Sticks and Stones… and Broken Bones.

By Steven Baldridge

           Many of us assume our bones are simply living stones that hold us vertical and protect our brains from trauma. Nothing could be further from the truth. Bones are living tissues with great blood supply, living cells, and intricate honeycomb structures with hard casings around them.  Constant molecular activity occurs within bones, without which we would not continue to live.

Bone is made mostly of a flexible protein called collagen. Deposited in this flexible framework are several minerals, predominately calcium, which add strength and harden the framework. However, calcium does more than add strength. Bones are the storehouse for the calcium used in vital functions in every cell in our bodies. To keep the supply of calcium available to cells at the correct levels, and to keep the bones themselves active and strong, our bones are constantly being broken down and rebuilt. It is a beautiful molecular and cellular ballet. Take a few molecules of calcium from the bones and let the blood take it around to the cells who need it. Add a little taken from our lunch and redeposit some to keep the bone-bank account full and to keep the bones strong. If there is any calcium left after consuming that cheeseburger, let the kidneys decide how much we don’t need.

            Like I said, a beautiful ballet - until somebody trips. As we age the tearing down process begins to work faster than the rebuilding process. The result? Osteoporosis. The bone gets a little less dense, then a little thinner still, until it is thin enough that it can no longer take the stress it once could.  Then what happens?  “Snap!”

            How much of a problem is osteoporosis? Each year in the United States, osteoporosis leads to approximately two million fractures.

            Most new bone is added during childhood and teenage years, and that is when bones usually become larger, heavier, denser, and stronger. After age 30, bone loss slowly begins to outpace new bone formation. Osteoporosis affects women much more than men, and is more common after menopause and with advancing age.

            Did I mention that there are no symptoms for osteoporosis until something breaks? If osteoporosis is so dangerous, so common, and so silent, how can we know if we have osteoporosis? Is there a test or a screening? I am glad you asked!
Health care providers recommend bone density testing for women who have been through menopause, and are at least 65. As with most disease conditions, there are risk factors that can move the recommended screening age up. Things like cigarette smoking, long-term use of steroid medications (such as prednisone), low body weight, rheumatoid arthritis, alcohol (three or more servings a day), diabetes, thyroid related diseases, chronic liver disease, and others.

            Experts agree that the most useful and reliable bone density test is a specialized kind of x-ray called dual-energy x-ray absorptiometry, or DXA. DXA provides precise measurements of bone density with minimal radiation. Talk to your Primary Care Provider about a bone density test – a DXA scan. University Hospitals Samaritan Medical Center has the tools and the know-how to provide this crucial test if you and your doctor decide it is right for you.

            Aside from testing what can you do to head off this silent foe? Of course, always consider your entire health picture before changing your diet-and don’t go crazy on the supplements until you talk it over with your doctor- but if there are no health reasons to avoid these foods or activities, consider these suggestions to help slow down or avoid osteoporosis:

-- A diet higher in calcium.
--Vitamin D.  Without enough vitamin D, people are unable to absorb calcium from the foods they eat. Some people make enough Vitamin D (sunlight hitting our skin) or get enough from their diets; many others may need vitamin D supplements.
--Exercise.  Physical stress on bones by the muscles attached to them signals our bodies to make those bones stronger. If this sounds a lot like exercise, you are right. Both aerobic (like walking and jogging) and resistance (lifting some weights–no need to go crazy here) have been proven to improve bone strength.
--Limit alcohol.
--Stop Smoking
--Avoid super-low-calorie diets.

            When you build and maintain strong bones through wise lifestyle choices, and when you get the DXA scan and follow your doctor’s advice, you need not be so concerned about those “sticks and stones” because these wise words have helped protect your bones.

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