Nursing is seeking postmenopausal women living in the Lincoln area to take part in a year-long study on bone health.

The federally funded study begins Jan. 1 and will follow 300 women diagnosed with osteopenia, divided into these three groups.

* Control group. Will be prescribed a regimen of Vitamin D and calcium supplements and continue a daily exercise program.

* Second group. Same as the control group, plus a monthly 150 mg dose of Risedronate, a bone strengthening medication.

* Third group, Will take vitamin D and calcium supplements and take part in weight-bearing exercise and resistance training programs three times a week.

The goal is to determine the best way to preserve bone health in aging women, said Nancy Waltman, nurse practitioner and professor at the UNMC College of Nursing in Lincoln. Participants will receive diagnostic screenings, medication and supplements at no cost, as well as a nominal travel stipend.

“Osteoporosis is a critical problem, and it doesn't get the publicity that it should,” she said.

“Osteoporosis … and the broken bones that result from it can interfere with women’s quality of life and can even cause their death. The fact is that every year more women die from hip fractures than breast cancer,” Waltman said.

For women, the risk of osteoporosis is greater than the incidence heart attack, stroke and breast cancer combined, according to the National Osteoporosis Foundation.

“Bone loss is a silent disease,” Waltman said.

It is also symptomless.

Some people learn that they have osteoporosis after they lose height from one or more broken bones in the spine -- these broken bones can occur without any noticeable pain, the national foundation says.

Most women don’t know they have it until they break a bone or have a bone density exam, which is typically given around age 65 -- about 10 years after the most significant bone loss has occurred, Waltman said.

In the five years after menopause, the average woman loses 10 to 20 percent of her bone, she said. Although bone loss continues throughout aging, the rate slows down significantly after that, Waltman said.

Adding to the concern, is that most women receive incomplete or too generalized information regarding how to best care for their bones. Although they are told to take vitamin D and calcium supplements, they don’t necessarily know how much to take or take them consistently, Waltman said. They are told to be active, but they may not know what activities are best for their bones.

To better understand bone health, here's a brief anatomy lesson.

Throughout life, people lose old bone and grow new bone. Bone grows faster in children and teens, peaking at age 30. After that, the rate of bone loss starts to exceed the rate of growth, according to the national foundation.

Calcium makes bones grow. The body does not produce calcium, it must be ingested through food and drink. To process calcium, a body needs vitamin D, which primarily comes from the sun.

“But the older you get the harder it is for your skin to synthesize the vitamin D from the sun,” Waltman said.

That's why doctors often prescribe vitamin D supplements for aging patients.

“A teenager who spends 15 minutes in the sun will get three times as much vitamin D as a grandparent spending the same amount of time in the sun,” Waltman said.

Add in Nebraska winters, when sunlight is scarce and temperatures require layers of protective clothing, and exposure to natural vitamin D sources shrinks even more, she said.

Estrogen and testosterone slow the breakdown of bone cells. Estrogen production ends with menopause. Women lose on average 2 to 4 percent of bone density per year those first five years after menopause, Waltman said.

"Eighty percent of osteopenia is due to the loss of estrogen," she said.

The risk of osteoporosis for men is less, because their bodies can produce testosterone much later in life.

Healthy bone looks like dense honeycomb. Weakened bone is more porous -- like the inside of an English muffin.

Weight-bearing exercise -- jogging, hiking, stair-climbing, jumping rope, aerobics and lifting weights -- strengthens bones. Swimming and bicycling, while great cardio activities, do little to protect bone health, Waltman said.

Waltman is osteopenic herself and takes a monthly dose of Risedronate, eats calcium-fortified foods, takes vitamin D supplements and follows a regimen of weight-bearing exercises.

“Women with osteopenia should be on a bone-building medication," she said. "But doctors don’t like you to be on them for more than five years.”

The UNMC study will look at whether exercise, calcium and vitamin D can slow down or even stop the loss of bone density.

“If we can prevent them from losing density … we can prevent them from having to take the medication -- or at least delay the need for bone-building medications until much later in life,” Waltman said.

“Keeping your bones healthy may not be at the top of your wellness list, but it should be,” she said, quoting the National Osteoporosis Foundation slogan.

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Reach the writer at 402-473-7217 or eandersen@journalstar.com.

On Twitter @LJSerinandersen.


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