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Health > Body of KnowledgeWinter 2012 IS Magazine

Stand Tall

Keep fit to beat bone loss.

By Paula Bender

My grandmother broke her back bending over to wipe the floor boards of her house. My mom broke both hips in separate incidents and fractured her wrist when she slipped in a puddle while playing tennis. Because the predisposition to osteoporosis can be inherited, I had a bone density test in my mid-40s. Bone loss had already begun despite my being premenopausal, very healthy, and having an active lifestyle.

Archeologists have unwrapped Egyptian mummies from 4,000 years ago with rounding of the upper back, the result of compression fractures of the vertebrae, or kyphosis. Postural kyphosis, normally attributed to slouching, occurs at all ages. Fortunately, we don’t have to accept that, thanks to posture-improving exercises.

With osteoporosis, bones are so weak they could easily break. Often people with osteoporosis – both men and women – are unaware they have it until a bone breaks. Although it can happen to any bone, it is most common in the hip, wrist, ribs, and vertebra. All ethnic groups are susceptible, especially Europeans and Asians. Those with a family history of fractures or osteoporosis are at an increased risk.

Until 1984, when the National Institutes of Health first publicized the disease, bone loss among postmenopausal women didn’t get much press. In the 18th century, English surgeon John Hunter discovered the process of remodeling, or the cycle that creates, destroys, and resorbs bone in the body. In the 1830s, pathologist Jean Lobstein noticed some patients’ bones were riddled with larger-than-normal holes. He called it osteoporosis.

In the 1940s, Fuller Albright, an endocrinologist at Massachusetts General Hospital, treated postmenopausal women with estrogen therapy to help prevent bone loss. Since then, devices such as the densitometer used to measure bone loss have helped with early detection. However, osteoporosis is still a medical challenge.

There are things we can do to help ourselves. Smokers should quit. Eat healthy. Get at least 1,200 mg. of calcium daily, either through a healthy diet or supplements. Cut back on sodium, balance protein with complex carbohydrates such as leafy greens and other vegetables, and skip sodas because they contain phosphoric acid. Avoid heavy metals such as the banned cadmium (found in costume jewelry) and lead. Moderate exercise such as jogging, walking, and stair-climbing, as well as aerobic, weight-bearing, and resistance exercises, are recommended to help build bone mineral density. These exercises can also help those with osteoporosis improve their balance and gait, resulting in fewer falls.

The U.S. Preventive Services Task Force (USPSTF) last year recommended bone density screening for all women age 65 and older and for younger women whose fracture risk is equal to or greater than that of a 65-year-old Caucasian woman who has no additional risk factors. In addition, osteoporosis screening for women over age 60, depending on risk factors, is now covered without a member copayment, coinsurance, or deductible if you receive these services from an HMSA participating provider under the Affordable Care Act (ACA). This ACA provision applies to all non-grandfathered health plans.

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