Osteoporosis — Why maintaining bone health is only one key factor to consider

Pat Surdyk broke both of her arms at once, then years later, her right arm — again — before she was diagnosed with osteoporosis.

Surdyk, 71, of suburban Westmont, chalked both incidents up to accidents and didn’t worry. After all, heart problems were a far bigger concern, given her family history.

Her primary care physician persuaded her to see a specialist, and when she got the diagnosis, only one thing crossed her mind.

“I wanted to meet this thing head on,” Surdyk said.

Cases like Surdyk’s are common. Most people don’t know they have osteoporosis until they break a bone. The National Osteoporosis Foundation (www.nof.org) estimates that 54 million Americans have osteoporosis and osteopenia, or low bone mass. Low bone mass increases the risk for osteoporosis.

Studies also show that one in two women and one in four men will break a bone as a result of the disease. That means that osteoporosis is responsible for about 2 million broken bones, the foundation estimates. The cost is high not only for well-being, but for the wallet, as well.

A patient’s lack of mobility can lead to feelings of isolation and depression. About 20 percent of seniors who break a hip die within one year from complications of the disease or the surgery itself. Osteoporosis-related costs top $19 billion each year, foundation figures show.

“Osteoporosis is not pretty,” said Muna Siddiqi, a registered dietician at Swedish Covenant Hospital on Chicago’s North Side.

So what is osteoporosis? Osteoporosis means “porous.” If you look at a sample of healthy bone under a microscope, it would look like a honeycomb with a dense, strong structure. People develop peak bone mass some time in their 30’s, and the higher the mass is, the less likely they are to develop osteoporosis later.

But as folks age, the mass can wear down. If osteoporosis develops, the holes in the bone structure grow bigger and the tissue, weaker. That makes bones brittle and more likely to break.

Osteoporosis is not something anyone feels coming on. It’s often not noticed until someone breaks a bone, develops a hunched or stooped posture, or loses a little height. Some people may develop back pain.

Surdyk’s own back pain complicated her diagnosis. “I have arthritis, so that made everything a little fuzzy,” she said.

Age, race, diet, lifestyle and medical conditions or treatments all play a role in developing osteoporosis. The older you get, the more likely you are to develop the disease, although women are more likely to develop it than men. Caucasian and Asian women tend to develop it more often, “but, honestly no race is spared from osteoporosis,” said Pauline Camacho, an endocrinologist with Loyola University Medical Center.

“Everyone does get it at some point.”

Family history is an important factor, too. Surdyk’s mother had a “Dowager’s Hump,” the telltale sign of the disease. “But she didn’t break any bones, so I didn’t think I had it,” she said.

Diseases and conditions that can increase the risk of bone-density loss include rheumatoid arthritis, celiac disease, diabetes, lupus, IBS, certain cancers and eating disorders. Some medicines, including antacids that contain aluminum and steroids may also contribute to it, as well.

But by far the most common contributors to osteoporosis are a sedentary lifestyle, excessive alcohol and tobacco use.

Osteoporosis cannot be cured, doctors say, but lifestyle changes coupled with medication can slow the disease and help maintain current bone health. To diagnose the disease and to determine treatment options, doctors review clinical histories, bone-density tests and fracture risk-assessments. Medicines include Boniva and Fosamax, which despite a recent scare that it damages jaw bones, is safe and effective to take, Camacho said.

The good news is that osteoporosis is preventable.

“Prevention is key,” said Sonali Khandelwal, a rheumatologist and co-director of the osteoporosis center at Rush University Medical Center.

Siddiqi, the dietician, recommends that people who want to build strong bones start young.

“A healthy diet will take you a long way.” She recommended the USDA’s My Plate website (www.choosemyplate.gov) as a good starting point, as it features nutrition guidelines for a healthy lifestyle.

Medical experts say that to build strong bones, people should maintain a healthy body weight, get ample exercise, including weight-bearing activity, and to be sure to eat plenty of calcium and Vitamin D. For women under 50, that’s 1,000 milligrams of calcium daily. Recommendations for vitamin D range from 600 to 1,000 IU each day.

The recommended amount of calcium is “easy” to reach through diet, Siddiqi said. Eight ounces of low-fat milk, yogurt and cheese are each about one-quarter of the way to the goal.

Calcium-fortified orange juice, canned sardines with bones, a half-cup of tofu and calcium-fortified cereal are all good options, too, she added.

Vitamin D is harder to take in through the diet alone, so experts urge patients to get plenty of sunlight, which stimulates vitamin D production, and to consider taking supplements.

Both exercise and nutrition are equally important to building strong bones, Khandelwal said.

“I tell my older patients: Just move.”

That’s what Surdyk chose, along with medication. Surdyk, who never swam a lap in her life, took lessons and heads to the gym several times a week for a senior boot camp class. She has maintained her bone density since then.

Some quick facts about osteoporosis (source: The National Osteoporosis Foundation):

— Experts say that by 2025, osteoporosis will cause 3 million fractures that cost patients $25.3 billion.

— People with osteoporosis can break bones from a minor fall or with something as simple as sneezing or bumping into furniture.

— A woman’s risk of fracture is equal to her combined risk of breast, uterine and ovarian cancers.

— A man is more likely to break a bone due to osteoporosis than he is to get prostate cancer.

Erika Hobbs is a local freelance writer.