Bones -- there are 206 of them in your body and despite popular myths, bone is not a stony, dead material within our bodies that our soft parts cling to.  It is a dynamic, living tissue.  Think about it, everyone knows that when you break a bone it will usually heal.  Bone continuously remodels its own architecture to bear the daily stresses imposed upon it by exercise, work, injury and even by our own body weight. 

  Your bone mass (total body bone) is like a savings account and how much you have depends upon how much you deposit.  The critical years for depositing are from teens to about age 30 and some experts believe that bone mass can be increased by as much as 20% during these years.  This presents an opportunity for most women to significantly prevent osteoporosis.  What is osteoporosis?  This is a condition caused by low bone density, which makes bones brittle and easily fractured.  It affects about 28 million Americans, 80% of whom are women, and is responsible for 1.5 million fractures each year.  Fractures are more common in women than heart attack, stroke and breast cancer combined.  Last year in the United States alone hip fractures resulted in approximately 300,000 hospital admissions and an estimated nine billion dollars in direct medical costs.

  Have you ever heard of or seen a “dowager’s hump” and wondered what it is?  It is the hump that some elderly women develop on their upper back and it is associated with “the little old lady” stereotype.  This hump is actually caused by multiple compression fractures (broken backbones) that cause the spine to bend and angulate, resulting in a kyphosis (hump). 

  Why do these fractures occur?  In bone, as in other aspects of our lives, there are givers and takers.  Two armies of cells with opposite functions live within the lacy caverns of bone normally remodeling our skeleton through a balanced system of bone formation and resorption (bone loss).  If more resorption than formation occurs, there will be a decrease in bone mass.  As part of the natural aging process resorption outpaces bone formation --- the takers outpace the givers.  In women, bone loss often accelerates after menopause when the ovaries stop making estrogen, a hormone that reduces bone loss.

  Two of the most commonly prevailing myths about osteoporosis are that it is an inevitable part of aging and that it only affects women.  One out of every two women and one out of every eight men have a risk of suffering an osteoporotic fracture sometime during their life and these can be prevented.  Successful prevention of this disease requires raising physician and public awareness about lifestyle and dietary effects upon the age related process within the bone so that measures can be taken at an appropriate time to prevent this condition.  Unfortunately, once you develop osteoporosis there is no cure but it can be treated.  There are now a variety of medications available to physicians that may be helpful in some patients who have this condition. 

    As with many medical conditions or diseases that potentially face us, it is important to understand the risk factors and to identify your risk factors for osteoporosis with the help of your physician.  The risk for this condition increases with age and women have four times the risk of men.  Caucasian and Asian women have the highest risk but African-American and Hispanic women also have significant risk.  Normal or early menopause brought on naturally or because of surgery increases the risk of osteoporosis.  Smoking tobacco and drinking too much alcohol as well as inadequate consumption of calcium and little or no weight bearing exercising increases your risk.  Certain medications, especially steroids, as well as some medical conditions can reduce one’s ability to exercise and may increase risk.  Also, young women whose mothers have a history of osteoporosis seem to have reduced bone mass and may be at increased risk. 

  Regardless of your age, discuss your risk analysis for this condition with your physician to determine pre-emptive solutions.  The tragic personal and financial consequences of this condition are not inevitable and can be reduced in the twenty-first century.