“When most people think of bones, they do not think of them as living and growing organisms; however, this is exactly what they are. Bones are made up of active cells that are constantly replaced and growing,” said Andrew Bunta, MD, vice chairman of the department of orthopaedic surgery Northwestern Memorial Hospital and at Northwestern University Feinberg School of Medicine. “The reverse is also true, as bones can decrease in density over time due to lack of care.”
Osteoporosis occurs when bone mass is deficient. Risk factors include being female, family history, advanced age, low body weight, sedentary lifestyle choices and insufficient calcium and vitamin D levels. While post-menopausal Caucasian women make up the largest percentage of osteoporosis cases, the disease can affect women of any ethnicity as well as men. More than 10 million Americans have osteoporosis and as many as 40 million more have low bone mass and are at high risk of developing the disease.
Lifestyle choices including smoking, excessive alcohol use, or overtraining in early adulthood can cause a condition called osteopenia, which is lowered bone mineral density. This deficiency can occur in the peak years of bone development and if not addressed, the condition may worsen and lead to osteoporosis in later years. People with eating disorders are also at heightened risk for developing osteopenia and osteoporosis.
“People mistakenly assume they don’t have to worry about osteoporosis until their later years, when in fact it is their behavior in their adolescent and early adulthood that helps determine whether or not they will suffer from bone loss,” said Bunta, who is also the chair of the scientific steering committee for the American Orthopaedic Association’s Own the Bone osteoporosis fracture prevention program for patients with previous fractures.
Osteoporosis and osteopenia prevention should start early in life as children and young adults have increased ability to gain bone mass. The majority of bone mass is formed by age 18 in females and by age 20 in males, with peak bone mass achieved in both men and women by age 30. According to Bunta, inadequate bone formation during these critical years will prevent a person from obtaining normal peak bone mass making it crucial to focus on bone health in early adulthood.
“Individuals continue to grow bone throughout their lives, but this ability is most heightened during the early years of life through a person’s 20s,” explained Bunta. “Young adulthood is prime time to take steps to prevent the development of bone related disorders and fight against fractures in later in life.”
A healthy lifestyle that includes regular exercise and a nutritious diet is a key component to promoting bone health. Consuming a sufficient amount of calcium and vitamin D is among the best ways to prevent osteoporosis. Calcium, a mineral which is stored primarily in the bones and teeth, aids in the expansion of blood vessels and muscles. “Our bodies continually remove and replace calcium as we grow, and vitamin D aids in its absorption and incorporation into our bones so it is important to get enough of both,” explains Bunta. “This is not always possible to accomplish through diet alone in later years, so it may be necessary to take calcium and vitamin D supplements as we age.”
In addition to calcium and vitamin D supplements there are prescription drugs known as Bisphosphonates that can help increase bone density and slow the breakdown of the bone; thus, helping to prevent fractures caused by decreased bone mass.
“Fractures associated with poor bone health affect nearly 2 million people annually,” said Bunta. “A person who sustains a fracture due to impaired bone mineral density more than doubles his or her chances of acquiring another fracture in the future which can be debilitating or even life-threatening.”
Prevention is the best step we can take to promote better bone health. Bunta suggests talking with your doctor about individual strategies for supporting overall bone health.
Since 1999, Northwestern Memorial has partnered with the National Osteoporosis Foundation to spread awareness about the importance of bone health. Formally launched in 2003, the Bone Health and Osteoporosis Program at Northwestern Memorial has focused on early screening, fracture prevention and effective medical treatment in combating osteoporosis and other bone-related disorders.
Northwestern Medicine is the shared vision that joins Northwestern Memorial HealthCare and Northwestern University Feinberg School of Medicine in a collaborative effort to transform medicine through quality healthcare, academic excellence and scientific discovery.
To learn more about Northwestern Memorial’s Bone Health and Osteoporosis Program or to find a physician, call 312-926-0779.